Is fruit and vegetable intake associated with asthma or chronic rhino-sinusitis in European adults? Results from the Global Allergy and Asthma Network of Excellence (GA2LEN) Survey

Vanessa García-Larsen ,Paolo Maria Matricardi ,Rhonda Arthur ,Ewa Niżankowska‐Mogilnicka ,Claus Bachert ,Grzegorz Brożek ,James Potts ,Thomas Keil ,Bertil Forsberg ,Tari Haahtela ,Carlos Loureiro ,Matti Ahlström ,Marek L Kowalski ,Peter H Howarth ,Trine Thilsing ,Thibaut Van Zele ,Barbara Rymarczyk ,Kjell Torén ,Christer Janson ,Joanna Makowska ,Ana Todo Bom ,Peter Burney

doi:10.1186/s13601-016-0140-9

Abstract

Background Fruits and vegetables are rich in compounds with proposed antioxidant, anti-allergic and anti-inflammatory properties, which could contribute to reduce the prevalence of asthma and allergic diseases.ObjectiveWe investigated the association between asthma, and chronic rhino-sinusitis (CRS) with intake of fruits and vegetables in European adults.MethodsA stratified random sample was drawn from the Global Allergy and Asthma Network of Excellence (GA2LEN) screening survey, in which 55,000 adults aged 15–75 answered a questionnaire on respiratory symptoms. Asthma score (derived from self-reported asthma symptoms) and CRS were the outcomes of interest. Dietary intake of 22 subgroups of fruits and vegetables was ascertained using the internationally validated GA2LEN Food Frequency Questionnaire. Adjusted associations were examined with negative binomial and multiple regressions. Simes procedure was used to control for multiple testing.ResultsA total of 3206 individuals had valid data on asthma and dietary exposures of interest. 22.8% reported having at least 1 asthma symptom (asthma score ≥1), whilst 19.5% had CRS. After adjustment for potential confounders, asthma score was negatively associated with intake of dried fruits (β-coefficient −2.34; 95% confidence interval [CI] −4.09, −0.59), whilst CRS was statistically negatively associated with total intake of fruits (OR 0.73; 95% CI 0.55, 0.97). Conversely, a positive association was observed between asthma score and alliums vegetables (adjusted β-coefficient 0.23; 95% CI 0.06, 0.40). None of these associations remained statistically significant after controlling for multiple testing.Conclusion and clinical relevanceThere was no consistent evidence for an association of asthma or CRS with fruit and vegetable intake in this representative sample of European adults.

Highlights

Fruits and vegetables are rich in compounds with proposed antioxidant, anti-allergic and anti-inflam‐ matory properties, which could contribute to reduce the prevalence of asthma and allergic diseases
Conclusion and clinical relevance: There was no consistent evidence for an association of asthma or chronic rhino-sinusitis (CRS) with fruit and vegetable intake in this representative sample of European adults
The current evidence on a possible protective effect of fruits and vegetables on allergic diseases is mixed, with some studies showing a negative association between intake of vegetables [5] or food groups that contain them [6] and a lower asthma prevalence, whilst several population-based studies have reported no association between allergic symptoms and fruits or vegetables when measured individually [7, 8] or as part of a dietary pattern [9, 10]

Summary

Introduction

Fruits and vegetables are rich in compounds with proposed antioxidant, anti-allergic and anti-inflam‐ matory properties, which could contribute to reduce the prevalence of asthma and allergic diseases. Within the Global Allergy and Asthma Network of Excellence (GA2LEN), we designed and piloted a single, common, food frequency questionnaire (FFQ) [11], which was used to estimate usual dietary intake of over 3500 adults from 10 European countries participating in the GA2LEN Follow-up survey. In this analysis, we investigate the cross-sectional association between asthma and chronic rhino-sinusitis (CRS), with dietary intake of fruits and vegetables in these adults

Methods

Results

Conclusion