Abstract
Approximately 15 million Americans including over 5 million children suffer from asthma, the most common chronic disease in childhood. The prevalence of pediatric asthma has risen sharply over the past four decades, with the sharpest increases occurring in children younger than 6 years and in urban, predominantly minority, populations. The reasons for this dramatic increase are not yet clear. Recent epidemiological studies indicate a higher prevalence of dietary antioxidant deficiency among asthmatics patients. However, the results of these studies are inconsistent or even contradictory. Epidemiological studies with robust design and use of novel epidemiological tools are urgently needed to examine the impact of dietary antioxidants on the incidence of asthma in preschool children. An incidence density case-control study which includes non-atopic controls, who are matched for age, gender, race, study center and sampling time to each asthmatic case will offer a robust study design. A validated food frequency questionnaire and an asthma and atopy severity score can be used to interview the parents of the recruited children. Risk set sampling may enable us to explore possible associations between the type and quantity of dietary antioxidants and the development and severity of asthma in such an epidemiological study.
Highlights
According to a large study that examined over 17,000 asthmatic children in 1988, these children had 10.1 million days missed from school and 200,000 hospitalizations
Epidemiological studies should be based on this hypothesis: an inadequate intake of antioxidants in children 2–6 years of age may interact with genetic and environmental risk factors of atopy and asthma and lead to the development and persistence of asthma, associated with other atopic conditions such as hay fever and eczema; the severity and the course of asthma and atopy in these children correlate with the type and degree of dietary antioxidant deficiency (Fig. 3)
In order to examine the hypothesis that the amount or type of antioxidant deficiency in the ingested food correlates with the degree of the severity of asthma and its course over time, the severity and frequency of asthmatic episodes can subsequently be assessed after a 12- to 24-month interval following the first interview by means of an asthma severity questionnaire in most asthmatic children who were recruited for the study, and the association between the amount of antioxidants as obtained by the first food frequency questionnaire (FFQ) and the severity and frequency of asthma episodes will be evaluated in these children
Summary
Relationship between dietary antioxidants and childhood asthma: more epidemiological studies are needed. The prevalence of pediatric asthma has risen sharply over the past four decades, with the sharpest increases occurring in children younger than 6 years and in urban, predominantly minority, populations. The reasons for this dramatic increase are not yet clear. Epidemiological studies with robust design and use of novel epidemiological tools are urgently needed to examine the impact of dietary antioxidants on the incidence of asthma in preschool children. Risk set sampling may enable us to explore possible associations between the type and quantity of dietary antioxidants and the development and severity of asthma in such an epidemiological study
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