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At a Glance Commentary
Scientific Knowledge in the Subject
Dietary intake of fatty acids, specifically omega-3 and omega-6, may modify pediatric asthma morbidity.
What This Study Adds to the Field
We present associations between higher omega-6 intake and worse asthma severity and lung function in an urban cohort of children with asthma. Furthermore, higher omega-3 intake was associated with diminished harmful effect of indoor particulate matter (PM) exposure on respiratory symptoms, whereas higher omega-6 intake was associated with an amplified effect. Higher omega-6 intake also associated with an amplified effect of indoor PM on circulating neutrophil percentage, reflecting a modification of PM effects on systemic inflammation by fatty acid intake level. To our knowledge, this investigation represents the first evidence of a protective association between omega-3 and detrimental association between omega-6 and PM-induced asthma symptoms and systemic inflammation among school-age children with asthma. If confirmed in similar populations, alterations in omega-3 and omega-6 intake may provide opportunity for intervention to improve asthma health and reduce the harmful effects of indoor PM exposure.
Dietary intake among minority, inner city children and adolescents diverges sharply from national nutritional guidelines (1–3). This population is also disproportionately impacted by asthma (4), an inflammatory disease driven by environmental exposures, with dietary exposures also representing a potential driver of asthma morbidity (5). Dietary intake among the children largely conforms to a “Western” diet, characterized by higher intakes of unhealthy/processed foods and omega-6 fatty acids, and lower intake of healthy foods, such as fruits, vegetables, and items including omega-3 fatty acids (3, 6). These fatty acids are a source of biologically active molecules found in the lung, known as lipid-derived inflammatory mediators, providing biologic rationale for respiratory effects (7). Despite these connections, few investigations examine effects of omega-3 and omega-6 on asthma-related morbidity within pediatric populations (8).
Furthermore, children in the inner city often inhabit environments with indoor pollutants levels, specifically particulate matter (PM), that far exceed standards for acceptable ambient levels set by the Environmental Protection Agency or acceptable indoor levels set by the World Health Organization (9–13). Children with asthma spend a striking amount of the day (roughly 70% on average) indoors (14), and indoor home PM levels are independently associated with increased asthma morbidity (9). Dietary exposure to excess...