Association between five dietary indices and childhood asthma: the mediating role of visceral adiposity indicators using NHANES data.

BACKGROUND: Asthma is a prevalent chronic respiratory condition in children, significantly impacting their quality of life. While various dietary indices have been linked to health outcomes, their specific association with asthma risk in children remains unclear. This study aimed to explore the relationship between dietary indices and asthma prevalence in children aged 3-5 years. METHODS: Data from the National Health and Nutrition Examination Survey (NHANES) 2011-2018, encompassing 1695 participants aged 3-5 years, were analyzed. The study employed logistic regression and restricted cubic splines to assess the associations among Dietary Approaches to Stop Hypertension (DASH), Alternative Healthy Eating Index (AHEI), Healthy Eating Index 2020 (HEI-2020), Mediterranean Diet (MED), and Dietary Inflammatory Index (DII) with asthma prevalence. Mediation effects of Body Mass Index (BMI), Lipid accumulation product (LAP), and Visceral Adipose Tissue Index (VAI) were further explored by causal mediation analysis. RESULTS: The analysis revealed that higher adherence to DASH, AHEI, HEI-2020, and MED was significantly associated with reduced asthma risk, with adjusted ORs of 0.93 (95% CI: 0.90-0.97), 0.98 (95% CI: 0.97-0.99), 0.98 (95% CI: 0.98-0.99) and 0.89 (95% CI: 0.84-0.94), respectively. Furthermore, mediation analysis indicated that BMI, LAP, and VAI significantly mediated these relationships (P<0.05). CONCLUSION: Our study indicates that adherence to healthier dietary patterns may significantly reduce the risk of asthma in children. The observed association between a diet low in inflammatory potential and a decreased likelihood of asthma suggests that anti-inflammatory diets could play a crucial role in asthma prevention. These insights could guide future dietary recommendations and interventions aimed at decreasing asthma prevalence among pediatric populations.