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Background: Epidemiological studies suggest beneficial associations between dietary fibre intake, lung function and chronic respiratory symptoms in adults. Our aim was to investigate the association between dietary fibre intake in childhood and respiratory health up to adulthood., Methods: The individual fibre intake of 1956 participants from the Swedish population-based birth cohort BAMSE was estimated from 98- and 107-item food frequency questionnaires at ages 8 and 16 years, respectively. At 8, 16 and 24 years, lung function was measured by spirometry. Respiratory symptoms (cough, mucus production, breathing difficulties/wheeze) were assessed by questionnaires, and airway inflammation by exhaled nitric oxide fraction ( F ENO ) (≥25 ppb) at 24 years. Longitudinal associations with lung function were analysed by mixed-effects linear regression; associations with respiratory symptoms and airway inflammation were analysed by logistic regression, adjusting for potential confounders., Results: There were no associations between fibre intake at 8 years, as total and from different sources, spirometry measurements and respiratory symptoms at 24 years. Higher fruit fibre intake tended to be inversely associated with airway inflammation at 24 years (OR 0.70, 95% CI 0.48-1.00), which became non-significant after exclusion of participants with food-related allergic symptoms (OR 0.74, 95% CI 0.49-1.10). No associations between fibre intake at 8 and 16 years as an updated lagged exposure and spirometry measurements up to 24 years were observed., Conclusion: In this longitudinal study, we observed no consistent association between dietary fibre intake in childhood and lung function or respiratory symptoms up to adulthood. Further research on dietary fibre in relation to respiratory health across the life course is needed., Competing Interests: Conflict of interest: The authors have no conflicts of interest to disclose., (Copyright ©The authors 2023.)

Background: Dietary fibre may reduce the risk of allergy. Our aim was to investigate the association between fibre intake in childhood, asthma, allergic rhinitis and IgE sensitization up to adulthood., Methods: The individual fibre intake of 2285 participants from the Swedish population-based birth cohort BAMSE was estimated between 98- and 107-item food frequency questionnaires at ages 8 and 16 years, respectively. At 8, 16 and 24 years, asthma and allergic rhinitis symptoms were assessed by questionnaires, and sensitization to common allergens by serum IgE. Longitudinal associations were analysed by generalized estimating equations, adjusting for potential confounders., Results: An inverse overall association was indicated between fibre intake at 8 years and allergic rhinitis symptoms up to 24 years (OR per 5 g/d 0.86; 95% CI 0.77-0.96), particularly in combination with airborne (0.74; 0.62-0.89) and food (0.69; 0.54-0.88) allergen sensitization. Higher fibre intake was also associated with specific allergen sensitization, for example, birch (0.77; 0.67-0.88) and soy (0.68; 0.53-0.87). No association was observed with asthma. Regarding sources, fruit (0.79; 0.67-0.94) and other (potatoes, chips/popcorn, legumes, and nuts, 0.71; 0.50-0.99), but not cereal or vegetable fibre were associated with allergic rhinitis. In additional analyses, including long-term fibre intake at 8 and 16 years, excluding participants with food-related allergic symptoms to examine reverse causation, as well as adjusting for antioxidant intake, associations were attenuated and became non-significant., Conclusion: Higher fibre intake in mid-childhood may be inversely associated with allergic rhinitis and sensitization to specific allergens up to adulthood. However, avoidance of food triggers of allergic symptoms in allergic rhinitis patients may contribute to the protective associations., Competing Interests: The authors have no conflicts of interest to disclose., (© 2022 The Authors. Clinical and Translational Allergy published by John Wiley and Sons Ltd on behalf of European Academy of Allergy and Clinical Immunology.)

Background: PUFAs may influence the risk of asthma; however, long-term prospective studies including objective biomarkers of PUFA intake are lacking., Objectives: The objective was to investigate the role of dietary intake and plasma concentrations of n-3 and n-6 (ω-3 and ω-6) PUFAs in childhood and adolescence for the development of asthma and lung function up to young adulthood., Methods: The study included participants from the Swedish prospective birth cohort BAMSE. Dietary intake of PUFAs was calculated from FFQs (n = 1992) and plasma proportions of PUFAs were measured in phospholipids (n = 831). We analyzed the n-3 PUFA α-linolenic acid (ALA; 18:3n-3); the sum of very-long-chain (VLC) n-3 PUFAs: EPA (20:5n-3), DHA (22:6n-3), and docosapentaenoic acid (22:5n-3); and the n-6 PUFAs linoleic acid (LA; 18:2n-6) and arachidonic acid (AA; 20:4n-6). Asthma was assessed by questionnaires at 8, 16, and 24 y and lung function was measured by spirometry at 24 y., Results: A high (≥median) self-reported dietary intake of LA at 8 y and AA at 16 y was associated with increased risk of prevalent asthma at 24 y (OR: 1.41; 95% CI: 1.10, 1.82 and OR: 1.32; 95% CI: 1.02, 1.70, respectively). In contrast, plasma proportions of ALA, ∑VLC n-3 PUFAs, and AA at 8 y, as well as LA at 16 y, were inversely associated with prevalent asthma at 24 y (e.g., OR: 0.55; 95% CI: 0.38, 0.81 for ∑VLC n-3 PUFAs). No consistent associations were observed with lung function., Conclusions: High dietary intake of certain n-6 PUFAs in childhood or adolescence may be associated with increased risk of asthma up to young adulthood, whereas dietary biomarkers of certain n-3 and n-6 PUFAs in plasma may be associated with decreased risk. Thus, the role of diet compared with altered metabolism of PUFAs needs further investigation to improve dietary preventive strategies for asthma., (© The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.)

A high intake of dietary fibre has been associated with a reduced risk of several chronic diseases. This study aimed to review the current evidence on dietary fibre in relation to asthma, rhinitis and lung function impairment. Electronic databases were searched in June 2021 for studies on the association between dietary fibre and asthma, rhinitis, chronic obstructive pulmonary disease (COPD) and lung function. Observational studies with cross-sectional, case-control or prospective designs were included. Studies on animals, case studies and intervention studies were excluded. The quality of the evidence from individual studies was evaluated using the RoB-NObs tool. The World Cancer Research Fund criteria were used to grade the strength of the evidence. Twenty studies were included in this systematic review, of which ten were cohort studies, eight cross-sectional and two case-control studies. Fibre intake during pregnancy or childhood was examined in three studies, while seventeen studies examined the intake during adulthood. There was probable evidence for an inverse association between dietary fibre and COPD and suggestive evidence for a positive association with lung function. However, the evidence regarding asthma and rhinitis was limited and inconsistent. Further research is needed on dietary fibre intake and asthma, rhinitis and lung function among adults and children.

Longitudinal evidence on the relation between dietary intake of n -3 (ω-3) very-long-chain polyunsaturated fatty acids, i.e. eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), in mid-childhood and asthma risk is scarce. We aimed to investigate whether a higher intake of EPA and DHA from fish in childhood is associated with a lower risk of incident asthma.In the Avon Longitudinal Study of Parents and Children, dietary intakes of EPA and DHA from fish were estimated by food frequency questionnaire at 7 years of age. We used logistic regression, controlling for confounders, to analyse associations between intake of EPA and DHA (quartiles) and incidence of doctor-diagnosed asthma at age 11 or 14 years, and explored potential effect modification by a fatty acid desaturase ( FADS ) polymorphism (rs1535). Replication was sought in the Swedish BAMSE birth cohort.There was no evidence of association between intake of EPA plus DHA from fish and incident asthma overall (n=4543). However, when stratified by FADS genotype, the odds ratio comparing the top versus bottom quartile among the 2025 minor G allele carriers was 0.49 (95% CI 0.31-0.79; p trend =0.006), but no inverse association was observed in the homozygous major A allele group (OR 1.43, 95% CI 0.83-2.46; p trend =0.19) (p interaction =0.006). This gene-nutrient interaction on incident asthma was replicated in BAMSE.In children with a common FADS variant, higher intake of EPA and DHA from fish in childhood was strongly associated with a lower risk of incident asthma up to mid-adolescence., Competing Interests: Conflict of interest: M. Talaei has nothing to disclose. Conflict of interest: E. Sdona has nothing to disclose. Conflict of interest: P.C. Calder has nothing to disclose. Conflict of interest: L.R. Jones reports grants from Nestle Nutrition, outside the submitted work. Conflict of interest: P.M. Emmett reports grants from Nestle Nutrition, outside the submitted work. Conflict of interest: R. Granell has nothing to disclose. Conflict of interest: A. Bergström has nothing to disclose. Conflict of interest: E. Melén has nothing to disclose. Conflict of interest: S.O. Shaheen has nothing to disclose., (Copyright ©The authors 2021.)

Dietary antioxidant intake has been hypothesised to influence lung function. The association between total antioxidant capacity (TAC) of the diet at age 8 years and lung function development up to 16 years in 2307 participants from the Swedish population-based birth cohort BAMSE (Children, Allergy, Milieu, Stockholm, Epidemiology) was investigated.Information on TAC was obtained from a food frequency questionnaire at 8 years. Lung function was measured by spirometry at 8 and 16 years, impulse oscillometry (IOS) and exhaled nitric oxide fraction ( F eNO ) at 16 years. Low lung function was defined as forced expiratory volume in 1 s (FEV 1 ) z-score below the 25th percentile. Longitudinal associations between TAC and lung function were analysed by mixed effect models adjusted for potential confounders. Stratification by asthma at 8 years was performed to examine effect modification.The median TAC intake was 10 067 μmol Trolox equivalents (TE)·g -1 , with males having a lower mean compared to females (9963 versus 10 819 μmol TE·g -1 ). In analyses of lung function change between 8 and 16 years, there were no statistically significant associations between TAC in tertiles and spirometry results for the total study population. Among children with asthma at 8 years (prevalence 7%), higher TAC was associated with higher mean FEV 1 (0.46 sd, 95% CI 0.11-0.80) and decreased odds of low lung function at 16 years (OR 0.28, 95% CI 0.12-0.65). There were no associations between TAC and forced vital capacity or IOS/ F eNO results.High dietary antioxidant intake in school age may be associated with improved lung function development from school age to adolescence among children with asthma., Competing Interests: Conflict of interest: E. Sdona has nothing to disclose. Conflict of interest: J. Hallberg reports personal fees from AstraZeneca, outside the submitted work. Conflict of interest: N. Andersson has nothing to disclose. Conflict of interest: S. Ekström has nothing to disclose. Conflict of interest: S. Rautiainen has nothing to disclose. Conflict of interest: N. Håkansson has nothing to disclose. Conflict of interest: A. Wolk has nothing to disclose. Conflict of interest: I. Kull has nothing to disclose. Conflict of interest: E. Melén has nothing to disclose. Conflict of interest: A. Bergström has nothing to disclose., (Copyright ©ERS 2020.)