title: Cured meat intake is associated with worsening asthma symptoms.
abstract: Cured meat intake-a recent carcinogenic factor-may increase the risk of COPD, but its association with asthma remains unknown. Though body mass index (BMI) is a likely risk factor for asthma, its role in the diet-asthma association as a mediator has never been studied. We investigated the association between cured meat intake and worsening asthma symptoms in adults, and the role of BMI as a potential mediator.
  
  
  
  Using data from the French prospective EGEA study (baseline: 2003-2007; follow-up: 2011-2013), we applied a mediation analysis in the counterfactual framework, a marginal structural model (MSM), to estimate the direct effect of baseline cured meat intake (<1, 1-3.9, ≥4 servings/week) on change in asthma symptom score (worsening or not), and the indirect effect mediated by BMI.
  
  
  
  Among the 971 participants (mean age 43 years; 49% men; 42% with asthma), 20% reported worsening asthma symptoms during the mean follow-up time of 7 years. Using the MSM, we reported a positive direct effect of cured meat intake on worsening asthma symptoms (multivariable OR=1.76, 95% CI 1.01 to 3.06 for ≥4 vs <1 serving/week). We also reported an indirect effect mediated by BMI (OR=1.07; 95% CI 1.01 to 1.14), accounting for 14% of the total effect.
  
  
  
  Higher cured meat intake was associated with worsening asthma symptoms over time, through a direct effect and to a lesser extent an effect mediated by BMI. This research extends the effect of diet on asthma in adults.
authors.affiliation: INSERM, U1168, VIMA: Aging and Chronic Diseases. Epidemiological and Public Health Approaches, Villejuif, France.|Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France.|Univ Paris-Sud, Kremlin-Bicêtre, France.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Li
authors.affiliation: INSERM, U1168, VIMA: Aging and Chronic Diseases. Epidemiological and Public Health Approaches, Villejuif, France.|Spanish National Cancer Research Centre (CNIO), Genetic & Molecular Epidemiology Group, Human Cancer Genetics Program, Madrid, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Rava
authors.affiliation: INSERM, U1168, VIMA: Aging and Chronic Diseases. Epidemiological and Public Health Approaches, Villejuif, France.|Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France.
authors.forename: Annabelle
authors.initials: A
authors.lastname: Bédard
authors.affiliation: INSERM, U1168, VIMA: Aging and Chronic Diseases. Epidemiological and Public Health Approaches, Villejuif, France.|Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France.
authors.forename: Orianne
authors.initials: O
authors.lastname: Dumas
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.|Universitat Pompeu Fabra (UPF), Barcelona, Spain.|CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
authors.forename: Judith
authors.initials: J
authors.lastname: Garcia-Aymerich
authors.affiliation: INSERM UMR1152, Physiopathologie et épidémiologie des maladies respiratoires, équipe Epidémiologie, Paris, France.
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Leynaert
authors.affiliation: Clinique Universitaire de Pneumologie, Pôle Thorax et Vaisseaux, CHU Grenoble, Grenoble, France.|INSERM U1055, Grenoble, France.|Université Alpes, Grenoble, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Pison
authors.affiliation: INSERM, U1168, VIMA: Aging and Chronic Diseases. Epidemiological and Public Health Approaches, Villejuif, France.|Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France.
authors.forename: Nicole
authors.initials: N
authors.lastname: Le Moual
authors.affiliation: Instituto Nacional De Salud Publica, Mexico, currently at International Agency for Research on Cancer, Lyon, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Romieu
authors.affiliation: INSERM IAB, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Inserm, Grenoble, France.|IAB, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Universite Grenoble Alpes, Grenoble, France.|CHU de Grenoble, IAB, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Grenoble, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Siroux
authors.affiliation: Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Camargo
authors.affiliation: INSERM, U1168, VIMA: Aging and Chronic Diseases. Epidemiological and Public Health Approaches, Villejuif, France.|Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France.
authors.forename: Rachel
authors.initials: R
authors.lastname: Nadif
authors.affiliation: INSERM, U1168, VIMA: Aging and Chronic Diseases. Epidemiological and Public Health Approaches, Villejuif, France.|Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France.
authors.forename: Raphaëlle
authors.initials: R
authors.lastname: Varraso
mesh_terms: D000328:Adult; D001249:Asthma / Q000453:epidemiology*; D015992:Body Mass Index; D005519:Food Preservation / Q000379:methods*; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008460:Meat / Q000009:adverse effects*; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: Asthma; Asthma Epidemiology