哮喘联盟

   摘要
   背景：2013年，20%有孩子的美国家庭处于食品不安全状态。超过700万的儿童遭受哮喘的折磨；哮喘患病率稳步上升，其中幼儿期是哮喘的发病高峰。哮喘和食品不安全具有共同的决定性因素——贫穷和种族，这些决定性因素与体重相关。然而，目前关于食品不安全与哮喘关系的研究却十分有限。
   目的：本研究旨在评估多样化的儿童样本中食品不安全与哮喘之间的关系。
   方法：纳入分析的横断面数据(n = 11,099)来源于幼儿纵向研究项目-幼儿园队列(ECLS-K)中3年级儿童的相关资料。食品安全性依据美国农业部标准，而哮喘诊断则依据父母所述；并对人体相关指标进行测定。通过多因素逻辑回顾模型评估食品安全与哮喘之间的关系，并根据不同的种族/民族进行评价。
   结果：食品不安全家庭中孩子患哮喘的校正几率高4%(95% CI: 1.02 - 1.06)。男童患哮喘的校正几率高70%(95% CI: 1.69 - 1.71)，非西班牙裔黑人儿童高53% (95% CI: 1.51 - 1.54)，西班牙裔儿童高20%(95% CI: 1.19 - 1.21)，超重儿童高38% (95% CI: 1.36 - 1.39)，肥胖儿童高67% (95% CI: 1.65 - 1.68)，低出生体重儿童高23% (95% CI: 1.21 - 1.24)，母亲有高中学历的儿童高24%(95% CI: 1.23 - 1.26)，而母亲接受过大学教育的儿童高33% (95% CI: 1.32 - 1.35)。高出生体重儿童(OR: 0.84; 95% CI: 0.83 - 0.85)和母亲出生于外国的儿童(OR: 0.52; 95% CI: 0.51 - 0.53)患哮喘几率更低。在非西班牙裔白人儿童和西班牙裔儿童中，食品不安全与哮喘呈正相关；而在非西班牙裔黑人儿童中，则呈负相关。在食品不安全和经济贫穷家庭中，所有儿童患哮喘的几率增加一倍(OR: 2.00; 95% CI: 1.97 - 2.03)；根据种族/民族进行划分，这种关系依然存在。
   结论：在美国三年级儿童中，食品不安全与哮喘呈正相关，而家庭经济贫穷则会进一步加强两者的相关性。
 

（杨冬 审校）
J Nutr. 2015 Dec;145(12):2756-64. doi: 10.3945/jn.115.215939. Epub 2015 Oct 21.

 

Household Food Insecurity Is Associated with Childhood Asthma.
 

Mangini LD1, Hayward MD2, Dong YQ3, Forman MR3.
 

Abstract
BACKGROUND:In 2013, 20% of US households with children experienced food insecurity. Asthma afflicts over 7 million children; prevalence has steadily increased while incidence peaks in young children. Asthma and food insecurity share the determinants of poverty and race that are associated with weight, yet limited research on the relation between food insecurity and asthma exists.
OBJECTIVE:The objective of this study was to determine the association between food insecurity and asthma in a diverse sample of children.
METHODS:Cross-sectional data from grade 3 of the Early Childhood Longitudinal Study-Kindergarten Cohort were analyzed (n = 11,099). Food security based on the USDA module and asthma diagnosis were reported by parents; anthropometric factors were measured. Multivariate logistic regression models of food security and asthma were analyzed overall and by race/ethnicity.
RESULTS:Children in food-insecure households had a 4% higher adjusted odds of asthma (95% CI: 1.02, 1.06). Adjusted odds of asthma were also higher by 70% for males (95% CI: 1.69, 1.71), 53% for non-Hispanic black (NHB) children (95% CI: 1.51, 1.54), 20% for Hispanic children (95% CI: 1.19, 1.21), 38% for overweight children (95% CI: 1.36, 1.39), 67% for obese children (95% CI: 1.65, 1.68), 23% for low-birth weight children (95% CI: 1.21, 1.24), 24% if mothers had a high school diploma (95% CI: 1.23, 1.26), and 33% if mothers had some college education (95% CI: 1.32, 1.35). High-birth weight children (OR: 0.84; 95% CI: 0.83, 0.85) and those with foreign-born mothers (OR: 0.52; 95% CI: 0.51, 0.53) had lower odds of asthma. Being food-insecure remained positively associated with asthma in non-Hispanic whites and Hispanics but was inversely associated with odds among NHBs. Odds of asthma doubled (OR: 2.00; 95% CI: 1.97, 2.03) for all children in households that were both food-insecure and poor; this relation remained positive in race/ethnicity-specific models.
CONCLUSIONS:Food insecurity is positively associated with asthma in US third graders, and household poverty strengthens the association.
 

J Nutr. 2015 Dec;145(12):2756-64. doi: 10.3945/jn.115.215939. Epub 2015 Oct 21.