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Combined impact of healthy lifestyle factors on risk of asthma, rhinoconjunctivitis and eczema in school children: ISAAC phase III

Morales, E; Strachan, DP; Asher, I; Ellwood, P; Pearce, N; García-Marcos, L; ISAAC Phase III Study Group, (2019) Combined impact of healthy lifestyle factors on risk of asthma, rhinoconjunctivitis and eczema in school children: ISAAC phase III. THORAX. ISSN 0040-6376 https://doi.org/10.1136/thoraxjnl-2018-212668
SGUL Authors: Strachan, David Peter

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Abstract

Background Asthma is not the key focus of prevention strategies. A Healthy Lifestyle Index (HLI) was developed to examine the combined effect of modifiable lifestyle factors on asthma, rhinoconjunctivitis and eczema using data from the International Study of Asthma and Allergies in Childhood (ISAAC) phase III. Methods Information on symptoms of asthma, rhinoconjunctivitis, eczema and several lifestyle factors was obtained from children aged 6–7 years through written questionnaires. The HLI combined five lifestyle factors: no parental smoking, child’s adherence to Mediterranean diet, child’s healthy body mass index, high physical activity and non-sedentary behaviour. The association between the HLI and risk of asthma, rhinoconjunctivitis and eczema was evaluated using multilevel mixed-effects logistic regression models. Findings Data of 70 795 children from 37 centres in 19 countries were analysed. Each additional healthy lifestyle factor was associated with a reduced risk of current wheeze (OR 0.87, 95% CI 0.84 to 0.89), asthma ever (OR 0.89, 95% CI 0.87 to 0.92), current symptoms of rhinoconjunctivitis (OR 0.95, 95% CI 0.92 to 0.97) and current symptoms of eczema (OR 0.92, 95% CI 0.92 to 0.98). Theoretically, if associations were causal, a combination of four or five healthy lifestyle factors would result into a reduction up to 16% of asthma cases (ranging from 2.7% to 26.3 % according to region of the world). Conclusions These findings should be interpreted with caution given the limitations to infer causality from cross-sectional observational data. Efficacy of interventions to improve multiple modifiable lifestyle factors to reduce the burden asthma and allergy in childhood should be assessed.

Item Type: Article
Additional Information: This article has been accepted for publication in Thorax, 2019 following peer review, and the Version of Record can be accessed online at http://dx.doi.org/10.1136/thoraxjnl-2018-212668. © Author(s) (or their employer(s)) 2019.
Keywords: 1103 Clinical Sciences, Respiratory System
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: THORAX
ISSN: 0040-6376
Dates:
DateEvent
21 March 2019Published Online
11 February 2019Accepted
Publisher License: Publisher's own licence
Projects:
Project IDFunderFunder ID
MS14/00046Miguel Servet Grant FellowshipUNSPECIFIED
URI: http://openaccess.sgul.ac.uk/id/eprint/110652
Publisher's version: https://doi.org/10.1136/thoraxjnl-2018-212668

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