Plant-Based Diets and the Incidence of Asthma Symptoms among Elderly Women, and the Mediating Role of Body Mass Index

• Published in: Nutrients Vol. 15; no. 1; p. 52
• Main Authors: Ait-Hadad, Wassila, Bédard, Annabelle, Delvert, Rosalie, Orsi, Laurent, Chanoine, Sébastien, Dumas, Orianne, Laouali, Nasser, Le Moual, Nicole, Leynaert, Bénédicte, Siroux, Valérie, Boutron-Ruault, Marie-Christine, Varraso, Raphaëlle
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01-01-2023; MDPI
• Subjects: Aged; Analysis; Asthma; asthma prevention; Body mass; Body mass index; Body size; Cardiovascular disease; Chronic illnesses; Diet; Evaluation; Food; Food and Nutrition; Grain; healthful plant-based diet index; incidence of asthma symptoms; Life Sciences; Mediation; Middle age; Nutritive value; Obesity; Older people; Questionnaires; unhealthful plant-based diet index; Womens health; France; incidence of asthma symptoms; body mass index; smoking; unhealthful plant-based diet index; counterfactual framework; healthful plant-based diet index; asthma prevention; mediation analyses; obesity
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu15010052

We aimed to test the hypothesis that adherence to a healthful plant-based diet (hPDI) is associated with a subsequent decrease in the incidence of asthma symptoms, with an opposite association with adherence to an unhealthful plant-based diet (uPDI). In addition, we evaluated a potential mediating role of body mass index (BMI) and the modifying effect of smoking. Among 5700 elderly women from the French Asthma-E3N study with dietary data in 1993 and 2005, we assessed the incidence of asthma symptoms in 2018 among women with no asthma symptoms in 2011. BMI was evaluated in 2008. Mediation analyses in the counterfactual framework were used to disentangle total, direct, and indirect effects mediated by BMI. We found that both healthful and unhealthful plant-based diets were associated with a lower incidence of asthma symptoms over time, mediated by BMI (OR (95%CI) for the indirect effect: 0.94 (0.89-1.00) for hPDI and 0.92 (0.70-1.00) for uPDI)). Associations with both healthful and unhealthful PDIs were mediated by changes in BMI by 33% and 89%, respectively. Plant-based diets (healthful and unhealthful) were associated with subsequently reduced incidences of asthma symptoms over time, partly or almost totally mediated by BMI according to their nutritional quality.