{"title":"体重指数在健康饮食与老年妇女哮喘症状演变的前瞻性关联中的中介作用","authors":"Wassila Ait-Hadad, Annabelle Bédard, Laurent Orsi, Sébastien Chanoine, Orianne Dumas, Nasser Laouali, Nicole Le Moual, Bénédicte Leynaert, Valérie Siroux, Marie-Christine Boutron-Ruault, Raphaëlle Varraso","doi":"10.1016/j.jarlif.2025.100011","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Diet and obesity exhibit complex interrelationships with asthma, particularly among elderly women. We aimed to clarify the impact of healthy diet assessed by the Alternate Healthy Eating Index-2010 (AHEI-2010) on: 1) the incidence of asthma symptoms, and 2) among women with symptoms in 2011, the change in asthma symptoms, while accounting for the potential mediating role of BMI.</p><p><strong>Design: </strong>A nested case-control study on asthma with follow-up data.</p><p><strong>Setting: </strong>Within the French E3N cohort.</p><p><strong>Participants: </strong>8621 elderly women (62 years on average in 1993).</p><p><strong>Measurements: </strong>Dietary data were collected in 1993 and 2005 using semi-quantitative questionnaires. Using the validated asthma symptom score assessed in 2011 and 2018, asthma symptom incidence among women with no asthma symptom in 2011 (<i>n</i> = 5700) and change in asthma symptoms (reduced, stable, increased) among those with asthma symptoms in 2011 (<i>n</i> = 2921) were defined. BMI was calculated in 2008. Marginal structural models were used to estimate total, direct and indirect effects mediated by BMI.</p><p><strong>Results: </strong>After adjustment for potential confounders, we found a significant indirect effect of healthier diet on lower risk of asthma symptoms incidence mediated by lower BMI (OR for AHEI-2010 quintile 5 vs quintile 1 = 0.95 (0.92-0.97)), without significant total (OR=0.87 (0.66-1.10)) nor direct (OR=0.92 (0.71-1.15)) effects. Among women with asthma symptoms, we also found a significant indirect effect of healthier diet on reduced asthma symptoms mediated by lower BMI (OR for AHEI-2010 >median <i>vs</i> ≤median=1.02 (1.00-1.03)) without significant total (OR=1.12 (0.94-1.34)) nor direct effects (OR=1.10 (0.93-1.31)).</p><p><strong>Conclusion: </strong>A healthy diet was associated with reduced risk of asthma symptoms over time, partly through a lower BMI.</p>","PeriodicalId":73537,"journal":{"name":"JAR life","volume":"14 ","pages":"100011"},"PeriodicalIF":0.0000,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12008553/pdf/","citationCount":"0","resultStr":"{\"title\":\"Mediating role of the body mass index in the prospective association between a healthy diet and evolution of asthma symptoms in elderly women.\",\"authors\":\"Wassila Ait-Hadad, Annabelle Bédard, Laurent Orsi, Sébastien Chanoine, Orianne Dumas, Nasser Laouali, Nicole Le Moual, Bénédicte Leynaert, Valérie Siroux, Marie-Christine Boutron-Ruault, Raphaëlle Varraso\",\"doi\":\"10.1016/j.jarlif.2025.100011\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Diet and obesity exhibit complex interrelationships with asthma, particularly among elderly women. We aimed to clarify the impact of healthy diet assessed by the Alternate Healthy Eating Index-2010 (AHEI-2010) on: 1) the incidence of asthma symptoms, and 2) among women with symptoms in 2011, the change in asthma symptoms, while accounting for the potential mediating role of BMI.</p><p><strong>Design: </strong>A nested case-control study on asthma with follow-up data.</p><p><strong>Setting: </strong>Within the French E3N cohort.</p><p><strong>Participants: </strong>8621 elderly women (62 years on average in 1993).</p><p><strong>Measurements: </strong>Dietary data were collected in 1993 and 2005 using semi-quantitative questionnaires. Using the validated asthma symptom score assessed in 2011 and 2018, asthma symptom incidence among women with no asthma symptom in 2011 (<i>n</i> = 5700) and change in asthma symptoms (reduced, stable, increased) among those with asthma symptoms in 2011 (<i>n</i> = 2921) were defined. BMI was calculated in 2008. Marginal structural models were used to estimate total, direct and indirect effects mediated by BMI.</p><p><strong>Results: </strong>After adjustment for potential confounders, we found a significant indirect effect of healthier diet on lower risk of asthma symptoms incidence mediated by lower BMI (OR for AHEI-2010 quintile 5 vs quintile 1 = 0.95 (0.92-0.97)), without significant total (OR=0.87 (0.66-1.10)) nor direct (OR=0.92 (0.71-1.15)) effects. Among women with asthma symptoms, we also found a significant indirect effect of healthier diet on reduced asthma symptoms mediated by lower BMI (OR for AHEI-2010 >median <i>vs</i> ≤median=1.02 (1.00-1.03)) without significant total (OR=1.12 (0.94-1.34)) nor direct effects (OR=1.10 (0.93-1.31)).</p><p><strong>Conclusion: </strong>A healthy diet was associated with reduced risk of asthma symptoms over time, partly through a lower BMI.</p>\",\"PeriodicalId\":73537,\"journal\":{\"name\":\"JAR life\",\"volume\":\"14 \",\"pages\":\"100011\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-04-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12008553/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JAR life\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jarlif.2025.100011\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JAR life","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.jarlif.2025.100011","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
Mediating role of the body mass index in the prospective association between a healthy diet and evolution of asthma symptoms in elderly women.
Objectives: Diet and obesity exhibit complex interrelationships with asthma, particularly among elderly women. We aimed to clarify the impact of healthy diet assessed by the Alternate Healthy Eating Index-2010 (AHEI-2010) on: 1) the incidence of asthma symptoms, and 2) among women with symptoms in 2011, the change in asthma symptoms, while accounting for the potential mediating role of BMI.
Design: A nested case-control study on asthma with follow-up data.
Setting: Within the French E3N cohort.
Participants: 8621 elderly women (62 years on average in 1993).
Measurements: Dietary data were collected in 1993 and 2005 using semi-quantitative questionnaires. Using the validated asthma symptom score assessed in 2011 and 2018, asthma symptom incidence among women with no asthma symptom in 2011 (n = 5700) and change in asthma symptoms (reduced, stable, increased) among those with asthma symptoms in 2011 (n = 2921) were defined. BMI was calculated in 2008. Marginal structural models were used to estimate total, direct and indirect effects mediated by BMI.
Results: After adjustment for potential confounders, we found a significant indirect effect of healthier diet on lower risk of asthma symptoms incidence mediated by lower BMI (OR for AHEI-2010 quintile 5 vs quintile 1 = 0.95 (0.92-0.97)), without significant total (OR=0.87 (0.66-1.10)) nor direct (OR=0.92 (0.71-1.15)) effects. Among women with asthma symptoms, we also found a significant indirect effect of healthier diet on reduced asthma symptoms mediated by lower BMI (OR for AHEI-2010 >median vs ≤median=1.02 (1.00-1.03)) without significant total (OR=1.12 (0.94-1.34)) nor direct effects (OR=1.10 (0.93-1.31)).
Conclusion: A healthy diet was associated with reduced risk of asthma symptoms over time, partly through a lower BMI.
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