Summary:
Asthma is a common long-term condition in childhood and adolescence. A substantial proportion of children experience asthma symptoms, and some continue to have frequent or severe attacks despite standard treatment with inhaled corticosteroids. Ongoing symptoms can impair lung function and place a significant psychological burden on both children and their families. Diet has been identified as a modifiable factor that may influence airway inflammation and asthma risk. Diets with higher inflammatory potential have been linked to more severe asthma in children. Vitamins, which are obtained through daily food intake, play key roles in normal biological processes and may affect the development of chronic disease. Some vitamins with antioxidant properties, such as vitamins C and E, are thought to reduce inflammation and oxidative stress, which may be relevant to asthma. In contrast, higher intake of certain vitamins, including vitamin B12, folic acid, and choline, has been associated with increased asthma risk in some studies, possibly through effects on DNA methylation and allergic airway responses. However, most previous research has examined individual vitamins in isolation rather than considering combined multivitamin intake. This study examined the overall and combined effects of multiple dietary vitamins on childhood asthma, as well as the contribution of individual vitamins. The study included children and adolescents aged 2 to 17 years. Associations between dietary intake of twelve vitamins and asthma were examined, adjusting for relevant demographic, perinatal, and lifestyle factors. Among more than 4,700 participants, just over 10% had asthma. Higher vitamin K intake was associated with a reduction in the odds of asthma. When vitamins were considered together, a lower asthma risk was observed at higher overall vitamin intake levels. Lower vitamin C intake was also linked to higher asthma risk. Overall, this study suggests that dietary vitamin intake, considered as a combined exposure, may be relevant to asthma risk in children and adolescents. The findings support the potential value of diet-based approaches in asthma prevention or management, particularly increasing intake of vitamin C-rich foods, while highlighting the need for balanced consumption of other vitamins.
Abstract:
Background: Dietary intakes of vitamins are associated with asthma. However, previous studies mainly explored the association between a single vitamin intake and asthma, which did not take the multivitamins into consideration. Herein, this study aims to explore the overall effect of dietary multivitamins consumption on childhood asthma. Methods: Data of children and adolescents (aged 2-17 years old) were extracted from the National Health and Nutrition Examination Survey (NHANES) database in 2015-2018 in this cross-sectional study. Weighted univariate logistic regression analysis was used to screen covariates. The association between multivitamins (including vitamin A, C, D, E, B1, B2, B6, B12, K, niacin, folic acid, and choline) and childhood asthma was explored using univariate and multivariate logistic regression analyses. The evaluation indexes were odds ratio (OR) and 95% confidence interval (CI). We further introduced the Bayesian kernel machine regression (BKMR) to assess the joint effect of the twelve vitamins on childhood asthma, the impact of an individual vitamin as part of a vitamin mixture, and the potential interactions among different vitamins. Results: Among 4,715 eligible children and adolescents, 487 (10.3%) had asthma. After adjusting for covariates including race, family history of asthma, pregnant smoking, BMI Z-score, energy intake, breast feeding, and low birth weight, we found that for each 1-unit increase in vitamin K consumption, the odds of childhood asthma decreased 0.99 (P=0.028). The overall effect analysis reported a trend of negative relationship between the multivitamins and childhood asthma, especially at the 75th percentile and over. According to the BKMR models, when other vitamins are fixed at the median level, the odds of childhood asthma increased along with the elevated vitamin D (VD) and vitamin B2 (VB2), whereas along with the depressed vitamin C (VC). In addition, no potential interaction has been found between every two vitamins of multivitamins on childhood asthma. Conclusion: Among children and adolescents who have high-risk of asthma, it may be beneficial to increase dietary consumption of multivitamins. Our findings recommended that children and adolescents should increase the intake of VC-rich foods, whereas control the dietary consumption of VD and VB2 in daily life.
Article Publication Date: 31/01/2024
DOI: 10.1186/s12887-024-04540-5
