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BACKGROUND: Poor diet quality may contribute to the disproportionate asthma burden in Puerto Rican youth.
OBJECTIVE: To examine whether an unhealthy diet at one or two study visits conducted over ∼5 years is associated with asthma, severe asthma exacerbations, and worse lung function in Puerto Rican youth.
METHODS: Prospective study of 406 Puerto Rican youth aged 6-14 years at a baseline visit and 9-20 years at a follow-up visit. As in prior work, diet was assessed using a dietary score ranging from -2 to +2. Our exposure of interest was an unhealthy diet, defined as a non-positive dietary score (0 to -2) at one or both visits. Our outcomes of interest were asthma (defined as physician-diagnosed asthma and ≥1 episode of wheeze in the year prior to the second visit), ≥1 severe asthma exacerbation in the year prior to the second visit, and change in percent predicted lung function measures (FEV, FVC, and FEV/FVC) between the first and second visits.
RESULTS: In a multivariable analysis, an unhealthy diet at both visits was associated with increased odds of asthma (adjusted odds ratio [aOR]=3.38, 95% confidence interval [CI]=1.74 to 6.57) and severe asthma exacerbations (aOR=2.65, 95% CI=1.16 to 6.03), but not with change in lung function.
CONCLUSIONS: An unhealthy diet at both visits was associated with increased odds of asthma and severe asthma exacerbations compared with a healthy diet at both visits. Our findings support health policies promoting a healthy diet in Puerto Rican youth, a population at high risk for asthma.
Juan C Celedón
Jessica Reyes-Angel,Yueh-Ying Han,Franziska Rosser,Erick Forno,Edna Acosta-Pérez,Glorisa Canino,Juan C Celedón