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The effect of lifestyle on wheeze, atopy, and bronchial hyperreactivity in Asian and white children.

Abstract

There is increasing evidence linking Western culture to increasing prevalence of asthma. We have measured the prevalence of symptoms of asthma, bronchial hyperreactivity, and atopy in a sample of white and Asian inner city schoolchildren aged 8-11 yr in the U.K. and assessed the influence of certain aspects of western culture on these variables. Bronchial reactivity was measured by methacholine challenge, atopy by allergen skin prick tests, and symptoms of asthma and aspects of lifestyle by questionnaire. Degree of Westernization was assessed from dietary habit categorized as exclusively Asian, mostly Asian, mixed, or exclusively English. The questionnaire was completed by 92% of children. The 308 white and 539 Asian children were of similar age (mean 9.3 yr versus 9.4 yr) with slightly more girls in the Asian group (52.6% versus 47.4%). The white children reported more wheeze within the past year (14.2% versus 8.8%, p = 0.01) but less were atopic (29.5% versus 38.4%, p = 0.01) with no significant difference in the prevalence of hyperreactivity (31.5% versus 29.6%, p = 0.57). Most Asians (97%) included Asian food in their diet; 35% ate a mostly Asian diet, 45% ate a mixed English and Asian diet, and 17% ate an exclusively Asian diet. After controlling for confounding factors whites were at higher risk of hyperreactivity and lower risk of atopy, and the risk of hyperreactivity and to a lesser extent atopy among Asian children was related to diet in a dose response fashion. The relative odds for hyperreactivity with an exclusively Asian, mostly Asian, or a mixed diet relative to an English diet were 0.31 (95% CI 0.15 to 0.62), 0.88 (0.56 to 1.37), and 0.99 (0.65 to 1.49), and for atopy were 1.22 (0.72 to 2.06), 1.47 (0.99 to 2.19), and 1.78 (1.23 to 2.58). These results suggest that diet or other closely related factors associated with Westernization are involved in the etiology of atopy and hyperreactivity.

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  • Authors+Show Affiliations

    ,

    Department of Medicine, Glenfield General Hospital, Leicester, United Kingdom.

    , ,

    Source

    MeSH

    Asian Continental Ancestry Group
    Asthma
    Bronchial Hyperreactivity
    Bronchial Provocation Tests
    Child
    Diet
    England
    European Continental Ancestry Group
    Female
    Humans
    Hypersensitivity, Immediate
    Life Style
    Male
    Methacholine Chloride
    Prevalence
    Respiratory Sounds
    Risk Factors
    Skin Tests
    Surveys and Questionnaires

    Pub Type(s)

    Comparative Study
    Journal Article

    Language

    eng

    PubMed ID

    8756835

    Citation

    Carey, O J., et al. "The Effect of Lifestyle On Wheeze, Atopy, and Bronchial Hyperreactivity in Asian and White Children." American Journal of Respiratory and Critical Care Medicine, vol. 154, no. 2 Pt 1, 1996, pp. 537-40.
    Carey OJ, Cookson JB, Britton J, et al. The effect of lifestyle on wheeze, atopy, and bronchial hyperreactivity in Asian and white children. Am J Respir Crit Care Med. 1996;154(2 Pt 1):537-40.
    Carey, O. J., Cookson, J. B., Britton, J., & Tattersfield, A. E. (1996). The effect of lifestyle on wheeze, atopy, and bronchial hyperreactivity in Asian and white children. American Journal of Respiratory and Critical Care Medicine, 154(2 Pt 1), pp. 537-40.
    Carey OJ, et al. The Effect of Lifestyle On Wheeze, Atopy, and Bronchial Hyperreactivity in Asian and White Children. Am J Respir Crit Care Med. 1996;154(2 Pt 1):537-40. PubMed PMID: 8756835.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The effect of lifestyle on wheeze, atopy, and bronchial hyperreactivity in Asian and white children. AU - Carey,O J, AU - Cookson,J B, AU - Britton,J, AU - Tattersfield,A E, PY - 1996/8/1/pubmed PY - 1996/8/1/medline PY - 1996/8/1/entrez SP - 537 EP - 40 JF - American journal of respiratory and critical care medicine JO - Am. J. Respir. Crit. Care Med. VL - 154 IS - 2 Pt 1 N2 - There is increasing evidence linking Western culture to increasing prevalence of asthma. We have measured the prevalence of symptoms of asthma, bronchial hyperreactivity, and atopy in a sample of white and Asian inner city schoolchildren aged 8-11 yr in the U.K. and assessed the influence of certain aspects of western culture on these variables. Bronchial reactivity was measured by methacholine challenge, atopy by allergen skin prick tests, and symptoms of asthma and aspects of lifestyle by questionnaire. Degree of Westernization was assessed from dietary habit categorized as exclusively Asian, mostly Asian, mixed, or exclusively English. The questionnaire was completed by 92% of children. The 308 white and 539 Asian children were of similar age (mean 9.3 yr versus 9.4 yr) with slightly more girls in the Asian group (52.6% versus 47.4%). The white children reported more wheeze within the past year (14.2% versus 8.8%, p = 0.01) but less were atopic (29.5% versus 38.4%, p = 0.01) with no significant difference in the prevalence of hyperreactivity (31.5% versus 29.6%, p = 0.57). Most Asians (97%) included Asian food in their diet; 35% ate a mostly Asian diet, 45% ate a mixed English and Asian diet, and 17% ate an exclusively Asian diet. After controlling for confounding factors whites were at higher risk of hyperreactivity and lower risk of atopy, and the risk of hyperreactivity and to a lesser extent atopy among Asian children was related to diet in a dose response fashion. The relative odds for hyperreactivity with an exclusively Asian, mostly Asian, or a mixed diet relative to an English diet were 0.31 (95% CI 0.15 to 0.62), 0.88 (0.56 to 1.37), and 0.99 (0.65 to 1.49), and for atopy were 1.22 (0.72 to 2.06), 1.47 (0.99 to 2.19), and 1.78 (1.23 to 2.58). These results suggest that diet or other closely related factors associated with Westernization are involved in the etiology of atopy and hyperreactivity. SN - 1073-449X UR - https://www.unboundmedicine.com/medline/citation/8756835/full_citation L2 - http://www.atsjournals.org/doi/full/10.1164/ajrccm.154.2.8756835?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -