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Toddler and maternal fructose intake linked to asthma

Reducing intake of sugary drinks in pregnancy and early childhood could cut childhood asthma risk

Louise Prime

Tuesday, 12 December 2017

Higher intake of sugar-sweetened drinks and of fructose during pregnancy and in early childhood might influence childhood asthma development, in part through mechanisms other than adiposity, US researchers have concluded. In response to their findings,* published this week in Annals of the American Thoracic Society, they suggested that avoiding high intake of sugary beverages during pregnancy and in early childhood could be one of several ways to reduce the risk of childhood asthma.

The research team said that previous cross-sectional studies have linked intake of high fructose corn syrup-sweetened beverages with asthma in school children; but there has been little research into when, during early development, fructose exposure might influence later health. They designed a study to investigate associations of maternal prenatal and early childhood intake of sugar-sweetened beverages and fructose with current asthma in mid-childhood.

They assessed maternal pregnancy (at means of 11.9 and 29.2 weeks’ gestational age) and child (median age 3.3 years) intake of sugar-sweetened beverages and total fructose, using food frequency questionnaires, in 1,068 mother-child pairs from Project Viva, a prospective pre-birth cohort. Using a multivariable analysis, they examined the associations of quartiles of maternal and child intake of sugar-sweetened beverage, juice, and total fructose with child current asthma in mid-childhood. Current child asthma was defined as maternal report of a doctor having ever diagnosed asthma, plus taking asthma medications or reporting wheezing in the past 12 months; overall prevalence was 19% in mid-childhood (at a median of 7.7 years old).

The authors reported that higher maternal consumption during pregnancy of sugar-sweetened drinks (mean 0.6 servings/day; range 0-5 servings) was associated with younger maternal age, non-white race/ethnicity, lower education and income, and higher pre-pregnancy body mass index (BMI).

Once they had adjusted for pre-pregnancy BMI and other covariates, they found that a greater risk of mid-childhood current asthma was associated with a higher maternal pregnancy intake of both sugar-sweetened drinks (odds ratio, OR 1.70 for quartile 4 compared with quartile 1) as well as with higher total fructose intake (OR 1.58). Higher early childhood fructose intake (quartile 4 vs. quartile 1) was also associated with mid-childhood current asthma in models adjusted for maternal sugar-sweetened beverages (OR 1.79) and after additional adjustment for mid-childhood BMI z-score (OR 1.77).

The researchers noted that higher intake of sugar-sweetened beverages and fructose might influence asthma either through increasing adiposity, and adiposity-related pulmonary restriction and inflammation; or through adiposity-independent mechanisms. They called for further evaluation of potential mechanisms for the influence of total fructose on asthma development, including further assessment of the effects of fructose and fructose metabolites on airway inflammation or hyperreactivity that might be independent of obesity.

They concluded: “Avoiding high intake of sugary beverages during pregnancy and in early childhood could be one of several ways to reduce the risk of childhood asthma.”


* Wright LS, Rifas-Shiman SL, Oken E, et al. Prenatal and early-life fructose, fructose-containing beverages, and mid-childhood asthma. Annals of the American Thoracic Society. Published Online: December 08, 2017. DOI: 10.1513/AnnalsATS.201707-530OC

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