Longitudinal Association Between Diet Quality and Asthma Symptoms in Early Adult Life in a Brazilian Birth Cohort

Figures & data

Table 1 Score of the Revised Version of the Brazilian Healthy Eating Index (IQD-R)

Components	Criterion for Minimum Score	Criterion for Intermediate Score	Criterion for Maximum Score
			Portions	Points
Total Vegetables			1.0 portion/1000 kcal	5 points
Dark-green and orange vegetables	No Consumption	Proportional	0.5 portion/1000 Kcal
Total fruits	0 points	Calculation	1.5 portion/1000 kcal
Total grains			3 portions/1000 kcal
Milk and dairy products			1.5 portions/1000 kcal
Meat, eggs, and legumes			1.0 portion/1000 kcal	10 points
Oils			0.5 portion/1000 kcal
Saturated fat	≥ 15% of TEV^a 0 points	10% of TEV 8 points	≤ 7% of TEV
Sodium	≥ 2.0 g/1000 kcal 0 points	1 g/1000 kcal 8 points	≤ 0.75 g/1000 Kcal
SoFAAS ^b	≥ 35% of TEV 0 points	Proportional calculation	≤ 10% of TEV	20 points
TOTAL				100 points

Notes: ^aTEV: total energy value: ^bSoFAAS – calories from solid fat, alcohol, and added sugar. Reproduced and translated from Castilhos CB de, Schneider BC, Muniz LC, Assunção MCF. Quality of the diet of 18-year-old adolescents belonging to the birth cohort of 1993 in Pelotas in the State of Rio Grande do Sul, Brazil. Cien Saude Colet [Internet]. 2015 Nov;20(11):3309. Creative Commons license and disclaimer available from: http://creativecommons.org/licenses/by/4.0/legalcode.¹⁵

Table 2 Characteristics of 1993 Pelotas (Brazil) Birth Cohort Study Participants

Variables	1993 Birth Cohort				p value
	Baseline 18y Follow-Up		Sample (Valid Information at 18y and 22y)
	N	%	N	%
	4106		2986
Gender					0.314
Male	2015	49.1	1451	48.6
Female	2091	50.9	1535	51.4
Skin color					0.028
White	2526	64.2	1894	65.3
Black	568	14.4	405	14.0
Brown	697	17.7	490	16.9
Other	143	3.6	111	3.8
Head of house schooling (years)					0.049
0–4	1022	26.3	714	25.1
5–8	1347	34.6	999	35.1
9–11	993	25.5	743	26.1
≥12	527	13.5	389	13.7
Participant schooling (years)					<0.001
0–4	196	4.8	107	3.6
5–8	1663	41.0	1101	36.9
9–11	2085	50.8	1657	55.5
≥12	160	3.9	119	4.0
Asset index (quintiles)					<0.001
1° (lowest)	837	20.4	534	17.9
2°	803	19.6	587	19.7
3°	821	20	614	20.6
4°	822	20	629	21.1
5° (higher)	820	20	620	20.8
Smoking					<0.001
No	3179	77.4	2392	80.1
Yes	926	22.6	594	19.9
Alcohol abuse					0.084
No	3020	73.6	2218	74.3
Yes	1086	26.5	768	25.7
Physical activity (300min or +/week)					0.187
No	1600	39.1	1185	39.7
Yes	2495	60.9	1801	60.3
Body mass index classification					<0.001
Low weight	53	1.3	42	1.4
Normal weight	2828	71.4	2177	72.9
Overweight	680	17.2	498	16.7
Obesity	400	10.1	269	9.0

Table 3 Median and Mean of Score Total, Components and Tertiles of Revised Brazilian Healthy Eating Index (IQD-R) at 18 and 22 Years of Age. 1993 Pelotas (Brazil) Birth Cohort. (n=2986)

Diet Quality	18 y			22 y
	Median	Mean	SD	Median	Mean	SD
IQD-R total score	62.2	62.0	11.9	60.8	61.3	10.9
IQD-R component score
Fruits	2.3	3.7	3.5	0.8	1.5	1.9
Grains	4.0	5.2	3.0	3.8	4.9	2.9
Milk and dairy products	2.9	3.7	3.0	4.2	4.8	3.1
Meat, eggs, and legumes	8.2	7.7	2.5	9.1	8.1	2.3
Vegetables	4.2	3.4	1.8	5.0	4.0	1.5
Dark-green and orange vegetables	3.3	3.0	2.0	5.0	3.3	2.0
Sodium	9.9	9.3	1.1	10.0	6.6	0.8
Saturated fat	7.9	6.9	2.7	7.1	6.3	2.9
Oils	10	10	0.03	10	10	0.03
SoFAAS^#	10.1	9.3	8.0	8.7	8.8	7.9
IQD-R tertile score
1º (poor)	50.3	48.9	6.1	50.5	49.4	5.0
2º (intermediate)	62.4	62.3	3.1	60.9	61.0	3.1
3º (good)	74.3	75.2	5.4	72.6	73.6	5.2

Notes: ^#SoFAAS – calories from solid fat, alcohol, and added sugar.

Table 4 Chest Wheezing and Wheezing Events Number Last 12 Months at 22 Years Age According to Mean Score of Total and Components of Revised Brazilian Healthy Eating Index (IQD-R) at 18 and 22 Years Age. 1993 Pelotas (Brazil) Birth Cohort. (n=2986)

Diet quality	Wheezing Last 12 Monthsat 22y			Wheezing Events Number Last 12 Monthsat 22y
	No	Yes	p value	None	1 to 3	≥4	p value
	µ (SD)	µ (SD)		µ (SD)	µ (SD)	µ (SD)
At 18y
IQD-R total score	62.3 (11.9)	59.2 (11.5)	<0.001	62.2 (11.9)	60.0 (11.8)	57.8 (11.0)	<0.001
IQD-R component score
Fruits	3.6 (3.5)	3.4 (3.0)	0.211	3.7 (3.5)	3.4 (3.3)	3.3 (3.3)	0.431
Grains	5.2 (3.0)	4.9 (3.0)	0.179	5.2 (3.0)	5.0 (3.0)	4.9 (2.8)	0.454
Milk and dairy products	3.7 (3.0)	3.4 (3.1)	0.050	3.7 (3.0)	3.3 (3.0)	3.4 (3.2)	0.117
Meat, eggs, and legumes	7.7 (2.4)	7.7 (2.5)	0.877	7.7 (2.4)	7.7 (2.6)	7.6 (2.5)	0.953
Vegetables	3.4 (1.8)	3.4 (1.8)	0.992	3.4 (1.8)	3.4 (1.8)	3.2 (1.9)	0.596
Dark-green and orange vegetables	3.0 (2.0)	3.0 (2.0)	0.939	3.0 (2.0)	3.1 (2.0)	2.6 (2.1)	0.109
Sodium	9.3 (1.1)	9.3 (1.0)	0.765	9.3 (1.1)	9.3 (1.0)	9.2 (1.1)	0.634
Saturated fat	6.9 (2.7)	6.8 (2.8)	0.659	6.9 (2.7)	6.7 (2.8)	7.0 (2.6)	0.590
Oils	10 (0.0)	10 (0.0)	0.623	10 (0.0)	10 (0.0)	10 (0.0)	0.889
SoFAAS^#	9.5 (7.9)	7.4 (8.0)	<0.001	9.5 (7.9)	8.0 (8.2)	6.5 (7.6)	<0.001
At 22y
IQD-R total score	61.5 (10.8)	59.1 (10.9)	<0.001	61.5 (10.8)	59.7 (10.6)	58.0 (10.1)	<0.01
IQD-R component score
Fruits	1.5 (2.0)	1.5 (1.9)	0.859	1.5 (2.0)	1.5 (1.9)	1.5 (2.0)	0.952
Grains	4.9 (2.9)	4.7 (2.9)	0.310	4.9 (2.9)	4.7 (2.9)	4.8 (2.9)	0.423
Milk and dairy products	4.8 (3.1)	4.6 (3.0)	0.242	4.8 (3.1)	4.7 (3.0)	4.3 (3.0)	0.262
Meat, eggs, and legumes	8.1 (2.3)	8.0 (2.4)	0.584	8.1 (2.3)	8.1 (2.4)	7.9 (2.5)	0.727
Vegetables	4.0 (1.5)	3.8 (1.6)	0.171	4.0 (1.5)	3.9 (1.6)	3.7 (1.7)	0.246
Dark-green and orange vegetables	3.3 (2.0)	3.2 (2.0)	0.363	3.3 (2.0)	3.2 (2.0)	3.2 (2.0)	0.695
Sodium	9.6 (0.8)	9.6 (0.9)	0.265	9.6 (0.8)	9.6 (0.9)	9.5 (0.9)	0.386
Saturated fat	6.3 (2.9)	6.3 (3.0)	0.692	6.3 (2.9)	6.3 (3.0)	6.3 (3.0)	0.918
Oils	10 (0.0)	10 (0.0)	0.738	10 (0.0)	10 (0.0)	10 (0.0)	0.947
SoFAAS^#	9.0 (7.9)	7.4 (7.9)	<0.001	8.9 (7.9)	7.8 (7.8)	6.9 (8.0)	<0.01

Notes: ^#SoFAAS – calories from solid fat, alcohol, and added sugar. Values with significance of p value<0.05 are shown in bold.

Table 5 Chest Wheezing and Wheezing Events Number Last 12 Months at 22 Years Age According to Total Score, Components, Tertiles and Continuity of Revised Brazilian Healthy Eating Index (IQD-R) from 18 to 22 Years Age. 1993 Pelotas (Brazil) Birth Cohort. (n=2986)

Diet Quality	Wheezing Last 12 Monthsat 22y *				Wheezing Events Number Last 12 Months at 22y **
	Crude		Adjusted		Crude		Adjusted
	OR	IC95%	OR	IC95%	OR	IC95%	OR	IC95%
At 18y
IQD-R total score	0.98	0.97–0.99	0.99	0.97–0.99	0.98	0.97–0.99	0.99	0.97–0.99
IQD-R tertile score
1º (poor)	2.21	1.62–3.03	1.97	1.33–2.91	2.17	1.58–2.96	2.06	1.40–3.04
2º (intermediate)	1.71	1.23–2.37	1.54	1.04–2.27	1.65	1.18–2.29	1.53	1.04–2.25
3º (good)	Ref.	-	Ref.	-	Ref.	-	Ref.	-
At 22y
IQD-R total score	0.98	0.97–0.99	0.97	0.96–0.98	0.98	0.97–0.99	0.97	0.96–0.99
IQD-R tertile score
1º (poor)	1.61	1.20–2.16	1.98	1.36–2.87	1.59	1.18–2.15	1.97	1.36–2.85
2º (intermediate)	1.12	0.82–1.53	1.38	0.94–2.03	1.13	0.83–1.55	1.39	0.95–2.04
3º (good)	Ref.	-	Ref.	-	Ref.	-	Ref.	-
From 18y to 22y
IQD-R continuity in tertile
Always poor (16.9%)	3.09	1.94–4.91	3.28	1.84–5.84	3.03	1.90–4.83	3.32	1.89–5.85
Intermediate (67.1%)	1.92	1.26–2.92	2.13	1.29–3.52	1.85	1.21–2.82	1.99	1.21–3.26
Always good (16.0%)	Ref.	-	Ref.	-	Ref.	-	Ref.	-

Notes: Values with significance of p value<0.05 are shown in bold. * Logistic regression. ** Ordinal logistic regression. Adjustment variables: sex, skin color, assets index, participant schooling, head of a family schooling, maternal history of asthma, alcohol abuse, physical activity, corticosteroid or inhaler use and wheezing at 18 years of age.