March 28, 2022
2 min read
Consumption of a higher-quality diet was associated with lower odds of wheezing among adolescents with substantial environmental tobacco smoke exposure, according to data published in Annals of the American Thoracic Society.
“Notably, over 9 million adolescents in the U.S. were exposed to secondhand or environmental tobacco smoke from 2013 to 2014, highlighting an important public health concern,” Jing Gennie Wang, MD, physician in the division of pulmonary, critical care medicine and sleep medicine at The Ohio State University Wexner Medical Center, and colleagues wrote. “Among adolescents, environmental tobacco smoke exposure is associated with a higher risk of respiratory symptoms and airways disease, reduced lung function and increased health care utilization. However, the role of diet in respiratory health among youths with environmental tobacco smoke exposure is unknown.”
The study included 7,026 adolescents who were not smokers (median age 13.4; 50.8% boys). It was based on the National Health and Nutrition Examination Survey 2003 – 2012. Researchers used the Healthy Eating Index 2010 score as a way to assess diet quality. They then classified the adolescents into quintiles, which range from the most unhealthy to the most healthy. Researchers determined the level of environmental tobacco use using serum cotinine. It was either high (>2.99 ng/ml), or low (2.99 ng/mL).
The primary outcome was wheezing and other symptoms during the past year.
Researchers observed a significant interaction between diet quality and serum cotinine on wheezing (P = .011). High serum cotinine diets and adolescents who eat the healthiest diets had lower wheezing rates than those who eat poorer diets (OR = 0,1; 95%CI: 0.02-0.1), according to models stratified by serum cozinine. Researchers found no difference in respiratory symptoms between adolescents with low serum cholesterol and those who ate the best diet.
The researchers found that there was a trend toward improved lung function in a subgroup of 3166 adolescents with spirometry data. This trend was not significant.
Researchers found no associations between diet quality or respiratory symptoms. There was no evidence of any effect modification by environmental tobacco smoking exposure on the relationship between diet and lung function.
“To our knowledge, this study is the first to investigate the intersection between diet quality and environmental tobacco smoking exposure on respiratory outcomes in adolescents, and emphasizes the need for an exposomic approach to better understand the determinants of respiratory health among vulnerable populations,” the researchers wrote.
Researchers pointed out several limitations in the current study, such as its cross-sectional design and exclusions of adolescents with recent smoking history and nicotine use.
“Population-level, longitudinal studies dedicated to understanding the role of diet in airways disorders among environmentally exposed adolescents are warranted,” the researchers wrote.
