February 2011

Salty-Snack Eating, Television or Video-Game Viewing, and Asthma Symptoms among 10- to 12-Year-Old Children: The PANACEA Study.

Fotini Arvaniti, MSc, RD; Kostas N. Priftis, MD, PhD; Anastasios Papadimitriou, MD, PhD; Panayiotis Yiallouros, MD; Maria Kapsokefalou, PhD; Michael B. Anthracopoulos, MD, PhD; Demosthenes B. Panagiotakos, PhD.

The purpose of this cross-sectional PANACEA (Physical Activity, Nutrition and Allergies in Children Examined in Athens) study was to evaluate the associations of salty-snack intake and TV and video-game viewing, as well as their role together with the presence of asthma symptoms in 10-12 year old children.

The participants included 700 students (323 male, 377 female), aged 10-12 year old, who were selected from 18 schools in the Athens, Greece area during the period of 2005-2006. The schools were randomly selected from a list provided by the regional education offices. The participation rate was 83.5%. Those that were excluded from the study were girls who already began menstruation and children with chronic diseases that prohibited them from free running.

The parents/guardians of the participants as well as the participants themselves completed several questionnaires. First they completed the International Study of Asthma and Allergies in Childhood questionnaire to assess the presence of asthma symptoms in the children such as wheezing, disturbed sleep due to wheezing, asthma, and dry cough at night, except in cold or chest infection cases. Next, the participants completed a questionnaire developed for this study designed to collect demographical information as well as social and economic status information. Then a Food Frequency Questionnaire was administered by trained personnel to the children and parents. This questionnaire included 63 foods and beverages usually consumed in Greece. The participants’ adherence to the Mediterranean diet was also assessed using the KIDMED index. Lastly, the participants’ physical activity was assessed using the Physical Activity Lifestyle Questionnaire. The participants were also weighed and measured by the pediatricians of the study to ensure privacy.

Overall, consumption of salty snacks was positively associated with hours of TV/video-game viewing and inversely associated with adherence to the Mediterranean diet. Prevalence of asthma symptoms was 31% among children who reported > 2 hours of TV/video-game viewing daily and 22.9% among children reporting ≤ 2 hours of TV/video-game viewing daily. Overall prevalence of asthma symptoms in participants was 23.7%. Participants who spent > 2 hours of TV/video-game viewing and ate salty snacks ≥ 1 time/week were 1.48 times more likely to have asthma symptoms than children who did not eat salty snacks on a weekly basis. Children who reported ≤ 2 hours of TV/video-game viewing and ate salty snacks on a weekly basis were only 1.14 times more likely to have asthma symptoms than those who did not eat salty snacks. Additional analyses were performed controlling for various factors including age, sex, physical activity, BMI, and adherence to the Mediterranean diet. The analysis showed that participants who reported eating salty snacks more than 3 times per week were almost 6 times more likely to have asthma symptoms than participants who reported never or rare consumption. Also, higher adherence to the Mediterranean diet was independently associated with a lower likelihood of having asthma symptoms.

The authors concluded by suggesting that since asthma prevalence is high in industrialized areas and has continued to increase over the past few years, future interventions and public health messages should focus on changing unhealthy behaviors such as high salty snack consumption, decreased adherence to the Mediterranean diet and frequent TV/video-game viewing during the early states of life by educating individuals that may be able to teach children about healthy behaviors such as teachers, parents, and guardians.

Arvaniti F, Priftis K, Panagiotakos D, et al. Salty-Snack Eating, Television or Video-Game Viewing, and Asthma Symptoms among 10- to 12-Year-Old Children: The PANACEA Study. J Am Diet Assoc. February 2011;111(2):251-257.

Related Article:
Hsin-Jen T, Tsai A. The Association of Diet with Respiratory Symptoms and Asthma in Schoolchildren in Taipei, Taiwan. Journal of Asthma. October 2007;44(8):599-603.