Advance-CTR

Advance RI-CTR Pilot Projects Program (Cycle 10)

"The Role of Dietary Patterns in Biomarkers and Clinical Outcomes of Urban Children with Asthma"

Asthma disproportionately affects children living in U.S. urban areas, such as Greater Providence, Rhode Island, and is highly comorbid with overweight/obesity (OW/OB). Diet is a modifiable lifestyle behavior that has potential to address both asthma and OW/OB in this population. Prior dietary interventions resulted in improved asthma clinical indicators in adults and children, but no work to date has considered potential additive roles of diet quality, quantity, and timing in childhood asthma, especially in the U.S. urban context.

This knowledge will be critical to inform future multi-component lifestyle interventions for urban children with asthma and at high risk for comorbid OW/OB. Moreover, diet can affect airway inflammatory and gut microbial metabolic biomarkers important to both asthma and OW/OB. An improved understanding of these biomarkers that may be sensitive to dietary patterns and predictive of clinical outcomes may enable us to track individual treatment responses and tailor intervention approaches. To address these gaps, we propose to conduct a multi-method, daily observational study with urban RI children with asthma and their caregivers to examine associations between dietary patterns (quality, quantity, timing), asthma activity, and relevant biomarkers. The study has two primary and one exploratory aims:

1. to examine associations between dietary patterns (quality, quantity, and timing) and asthma outcomes (lung function, asthma control, symptoms) in urban children with persistent asthma
2. to examine associations between dietary patterns and relevant inflammatory (fractional exhaled nitric oxide; FeNO) and metabolic biomarkers (short-chain fatty acids; SCFA)
3. and to explore differences in these associations based on variability in weight status.

The proposed 14-day observational protocol will involve daily diet (weighed food diary), lung function (spirometry), and asthma symptoms (diary) assessments, and weekly FeNO (NIOX VERO®) and asthma control (caregiver-report) measures in children’s homes. We will also collect weekly serum SCFA in a randomly selected subsample of children (N=15)  to obtain pilot data. We will recruit children across the weight continuum to ensure variability and consider the role of weight status in the diet-asthma link.

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