Dietary patterns, lung function and asthma in childhood: a longitudinal study

BACKGROUND: Longitudinal epidemiological data are scarce examining the relationship between dietary patterns and respiratory outcomes in childhood. We investigated whether three distinct dietary patterns in mid-childhood were associated with lung function and incident asthma in adolescence. METHODS: In the Avon Longitudinal Study of Parents and Children, ‘processed’, ‘traditional’, and ‘health-conscious’ dietary patterns were identified using principal components analysis from food frequency questionnaires at 7 years of age. Post-bronchodilator forced expiratory volume in 1 s (FEV(1)), forced vital capacity (FVC), and forced expiratory flow at 25–75% of FVC (FEF(25–75)) were measured at 15.5 years and were transformed to z-scores based on the Global Lung Function Initiative curves. Incident asthma was defined by new cases of doctor-diagnosed asthma at age 11 or 14 years. RESULTS: In multivariable-adjusted models, the ‘health-conscious’ pattern was positively associated with FEV(1) (regression coefficient comparing top versus bottom quartile of pattern score 0.16, 95% CI 0.01 to 0.31, P for trend 0.04) and FVC (0.18, 95% CI 0.04 to 0.33, P for trend 0.02), while the ‘processed’ pattern was negatively associated with FVC (− 0.17, 95% CI − 0.33 to − 0.01, P for trend 0.03). Associations between the ‘health-conscious’ and ‘processed’ patterns and lung function were modified by SCGB1A1 and GPX4 gene polymorphisms. We found no evidence of an association between the ‘traditional’ pattern and lung function, nor between any pattern and FEF(25–75) or incident asthma. CONCLUSIONS: A ‘health-conscious’ diet in mid-childhood was associated with higher subsequent lung function, while a diet high in processed food was associated with lower lung function. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12931-023-02383-9.