Editors' ChoiceAsthma

Fast Food Linked to Asthma and Allergies in Children

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Science Translational Medicine  06 Feb 2013:
Vol. 5, Issue 171, pp. 171ec26
DOI: 10.1126/scitranslmed.3005803

Fast food originated in the 1950s and now pervades almost every community in the world. Fast food is easy to get, affordable, tasty, and appealing to most children. Eating fast food has been linked to childhood obesity, but what about asthma, eczema, and allergies? Prior studies have explored the relationship between diet and allergic diseases such as asthma. Now, Ellwood et al. further investigate the association between allergic disease and food intake in school-aged children in a multicenter, multicountry, multiphase cross-sectional study, the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three.

The authors analyzed data from 319,196 adolescents (ages 13 to 14 years) from 107 centers in 51 countries and 181,631 children (ages 6 to 7 years) from 64 centers in 31 countries. The adolescents and children were selected from a random sample of schools in a defined geographical area. ISAAC Phase Three used standardized questionnaires completed by adolescents and by the parents of younger children. The questionnaires asked about current and severe symptoms of asthma, rhinoconjunctivitis, and eczema, as well as intake of different food types over the previous 12 months.

Eating fast food three or more times per week was associated with a 39% increased risk of severe asthma in adolescents and 27% increased risk among children, as well as an increased risk of severe rhinoconjunctivitis and severe eczema. On the other hand, intake of fruit three or more times per week was associated with an 11% decrease in the prevalence of severe asthma in adolescents and a 14% decrease in younger children.

The results of this study suggest that fast food consumption may be contributing to the increasing prevalence of asthma, rhinoconjunctivitis, and eczema in adolescents and children, whereas fruit intake showed a protective association with the three conditions. The authors postulate some possible mechanisms to explain the relationship between fast food consumption and asthma and allergic disease, which may involve higher concentrations of saturated fatty acids, trans fatty acids, sodium, carbohydrates, and sugar in fast foods, as well as preservatives that may modulate immune reactions.

This study included a large sample of participants with detailed information on food intake and symptoms of the three conditions. However, it is limited by a cross-sectional design that does not allow causal inferences. Although further prospective studies in children are needed to address this limitation, this study adds to the previous literature by suggesting that a person’s diet may contribute to disease severity for asthma and other allergic conditions.

P. Ellwood et al., Do fast foods cause asthma, rhinoconjunctivitis and eczema? Global findings from the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three. Thorax, published online 14 January 2013 (10.1136/thoraxjnl-2012-202285). [Abstract]

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