. Author manuscript; available in PMC: 2016 Jun 1.

Published in final edited form as: Ann Allergy Asthma Immunol. 2014 Dec 15;114(4):273–280. doi: 10.1016/j.anai.2014.11.003

Table 1.

Summary of studies examining associations between a Western diet pattern (via comprehensive dietary assessment or as represented by fast food or processed food intake) and adult asthma

Study	Location	Study population	Dietary assessment	Dietary analyses	Asthma assessment	Adjustments	Prevalence/incidence	Symptoms/morbidity
Priftanji et al,²¹ 2002 Cross-sectional study of factors associated with asthma	Albania	717 adults (20–44 y old)	question regarding frequency of prepackaged food intake	binary scale (consumption <1 vs >1×/wk)	self-report: asthma attack, nighttime awakening for shortness of breath, or current treatment	age, sex, smoking	prepackaged food intake was associated with possible allergic asthma (OR 1.61, 95% CI 1.01–2.55) and possible nonallergic asthma (OR 1.82, 95% CI 1.17–2.83)
Butler et al,¹⁸ 2006 Prospective study of dietary patterns and persistent cough with phlegm	Singapore	52,325 adults (45–74 y old)	165-item FFQ	PCA	self-report: incident asthma confirmed by symptom and medication report	age, energy intake, dialect group, sex, smoking status, age at smoking initiation, cigarettes/d, secondhand smoke, education; BMI explored and not correlated with dietary pattern	adherence to a diet rich in meat, sodium, and refined carbohydrates was not significantly associated with incident asthma
Varraso et al,²⁴ 2007 Prospective study of dietary patterns and chronic obstructive pulmonary disease	United States	72,043 women (30–55 y old)	116-item FFQ recording intake during previous 12 mo	PCA-FA	self-report: physician diagnosis and use of medication for asthma within previous 12 mo	age, race/ethnicity, energy intake, spouse’s educational attainment, supplement use, physical activity, smoking, secondhand smoke, menopausal status, physician visits, US region	no association was found between Western diet pattern and adult-onset asthma
Varraso et al,²⁵ 2007 Prospective study of dietary patterns and chronic obstructive pulmonary disease	United States	42,917 men (40–75 y old)	131-item FFQ	PCA-FA	self-report: physician diagnosis and use of medication for asthma within previous 12 mo	age, race/ethnicity, energy intake, smoking, supplement use, BMI, physical activity, physician visits, US region	no association was found between Western diet pattern and adult-onset asthma
Uddenfeldt et al,²³ 2010 Long-term follow-up study of diet and asthma in 3 age groups	Sweden	8,150 adults (16, 30–39, 60–69 y old)	7 questions about consumption of foods	consumption score by frequency, summary score for fruit and fish	self-report: asthma or use of asthma medication	age, sex, smoking, socioeconomic group, BMI heredity, hay fever, GERD, snoring, physical activity, building dampness	fast food intake was not associated with incident asthma
Takaoka and Norback,²² 2008 Cross-sectional study of diet and asthmatic symptoms, infections, pollen and furry pet allergy	Japan	153 female university students (mean age 21 y)	11 questions abstracted from a FFQ and a question on type of oil used for cooking	FFQ (intake) scales and PCA-FA	self-report: “current asthma”current asthma medication use or attack in previous 12 mo	age, smoking, parental asthma/allergy	no association was found between any dietary factors (including fast food) and asthma prevalence	fast food intake was associated with wheeze (OR 1.68, 95% CI 1.02–2.78) and nocturnal breathlessness (OR 2.26, 95% CI 1.06–4.79); a diet pattern score, including fast food, juice, and soft drinks, was related to wheeze (OR 1.19, 95% CI 1.04e1.37)
Varraso et al,²⁶ 2009 Prospective study of dietary patterns and asthma in E3N Study	France	54,672 women (40–65 y old)	French FFQ	PCA-FA	self-report: history of asthma attacks and, when available, self-reported physician diagnosis	age, energy intake, smoking status, years of education, hay fever, supplement use, BMI, physical activity, menopausal status	no association of dietary patterns was found with asthma incidence, ever asthma, or current asthma	Western diet pattern was associated with increased odds of frequent (≥1/wk) asthma attacks only in those with asthma not taking vitamin supplements (OR 1.56–1.79, P < .05)
Hooper et al,¹⁹ 2010 Cross-sectional study of dietary patterns and asthma in residents of 3 countries in European Community Respiratory Health Survey-–II	Europe	1,174 adults (29–55 y old)	German and UK FFQs recording intake during previous 12 mo and supplemental questions using local food tables	PCA	self-report: asthma or nocturnal shortness of breath, attack in previous 12 mo, or asthma medication use	age, sex, social class, smoking status, exercise, BMI, energy intake	diet pattern was not associated with asthma prevalence	meat-and-potato diet (similar to Western diet) was associated with increased per-quintile asthma symptoms in the United Kingdom (ratio 1.34, 95% CI 1.09–1.67) and Norway (ratio 1.24, 95% CI 1.00–1.55), but decreased per-quintile asthma symptoms in Germany (ratio 0.81, 95% CI 0.68–0.97)
McKeever et al,²⁰ 2010 Combined cross-sectional and longitudinal study of diet and relation to respiratory disease and lung function	Netherlands	cross-sectional, 12,648 adults (20–59 y old); longitudinal, 2,911 adults	178-item FFQ	PCA-FA	physician-diagnosed asthma	age, sex, educational level, smoking status, pack-years height, BMI	a refined diet pattern (similar to a Western diet pattern) was not associated with asthma prevalence	a refined diet pattern (similar to a Western diet pattern) showed a trend for increased wheeze prevalence across increasing quintiles of intake (P = .07)
Bakolis et al,¹⁷ 2010 Population-based case—control study of dietary patterns and asthma	United Kingdom	599 cases, 854 controls (16–50 y old)	>200-item FFQ	PCA	self-report: asthma attack, waking, shortness of breath in previous 12 mo, asthma medication use	age, sex, ethnicity, BMI, social class, housing tenure, employment status, single parent, smoking, secondhand smoke, energy intake, number of siblings, paracetamol use, supplement use	no association was found between a Western dietary pattern and asthma prevalence after adjustment	no association was found between a Western dietary pattern and nocturnal asthma symptoms or asthma quality-of-life score

Abbreviations: BMI, body mass index; CI, confidence interval; FFQ, food frequency questionnaire; GERD, gastroesophageal reflux disease; OR, odds ratio; PCA, principal components analysis; PCA-FA, principal components analysis and factor analysis.