FCAAIA Notes: The “big three” atopic (or allergic) diseases are eczema (atopic dermatitis), asthma, and allergic rhinitis (nasal allergies).  This study shows that children who eat at fast food restaurants at least 3 times per week are more likely to have one or more of the conditions in this “atopic triad”.  Like so many other studies, it does not address cause and effect (nor was it designed to).  Is it the fast food itself that increases the risk? Is it related to higher rates of obesity or lower vitamin D levels (as addressed in other articles on our web site).

The origin of the old saying, “You are what you eat” goes back to 1826.  It implies the notion that to be fit and healthy you need to eat good food.  We are not suggesting any fad diets here, as there is no evidence that they are any better for you than a good old-fashioned, balanced diet. What we are advocating is that you watch what you eat, do not load up on so-called “empty calories”, and get the right amount of calories from protein, carbohydrates and fats.

(Source:  January 14, 2013. Adapted from Thorax 2013; DOI: 10.1136/thoraxjnl-2012-202285.

Children and teens who ate fast foods multiple times a week were at an increased risk for severe asthma, rhinoconjunctivitis, and eczema, researchers found.

Consumption of fast foods three or more times a week was associated with a 39% increased risk of severe asthma and a 70% increased risk of severe eczema among teens, according to Philippa Ellwood, DDN, DPH, of the University of Auckland in New Zealand, and colleagues.

In addition, children who dined on fast foods with the same frequency had significantly increased risk of rhinoconjunctivitis and severe eczema, they wrote online in the journal Thorax.

Lower levels of fast food consumption (one to two times weekly) also were significantly associated with wheezing and severe asthma in children, they added.

However, Ellwood and colleagues also found that fruit consumption three or more times a week among children and teens offered a protective effect against severe asthma.

If the associations found in this study are causal, “the findings have major public health significance owing to the rising consumption of fast foods globally,” the authors stated.

The authors noted that earlier research had found diets with high intake of cereal, rice, and nut and cereal protein showed decreased prevalence of the allergic conditions and a protective effect against the conditions with elevated fruit consumption. Similarly, other research has shown a harmful effect of linoleic acid and trans fatty acid consumption.

The researchers gathered symptom prevalence data on types of food intake and symptom prevalence of asthma, rhinoconjunctivitis, wheezing, and eczema from 319,196 teens, ages 13 and 14, from 51 countries, and 181,631 children, ages 6 and 7, from 31 countries through the third phase of the International Study of Asthma and Allergies in Childhood (ISAAC). The latter is a multicenter, multicountry, multiphase cross-sectional study.

Teen participants, or parents of young children, were administered questionnaires that looked at symptoms and symptom frequency over the 12 months prior to the study. Questions about food intake looked at types of foods and whether foods were eaten once, twice, or three or more times weekly.

Fast food consumption three or more times weekly in both teens and children was associated with the following odds ratios for children and teens respectively:

  • Severe      asthma: OR 1.27 (95% CI 1.13 to 1.42) and OR 1.39 (95% CI 1.30 to 1.49)
  • Severe      rhinoconjunctivitis: OR 1.32 (95% CI 1.04 to 1.68) and OR 1.73 (95% 1.50      to 2.00)
  • Severe      eczema: OR 1.30 (95% CI 1.05 to 1.61) and OR 1.70 (95% CI 1.48 to 1.95)

Eating fast food was also tied to current wheezing in teens (OR 1.25, 95% CI 1.18 to 1.33) and children (OR 0.87, 95% CI 0.80 to 0.95) when consumed three or more times a week.

Fruit consumption at least once or twice a week was associated with a significant protective effect against current wheezing (OR 0.90, 95% CI 0.83 to 0.97), severe asthma (OR 0.89, 95% CI 0.82 to 0.98), and severe rhinoconjunctivitis (OR 0.72, 95% CI 0.56 to 0.93) among children. This effect extended to severe eczema (OR 0.90, 95% CI 0.82 to 0.98) among children who consumed fruit three or more times a week.

Among teens, eating fruit at least once or twice a week had a significant protective effect against current wheeze (OR 0.90, 95% CI 0.83 to 0.97), severe asthma (OR 0.89, 95% CI 0.82 to 0.98), severe rhinoconjunctivitis (OR 0.79, 95% CI 0.65 to 0.95), and severe eczema (OR 0.81, 95% CI 0.67 to 0.97).

The protective effect lost significance in participant teens who ate fruit three or more times a week for severe rhinoconjunctivitis (OR 0.83, 95% CI 0.70 to 1.00) and severe eczema (OR 0.89, 95% CI 0.76 to 1.06).

Milk consumption was inversely associated with current wheeze at once or twice weekly, severe asthma three or more times weekly, and severe rhinoconjunctivitis and severe eczema once or twice a week in teens.

Consumptions of eggs, fruit, meat, and milk three or more times a week protected against “all three conditions, current or severe” among children.

“The positive associations with severe disease suggest that fast foods are a predictor of disease severity rather than disease occurrence, although it is difficult to separate out the two in this study,” they concluded.

They also noted that “the protective association between fruit and vegetables and the three conditions should be further explored at country and regional levels.”

The authors found the study was limited by a number of factors, including self-report biases or misclassification, socioeconomic status’ effect on food consumption, and missing temporal data on disease outcome relative to diet.

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