Primary prevention of asthma: from risk and protective factors to targeted strategies for prevention

Mutius, Erika von; Smits, Hermelijn H.

doi:10.1016/s0140-6736(20)31861-4

Cited by 164 publications

(140 citation statements)

References 94 publications

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“…CS might boost inflammatory responses, affect bronchial epithelial barrier function, or associate with the metabolic syndrome, or both. In turn, breastfeeding could strengthen bronchial epithelial barrier function and boost innate immunity and regulatory immune responses [26].…”

Section: Discussionmentioning

confidence: 99%

Breastfeeding duration modified the effects of neonatal and familial risk factors on childhood asthma and allergy: a population-based study

Chen

Liu

et al. 2021

Respir Res

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Background Childhood asthma and allergic diseases are a significant global problem. There are inconsistent findings on the associations of delivery mode, the number of children in the household and breastfeeding with childhood asthma and allergic diseases. We assessed these associations and examined whether breastfeeding modified the effects of neonatal and familial risk factors on childhood asthma and allergic diseases. Methods A population-based cross-sectional study was conducted in Shanghai, China. A total of 17 primary schools were randomly selected from 13 districts of Shanghai in this study. The International Study of Asthma and Allergies in Childhood questionnaire was adopted to assess the childhood asthma and allergic diseases. Multivariable logistic regression models were used to evaluate the associations between neonatal and familial factors and childhood asthma and allergic diseases, and to examine the modification effects of breastfeeding on the associations assessed. Results Of 10,464 primary school children aged 6–11 years, the overall prevalence of childhood asthma, allergic rhinitis, urticaria, food allergy and drug allergy was 13.9, 22.7, 15.3, 8.1 and 4.6%, respectively. Male sex, high socioeconomic status, cesarean section delivery, only one child in the household and having family history of allergy were associated with increased odds ratio (OR) of childhood asthma and allergic diseases while longer breastfeeding duration (> 6 months) was inversely associated with these diseases. Longer breastfeeding duration also attenuated the OR of neonatal and familial risk factors on childhood asthma and allergic diseases. For instance, the adjusted OR of childhood asthma in the group of vaginal delivery and breastfeeding duration > 6 months was lowest (0.78, 95% confidence interval: 0.66, 0.92). Conclusions Longer breastfeeding duration was inversely associated with childhood asthma and allergic diseases, and also reduced the OR of neonatal and familial risk factors on these diseases. Giving the prevalence of childhood asthma and allergic diseases is rapidly rising across the globe, these findings may have important clinical and public health implications.

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Section: Discussionmentioning

confidence: 99%

Breastfeeding duration modified the effects of neonatal and familial risk factors on childhood asthma and allergy: a population-based study

Chen

Liu

et al. 2021

Respir Res

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“…Thus, the results of childhood wheezing and asthma deteriorative effects of lower educational attainment of mothers and fathers, and the protective effect of higher educational attainment in crude analysis in this study are consistent with previous reports. Because early intervention in high-risk groups may reduce asthma development [21], health education for parents risk reduction such as smoking cessation, prevention of exposure to environmental tobacco smoke [22,23], should be performed from pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Parental educational level and childhood wheezing and asthma: A prospective cohort study from the Japan Environment and Children’s Study

et al. 2021

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Background The influence of mothers’ and fathers’ educational levels in separate evaluations of asthma has not been fully investigated. This study aims to examine the associations of the mother’s and fathers’ educational levels with childhood wheeze and asthma adjusting for crude and pre-and post-natal modifiable risk factors. Methods We conducted a prospective cohort study using data from the Japan Environment and Children’s Study, which recruited pregnant women from 2011 to 2014. The mother’s and father’s educational levels were surveyed by a questionnaire during the pregnancy, and childhood wheezing and doctor-diagnosed asthma were estimated using a 3-year questionnaire. Multilevel logistic regression analysis was performed to evaluate the association between the mother’s and father’s educational levels and childhood wheezing and asthma, adjusted for pre-and post-natal factors. Results A total of 69,607 pairs of parents and their single infants were analyzed. We found 17.3% of children had wheezing and 7.7% had asthma. In crude analyses, lower educational level of parents was associated with an increased risk of childhood wheezing and asthma. After full adjustment, a lower educational level of mothers was associated with an increased risk of childhood asthma (junior high school (reference: high school); odds ratio (OR): 1.17, 95% CI, 1.01–1.36), and higher educational level, especially the mother’s, was associated with an increased risk of childhood wheezing (technical junior college, technical/vocational college, or associate degree (ECD3); OR: 1.12, 95% CI, 1.06–1.18, bachelor’s degree, or postgraduate degree; OR: 1.10, 95% CI, 1.03–1.18), and asthma (ECD3; OR: 1.13, 95% CI, 1.04–1.21). Conclusions Parents’ lower educational level was a crude risk factor for childhood wheezing and asthma. However, an increased risk of wheezing due to mothers’ higher educational level was found after adjusting for pre-and post-natal factors.

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“…As recently underlined in The Lancet [8], given the immense societal and individual burden of asthma, there is an urgent need to further develop novel strategies to limit or even eradicate the disease. In this context, investigating the role of modifiable lifestyle factors (such as diet, physical activity and, consequently, body composition) is key for the primary and secondary prevention of this common disease.…”

Section: Introductionmentioning

confidence: 99%

The Role of Nutritional Factors in Asthma: Challenges and Opportunities for Epidemiological Research

Bédard

Ait‐hadad

et al. 2021

IJERPH

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The prevalence of asthma has nearly doubled over the last decades. Twentieth century changes in environmental and lifestyle factors, including changes in dietary habits, physical activity and the obesity epidemic, have been suggested to play a role in the increase of asthma prevalence and uncontrolled asthma worldwide. A large body of evidence has suggested that obesity is a likely risk factor for asthma, but mechanisms are still unclear. Regarding diet and physical activity, the literature remains inconclusive. Although the investigation of nutritional factors as a whole (i.e., the “diet, physical activity and body composition” triad) is highly relevant in terms of understanding underlying mechanisms, as well as designing effective public health interventions, their combined effects across the life course has not received a lot of attention. In this review, we discuss the state of the art regarding the role of nutritional factors in asthma, for each window of exposure. We focus on the methodological and conceptual challenges encountered in the investigation of the complex time-dependent interrelations between nutritional factors and asthma and its control, and their interaction with other determinants of asthma. Lastly, we provide guidance on how to address these challenges, as well as suggestions for future research.

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Primary prevention of asthma: from risk and protective factors to targeted strategies for prevention

Cited by 164 publications

References 94 publications

Breastfeeding duration modified the effects of neonatal and familial risk factors on childhood asthma and allergy: a population-based study

Breastfeeding duration modified the effects of neonatal and familial risk factors on childhood asthma and allergy: a population-based study

Parental educational level and childhood wheezing and asthma: A prospective cohort study from the Japan Environment and Children’s Study

The Role of Nutritional Factors in Asthma: Challenges and Opportunities for Epidemiological Research

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