Association between wheezing and dietary patterns among 5- to 6-year-old preschool children in Tshwane, South Africa

BackgroundDietary patterns influence inflammation and immune responses, playing a critical role in childhood asthma. Wheezing is a common respiratory symptom, with approximately half of all children experiencing at least one episode during early childhood.AimTo investigate associations between dietary patterns and wheezing among 5- to 6-year-old preschool children in Tshwane, South Africa.MethodsAn observational cross-sectional study was conducted between January 2022 and March 2023. A total of 630 children from 40 randomly selected preschools participated. Parents completed a modified International Study of Asthma and Allergies in Childhood Phase III questionnaire. Univariable and multiple logistic regression models estimated adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for associations between dietary intake and wheezing. Most participants were from Soshanguve (50.3%), with a median age of 5 years. Ever wheeze and current wheeze were reported in 12.4% and 9.8% of children, respectively. Consumption of meat (≥3 times/week), seafood (1-2 times/week) and vegetables (≥3 times/week) was associated with lower odds of ever wheezing (meat: AOR = 0.27, 95% CI: 0.10-0.75; seafood: AOR = 0.24, 95% CI: 0.13-0.46; vegetables: AOR = 0.32, 95% CI: 0.11-0.93), while no clear associations were observed for current wheeze.SummaryHigher consumption of meat, seafood and vegetables was linked to lower odds of ever wheezing in Tshwane preschool children. Promoting nutrient-rich dietary patterns may help prevent early-life respiratory symptoms in underserved communities.