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Asthma highest in families who drink sugary drinks
Children between the ages of 7 and 9 may be at greater risk for developing asthma if they consumed high amounts of fructose in early childhood — or, if their mothers drank a lot of sugar-sweetened beverages while pregnant. This new research is published online in the Annals of the American Thoracic Society.
In the paper, researchers reported on the results of 1,068 mother-child pairs who participated in Project Viva, a longitudinal study based in Eastern Massachusetts designed to find ways to improve the health of mothers and their children.
"Previous studies have linked intake of high fructose corn syrup sweetened beverages with asthma in school children, but there is little information about when during early development exposure to fructose might influence later health."
After their first and second trimesters, mothers who participated in the study completed questionnaires about their food and beverage consumption, including all regular soda and fruit drinks. When their children reached early childhood (3.3 years), the mothers completed another questionnaire to report their children's consumption of a variety of foods and beverages, including regular sodas and fruit drinks. Based on these responses, the researchers computed fructose intake and analyzed results based on quartiles of sugar-sweetened beverage and fructose consumption.
The authors note that it was important to look at fructose consumption because it is a major contributor to total sugar intake and may have specific airway effects.
Asthma in mid-childhood was determined by a mother reporting a doctor's diagnosis of asthma, plus wheezing or asthma medication use in the past year.
Study results found:
• In mid-childhood, 19 percent of the children had asthma. Mothers in the highest quartile of sugar-sweetened beverage and fructose consumption during pregnancy were 63 percent and 61 percent more likely, respectively, than those in the lowest quartile to have mid-childhood-age kids with asthma, when adjusted for pre-pregnancy body mass, age, race/ethnicity and other factors that may have affected results.
• The difference between the top and bottom quartiles was about 2 vs. 0 servings per day of sugar-sweetened beverages and 46 vs. 21 grams per day of fructose.
• Kids in the highest quartile of fructose consumption during their early childhoods were 64 percent more likely than those in the lowest quartile to have asthma mid-childhood. When adjusted for maternal sugar-sweetened beverage consumption, this number remained the same even after adjusting for mid-childhood-age body mass.
• The difference between the top and bottom quartiles was about 44 vs. 15 grams per day of fructose.
The authors reported that other studies have found links between obesity and asthma and between sugar-sweetened beverage and high fructose intake and increased asthma risk. They add that though recent studies suggest an increasing asthma risk through obesity, fructose itself may cause inflammation in the lungs.
Limitations of the study are that an observational study cannot show cause and effect, and that study participants were mostly from affluent families so findings may not generalize to economically disadvantaged families.
"Avoiding high intake of sugary beverages during pregnancy and in early childhood could be one of several ways to reduce the risk of childhood asthma."
Background: Cross-sectional studies have linked intake of high fructose corn syrup sweetened beverages with asthma in school children. Objective: To examine associations of maternal prenatal and early childhood intake of sugar sweetened beverages and fructose with current asthma in mid-childhood (median 7.7years).
Methods: We assessed maternal pregnancy (1st and 2nd 6 trimester average) and child (median 3.3years) intake of sugar sweetened beverages and total fructose using food frequency questionnaires in 1068 mother-child pairs from Project Viva, a prospective pre-birth cohort. In a multivariable analysis, we examined associations of quartiles of maternal and child sugar sweetened beverage, juice, and total fructose intake with child current asthma in mid-childhood, assessed by questionnaire as ever doctor -diagnosed asthma plus taking asthma medications or reporting wheezing in the past 12months.
Results: Higher maternal pregnancy sugar sweetened beverage consumption (mean 0.6 servings/day; range 0-5) was associated with younger maternal age, non-white race/ethnicity, lower education and income, and higher pre-pregnancy BMI. Adjusting for pre-pregnancy BMI and other covariates, comparing quartile 4 v. quartile 1, higher maternal pregnancy intake of sugar sweetened beverages (OR 1.70; 95%CI 1.08, 2.67) and total fructose (OR 1.58; 0.98, 2.53) were associated with greater odds of mid-childhood current asthma (prevalence=19%). Higher early childhood fructose intake (quartile 4 v. quartile 1) was also associated with mid-childhood current asthma in models adjusted for maternal sugar sweetened beverages (OR 1.79; 1.07, 2.97) and after additional adjustment for mid-childhood BMI z-score (OR 1.77; 1.06, 2.95).
Conclusion: Higher sugar sweetened beverage and fructose intake during pregnancy and in early childhood was associated with childhood asthma development independent of adiposity.
Authors: Lakiea S. Wright, MD, MAT, MPHa,b; Sheryl L. Rifas-Shiman, MPHc; Emily Oken, MD, MPHc; Augusto A Litonjua, MD, MPHd,e; and Diane R. Gold, MD, MPH
This study was supported by the National Institutes of Health (R01 HD034568, R01 AI102960, K24 HD069408, P30 DK092924, UG3OD023286, and F32HL124919-01).
This publication was supported in part by United States Environmental Protection Agency (USEPA) Grant RD-83479801. Its contents are solely the responsibility of the grantee and do not necessarily represent the official views of the US EPA. Furthermore, the USEPA does not endorse the purchase of any commercial products or services mentioned in the paper.
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Drinking highly sugar sweetened drinks during pregnancy and in early childhood increases childhood asthma. Image credit: thepioneer.com.