According to a study, youth who were exposed to ambient cigarette smoke had a lower risk of wheezing when they ate a higher-quality diet.
In the United States, more than four million adolescents have asthma, and many more who haven’t been diagnosed with the disease nonetheless experience wheezing.
Adolescence is a time of significant physiologic changes, including rapid growth toward peak lung function—a period in life when environmental exposures may have an impact on development and lead to chronic respiratory disease in adulthood.
Adolescence is also a significant time for the creation of possibly lifelong dietary patterns, as habits formed during this time predict adult food choices.
This cross-sectional study of a nationally representative sample of adolescents found that youth who had significant exposure to environmental tobacco smoke and ate a higher quality diet—such as the Mediterranean diet, which includes eating more fruits, vegetables, omega-3 fatty acids, and fiber—had significantly lower odds of wheezing than adolescents who had the same exposure but ate a lower quality diet that included saturated fats and processed foods.
Targeted public health initiatives to enhance access to and consumption of higher-quality foods could be a future strategy for reducing respiratory ailments connected to tobacco smoke exposure from cigarettes and cigars in the environment.
More population-level, longitudinal studies are needed to better understand the impact of nutrition on airway diseases in environmentally exposed adolescents, according to Mount Sinai researchers.
The researchers used data from the National Health and Nutrition Examination Survey from 2003 to 2012 to conduct a cross-sectional investigation on over 7,000 non-smoking teenagers. The Healthy Eating Index-2010 score, which is divided into quintiles, was used to assess diet quality.
A higher Healthy Eating Index–2010 score reflects better adherence to the USDA Food and Nutrition Services’ dietary guidelines for Americans. Serum cotinine, a marker of nicotine intake, was used to assess the teenagers’ exposure to environmental cigarette smoke, with values classified as high (> 2.99 ng/ml) or low (2.99 ng/ml).
The researchers looked at outcomes such as self-reported wheeze and cough symptoms over the past 12 months, as well as a subset of people who had lung function tests.
The researchers evaluated relationships between diet and respiratory symptoms as well as diet and lung function using survey-designed adjusted logistic and linear regression models, as well as the interaction between the Healthy Eating Index-2010 score and serum cotinine levels.
While there were no significant links between diet quality and respiratory symptoms, the Healthy Eating Index-2010 score and serum cotinine on wheeze had a significant interaction. Adolescents with the healthiest diet are less likely than those with the poorest diet to develop wheeze when their serum cotinine levels are high.
There were no significant differences in any respiratory symptoms between those with the greatest and those with the lowest food quality among adolescents with low blood cotinine.
There was a trend toward better lung function with improving diet quality among the subgroup of heavier secondhand smoke exposure, with detailed data on their breathing and lung function, albeit this did not reach statistical significance.
In teenagers who were exposed to a lot of cigarette smoke, eating a higher-quality diet was linked to a lower risk of wheezing. While more longitudinal studies are needed to better understand the effect of diet on airway diseases in adults who smoke, experts recommend that public health measures to improve diet quality in vulnerable, environmentally-exposed groups be considered.
This study, despite its cross-sectional methodology, demonstrates the potential benefits of a balanced diet in reducing the negative consequences of secondhand smoking exposure among teenagers.
“We hope that future research will provide diet-based solutions that empower disadvantaged teenagers to safeguard their lung health, as such passive environmental exposures may be inevitable,” Dr. Sonali Bose of Mount Sinai stated in the study.
Researchers from Mount Sinai’s Department of Population Health Science & Policy and Institute for Translational Epidemiology, as well as researchers from Ohio State University Wexner Medical Center and the University of Nebraska Medical Center, all participated in this study.