Nutrition Research and Practice

The Korean Nutrition Society (한국영양학회)
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Associations of dietary vitamin A and C intake with asthma, allergic rhinitis, and allergic respiratory diseases

  • Carolina Garcia-Garcia (Department of Foods and Nutrition, College of Science and Technology, Kookmin University) ;
  • Minju Kim (Department of Foods and Nutrition, College of Science and Technology, Kookmin University) ;
  • Inkyung Baik (Department of Foods and Nutrition, College of Science and Technology, Kookmin University)
  • Received : 2022.10.05
  • Accepted : 2023.07.20
  • Published : 2023.10.01
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Abstract

BACKGROUND/OBJECTIVES: Asthma and allergic rhinitis (AR) are closely related and considered as allergic respiratory diseases (ARD), and their prevalence has recently increased. Data on the association of dietary antioxidant vitamin intake with asthma and AR in adults are limited. The present study aimed to investigate the associations of vitamin A and C intake with asthma, AR, and all cases of both diseases in young adults who participated in a cross-sectional national survey, with the use of high-sensitivity C-reactive protein (hs-CRP) level as an effect modifier. SUBJECTS/METHODS: This study included 6,293 male and female adults aged 20-49 years from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted between 2016 and 2018. The questionnaire-based reports on asthma and AR diagnosis were used to determine outcome variables. Further, 24-h recall data on dietary vitamin A and C, carotene, and retinol intake were acquired. Logistic regression analysis was performed to calculate odds ratios (ORs) and 95% confidence interval (CI). RESULTS: Dietary vitamin C intake was inversely associated with asthma prevalence among participants with hs-CRP levels (≥ 1 mg/L); the OR of asthma prevalence was 0.27 (95% CI, 0.08-0.84) for participants with vitamin C consumption ≥ 75 mg/day compared with those consuming < 20 mg/day. Similar association analyses limiting to non-users of dietary supplements were performed to rule out the potential effects of supplement intake on the outcomes; results showed a stronger association. However, the association between vitamin C and asthma was not significant in participants with hs-CRP levels < 1 mg/L; the OR of asthma was 1.44 (95% CI, 0.66-3.16) for participants with vitamin C consumption ≥ 75 mg/day compared with those consuming < 20 mg/day. Vitamin C intake was not associated with AR. Moreover, there was no association between vitamin A intake and neither asthma nor AR. CONCLUSIONS: These findings suggest that higher vitamin C intake may play a potential role in reducing asthma prevalence. Nevertheless, further studies should be conducted to evaluate whether this association is causal.

Keywords

Acknowledgement

This study was supported by National Research Foundation of Korea Grant funded by the Korean Government (NRF2019R1A2C2084000).

References

  1. Pawankar R, Canonica GW, Holgate ST, Lockey RF, Blaiss MS. World Allergy Organisation (WAO) White Book on Allergy: Update 2013. Milwaukee (WI): World Allergy Organization; 2013.
  2. Pawankar R. Allergic diseases and asthma: a global public health concern and a call to action. World Allergy Organ J 2014;7:12.
  3. Ha J, Lee SW, Yon DK. Ten-year trends and prevalence of asthma, allergic rhinitis, and atopic dermatitis among the Korean population, 2008-2017. Clin Exp Pediatr 2020;63:278-83. https://doi.org/10.3345/cep.2019.01291
  4. Kim SY, Yoon SJ, Jo MW, Kim EJ, Kim HJ, Oh IH. Economic burden of allergic rhinitis in Korea. Am J Rhinol Allergy 2010;24:e110-3. https://doi.org/10.2500/ajra.2010.24.3513
  5. Lee EW, Kim HS, Kim W, Nam JY, Park JH. Socioeconomic burden of disease due to asthma in South Korea. Asia Pac J Public Health 2020;32:188-93. https://doi.org/10.1177/1010539520920524
  6. Nicolaou N, Siddique N, Custovic A. Allergic disease in urban and rural populations: increasing prevalence with increasing urbanization. Allergy 2005;60:1357-60. https://doi.org/10.1111/j.1398-9995.2005.00961.x
  7. Rutkowski K, Sowa P, Rutkowska-Talipska J, Sulkowski S, Rutkowski R. Allergic diseases: the price of civilisational progress. Postepy Dermatol Alergol 2014;31:77-83. https://doi.org/10.5114/pdia.2014.40936
  8. Allen S, Britton JR, Leonardi-Bee JA. Association between antioxidant vitamins and asthma outcome measures: systematic review and meta-analysis. Thorax 2009;64:610-9. https://doi.org/10.1136/thx.2008.101469
  9. Sargeant LA, Jaeckel A, Wareham NJ. Interaction of vitamin C with the relation between smoking and obstructive airways disease in EPIC Norfolk. European Prospective Investigation into Cancer and Nutrition. Eur Respir J 2000;16:397-403. https://doi.org/10.1034/j.1399-3003.2000.016003397.x
  10. Bai YJ, Dai RJ. Serum levels of vitamin A and 25-hydroxyvitamin D3 (25OHD3) as reflectors of pulmonary function and quality of life (QOL) in children with stable asthma: A case-control study. Medicine (Baltimore) 2018;97:e9830.
  11. Seo JH, Kwon SO, Lee SY, Kim HY, Kwon JW, Kim BJ, Yu J, Kim HB, Kim WK, Jang GC, et al. Association of antioxidants with allergic rhinitis in children from Seoul. Allergy Asthma Immunol Res 2013;5:81-7. https://doi.org/10.4168/aair.2013.5.2.81
  12. Kompauer I, Heinrich J, Wolfram G, Linseisen J. Association of carotenoids, tocopherols and vitamin C in plasma with allergic rhinitis and allergic sensitisation in adults. Public Health Nutr 2006;9:472-9. https://doi.org/10.1079/PHN2005868
  13. Lee E, Suh DI, Lee SY, Jung S, Yoon SJ, Cho HJ, Kim Y, Yang SI, Kwon JW, Jang GC, et al. Association between sensitization and allergic diseases in 7-years-old Korean children. Asian Pac J Allergy Immunol 2021;39:231-40.
  14. Qian FH, Zhang Q, Zhou LF, Liu H, Huang M, Zhang XL, Yin KS. High-sensitivity C-reactive protein: a predicative marker in severe asthma. Respirology 2008;13:664-9. https://doi.org/10.1111/j.1440-1843.2008.01314.x
  15. Kweon S, Kim Y, Jang MJ, Kim Y, Kim K, Choi S, Chun C, Khang YH, Oh K. Data resource profile: the Korea National Health and Nutrition Examination Survey (KNHANES). Int J Epidemiol 2014;43:69-77. https://doi.org/10.1093/ije/dyt228
  16. Bergeron C, Hamid Q. Relationship between asthma and rhinitis: Epidemiologic, pathophysiologic, and therapeutic aspects. Allergy Asthma Clin Immunol 2005;1:81-7.
  17. Fujita M, Ueki S, Ito W, Chiba T, Takeda M, Saito N, Kayaba H, Chihara J. C-reactive protein levels in the serum of asthmatic patients. Ann Allergy Asthma Immunol 2007;99:48-53. https://doi.org/10.1016/S1081-1206(10)60620-5
  18. Kilic H, Karalezli A, Hasanoglu HC, Erel O, Ates C. The relationship between hs-CRP and asthma control test in asthmatic patients. Allergol Immunopathol (Madr) 2012;40:362-7. https://doi.org/10.1016/j.aller.2011.10.002
  19. Sahiner UM, Birben E, Erzurum S, Sackesen C, Kalayci O. Oxidative stress in asthma: part of the puzzle. Pediatr Allergy Immunol 2018;29:789-800. https://doi.org/10.1111/pai.12965
  20. Barrera-Mendoza CC, Ayala-Mata F, Cortes-Rojo C, Garcia-Perez ME, Rodriguez-Orozco AR. Antioxidant vitamins in asthma. Alergia 2018;65:61-77.
  21. Khan DA. Allergic rhinitis and asthma: epidemiology and common pathophysiology. Allergy Asthma Proc 2014;35:357-61. https://doi.org/10.2500/aap.2014.35.3794
  22. Kubota Y, Moriyama Y, Yamagishi K, Tanigawa T, Noda H, Yokota K, Harada M, Inagawa M, Oshima M, Sato S, et al. Serum vitamin C concentration and hs-CRP level in middle-aged Japanese men and women. Atherosclerosis 2010;208:496-500. https://doi.org/10.1016/j.atherosclerosis.2009.07.052