Physical activity and diet in mild-to-severe asthmatics: a cluster analysis

<bold>Introduction:</bold> Dietary Inflammatory Index (DII) assesses the role of diet in relation to its inflammatory potential. Positive values indicate a proinflammatory diet while negative anti-inflammatory. International Physical Activity Questionnaire (IPAQ) measures physical activity (PA) in populations. <bold>Aim of the study:</bold> In this pilot study we evaluated a cohort of mild-moderate-to severe asthmatic patients to define potential clusters based on DII, IPAQ and age. <bold>Methods:</bold> K-means cluster analysis was performed in 60 mild-moderate to severe asthmatics recruited until January 2024: n=30 GINA STEP from 1 to 3, n=30 GINA STEP 4-5. DII and IPAQ were calculated for each subject. 5 groups were identified: inactive young with negative DII (IY, N=8), active young with positive DII (AY, N=7), inactive elderly with negative DII (IEN, N=18), very active elderly with positive DII (VAE, N=7), inactive elderly with positive DII (IEP, N=20). <bold>Results:</bold> AY had lower BMI, ICS equivalent dose, LTRAs treatment, SNOT-22, ER accesses, total IgE, peripheral neutrophil/eosinophils count, LDL/cholesterol levels, less obesity, dyslipidemia, higher ACT, FEV1 abs, FVC abs compared to IY. IEN showed a T2 profile with more exacerbations/year, nasal polyposis, sinusitis, higher doses of daily ICS, LDL/cholesterol levels and lower ACT. VAE had a T2 profile too, with more atopy, rhinitis, less obesity, hypertension, dyslipidemia, LDL/cholesterol levels and A1AT values. IEP showed a non-T2 profile with higher parameters correlated to metabolic syndrome. <bold>Conclusions:</bold> PA seems to have a greater impact than diet on asthma outcomes, in both young and elderly patients. Extensive studies are needed to better define the mutual role of PA and diet in asthma.