The relationship between gut microbiota‐friendly diet and the prevalence and severity of asthma in children

OBJECTIVES: Dietary factors may impact asthma indirectly by modulating the composition and activity of the gut microbiota. This study aimed to explore the potential relationship between gut microbiota-friendly diet and both the prevalence and severity of asthma in children. METHODS: We selected a total of 2256 children from the 2021-2023 National Health and Nutrition Examination Survey. The gut microbiota-friendly diet was assessed using the Diet-Gut Microbiome Index (DI-GM), which incorporates 14 specific food constituents. To calculate the DI-GM, two non-consecutive 24-h dietary recalls data were used, from which the relevant food constituents were derived. A higher DI-GM score indicates greater alignment with a gut microbiota-friendly diet. RESULTS: Among the 2256 U.S. children, the weighted prevalence of asthma is 13.36%. In fully adjusted models, DI-GM was not significantly associated with asthma prevalence overall or within any subgroups. However, higher DI-GM (T2) was significantly associated with a lower risk of the mild asthma phenotype in the 5-16 age group. In contrast, no significant associations were observed between DI-GM and asthma severity in the other age groups. Subgroup analysis showed a higher DI-GM score was significantly correlated with a lower risk for asthma in subgroups stratified by obesity status. CONCLUSIONS: Higher DI-GM scores were significantly inversely associated with asthma severity risk in children aged 5-16 years and in obese individuals. These cross-sectional findings support the need for longitudinal studies to determine whether dietary modulation may affect asthma severity via microbiota-dependent mechanisms.