A groundbreaking study published in Pediatric Investigation on September 4, 2025, has unveiled vital insights into the complex relationship between childhood dietary preferences and the risk of developing asthma. This large-scale observational study, conducted among first-grade primary school children in Shanghai, examined how different food preferences, especially those for pickled, smoked, and fried foods, can influence respiratory health outcomes in early childhood. Intriguingly, the research also found a protective link associated with seafood consumption, shedding light on potential nutritional interventions to mitigate asthma risk.
Asthma remains a pervasive chronic inflammatory disorder of the airways, affecting millions of children worldwide with increasing prevalence. Although genetic predisposition and environmental exposures have long been implicated in its pathogenesis, the role of diet, particularly food choices made in early childhood, has been less extensively explored. This study fills a critical gap by investigating how flavor and texture preferences might correlate with susceptibility to airway inflammation and bronchial hyperreactivity, potentially informing public health strategies.
The research team surveyed a massive cohort of 8,412 children, approximately 6.6 years of age, from 42 public schools in Shanghai’s Minhang District. Parents completed detailed questionnaires regarding their children’s dietary habits and medical histories. Simultaneously, trained healthcare professionals performed systematic physical examinations to document respiratory health and verify asthma diagnoses. The use of logistic regression models enabled precise estimation of associations between specific dietary preferences and asthma prevalence while adjusting for various confounders.
One of the key findings from the study was the significantly elevated risk of asthma among children who preferred pickled and smoked foods. Statistically, these children demonstrated an odds ratio of 1.81 for asthma compared to peers who did not favor such foods, indicating nearly twice the likelihood of having the condition. This robust association may relate to the chemical composition of these foods, which often contain high levels of nitrites, polycyclic aromatic hydrocarbons, and sodium, compounds known to induce oxidative stress and exacerbate airway inflammation.
Another compelling aspect was the observed sex-specific difference in asthma risk linked to dietary preference. Girls displaying a pronounced liking for fried foods showed a staggering odds ratio of 14.72 for asthma, emphasizing a potentially heightened vulnerability. Boys, conversely, were especially susceptible when choosing pickled and smoked items, with an odds ratio of 2.01. These divergent patterns underscore the possible interaction between sex hormones, airway physiology, and environmental exposures influenced by diet, highlighting the need for tailored preventive approaches.
Contrasting the risks associated with certain processed foods, the preference for seafood presented a fascinating protective effect, particularly among children with normal body weight. The consumption of seafood correlated with a 40% reduction in asthma risk (OR 0.60). This benefit likely stems from the anti-inflammatory properties of omega-3 fatty acids prevalent in marine products and the immunoregulatory role of vitamin D, which is abundant in many types of seafood. These nutrients may help modulate inflammatory pathways and improve airway barrier functions.
The research meticulously examines the biological mechanisms underpinning these associations. Pickled and smoked foods’ high salt content may activate epithelial sodium channels within the airways, leading to surface dehydration and subsequent bronchoconstriction—a hallmark of asthma attacks. Additionally, nitrites and polycyclic aromatic hydrocarbons can impair epithelial integrity and promote Th2-mediated inflammation, a core immunological process in asthma. These pathophysiological effects provide a scientific rationale for why certain dietary patterns amplify asthma risk.
Conversely, omega-3 fatty acids derived from seafood attenuate inflammation by shifting immune responses toward a less reactive state and reducing the production of pro-inflammatory cytokines. Vitamin D further supports immune homeostasis by enhancing regulatory T-cell activity, potentially dampening hypersensitivity reactions in the lung. These protective biochemical effects elucidate why seafood consumption may confer resilience against asthma development in children.
The epidemiological findings align with broader trends reported across China, where childhood asthma prevalence has surged from under 1% in 1990 to beyond 3% two decades later. The Minhang cohort displayed an asthma prevalence of approximately 4.66%, corroborating the troubling upward trajectory. This rise not only reflects improved disease recognition but also points to evolving environmental and lifestyle factors, such as urbanization, air pollution, and dietary modernization—all contributing to a compounded public health challenge.
This study’s cross-sectional design limits causal inference, yet the substantial sample size and comprehensive adjustments for potential confounders lend credence to the notable associations identified. The data accentuate how dietary habits represent a modifiable factor within the constellation of asthma determinants, inviting further longitudinal exploration and intervention trials to validate causality and investigate mechanisms at a molecular level.
Looking forward, the researchers advocate for advanced longitudinal studies employing metabolomic profiling to decipher metabolic signatures linked with dietary exposures and asthma outcomes. Such comprehensive biomarker investigations could illuminate metabolic pathways and predict asthma susceptibility, facilitating personalized preventive strategies tailored to a child’s dietary pattern and genetic makeup.
The public health implications are profound. As processed, pickled, and fried foods become increasingly prevalent in children’s diets globally, efforts to promote healthier alternatives rich in anti-inflammatory nutrients are urgently needed. Policymakers, educators, and parents should collaborate to implement dietary guidelines emphasizing balanced meals, including seafood, fruits, and vegetables, to potentially curb the burgeoning asthma epidemic among children.
Dr. Zengliang Ruan, the study’s corresponding author and Associate Professor at Southeast University’s School of Public Health, emphasized: “Our findings reveal that seemingly innocuous food preferences during early childhood may have lasting consequences on respiratory health. Modifying dietary choices could emerge as a practical strategy for asthma prevention, supplementing traditional approaches focused on genetics and environment.”
This research contributes a compelling piece to the intricate puzzle of asthma etiology, integrating nutrition science with respiratory epidemiology. By unveiling nuanced relationships between diet and airway disease, it opens new avenues for risk assessment and health promotion focused on lifestyle factors that are amenable to change. In a world with increasing asthma burdens, such insights could help reduce childhood morbidity and improve quality of life globally.
Subject of Research: People
Article Title: Association between dietary preferences and asthma among first-grade primary school children
News Publication Date: 4-Sep-2025
Web References: https://doi.org/10.1002/ped4.70021
References: 10.1002/ped4.70021
Image Credits: Pediatric Investigation
Keywords: Asthma, Pediatrics, Public Health, Nutrition, Respiratory Disorders, Epidemiology, Preventive Medicine, Risk Factors, Environmental Health, Food Science
