Sheryl Rifas-Shiman, MPH

In the December 2017 online issue of the Annals of the American Thoracic Society, several colleagues and I reported that children who consumed high amounts of fructose in early childhood or whose mothers drank a lot of sugary beverages while pregnant may be at greater risk for developing asthma in mid-childhood.
In “Prenatal and Early-life Fructose, Fructose-containing Beverages, and Mid-Childhood Asthma,” we looked at 1,068 mother-child pairs in Project Viva, a pre-birth cohort study in Massachusetts designed to find ways to improve the health of mothers and their children.

Previous studies have linked intake of sugary beverages with obesity, and obesity with asthma in school children. But there is little information about when exposure to sugary beverages and fructose during early development might influence later health.

In Project Viva, mothers reported their consumption of foods and beverages during their first and second trimesters of pregnancy, including regular soda and fruit drinks. When their children reached early childhood (~3.3 years), the mothers reported their children’s consumption of foods and beverages. Based on these responses, we computed fructose intake for both the moms and kids and analyzed results based on quartiles of sugary beverage and fructose consumption.

It was important to look at fructose consumption because it is a major contributor to total sugar intake, and may have specific effects on our airways.

We defined asthma in mid-childhood (~7.7 years) as a mother’s report of a doctor’s diagnosis of asthma, plus wheezing or asthma medication use in the past year. In our study, 19 percent of the children had asthma.

We found that mothers in the highest quartile of sugary beverage and fructose consumption during pregnancy had 70% and 58% higher odds, respectively, of having children with asthma than those in the lowest quartile, when adjusted for pre-pregnancy body mass, age, race/ethnicity and other factors that may have affected the results.

Children in the highest quartile of fructose consumption during their early childhoods had 79% higher odds of having asthma in mid-childhood than those in the lowest quartile. These associations held even after we adjusted for the child’s body mass.

Other studies have found links between obesity and asthma, and between sugary drinks and high fructose intake and increased asthma risk. Recent studies suggest that in addition to increasing asthma risk through obesity, fructose itself may cause inflammation in the lungs.

Parents have many reasons to limit intake of sugary beverages, both for themselves and for their children. Both pregnant women and kids should drink water or milk as their preferred beverages.

Our observational study cannot prove a direct cause-and-effect relationship between sugary beverages, fructose consumption, and asthma. Still, avoiding high consumption of sugary beverages during pregnancy and in early childhood could be one of several ways to reduce the risk of childhood asthma.



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