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Background: A diet rich in fruits and vegetables has been suggested to counteract the oxidative stress and inflammation that characterize asthma. We aimed to assess the association between vegetable and fruit diversity consumption and asthma and its related outcomes in school‐aged children. Methods: Participants included 647 children (49% females, aged 7‐12 years) recruited from 20 public schools across the city of Porto, in Portugal. Vegetable intake and fruit intake were ascertained using a single self‐reported 24‐hour recall questionnaire. A diversity score was built taking into account the different number of individual vegetables and fruits consumed and categorized into two groups based on the total reported median consumption, which was rounded to the nearest whole number (≤3 and >3, for vegetables; and ≤1 and >1, for fruits). A questionnaire was used to enquire about self‐reported medical diagnosis of asthma and respiratory symptoms. Airway inflammation was assessed measuring exhaled fractional nitric oxide concentration (eNO) and was categorized into two groups (<35 and ≥35 ppb). The association between fruit and vegetable diversity and respiratory outcomes was examined using logistic regression models, adjusting for confounders. Results: A higher vegetable diversity consumption per day was negatively associated with having self‐reported asthma (OR = 0.67; 95% CI 0.47, 0.95), while having a vegetable diversity consumption superior to 3 items per day was negatively associated with levels of eNO ≥ 35 ppb (OR = 0.38; 95% CI 0.16, 0.88) and breathing difficulties (OR = 0.39; 95% CI 0.16, 0.97). Conclusion: Eating a greater variety of vegetables was associated with a lower chance of airway inflammation and prevalence of self‐reported asthma in school children. [ABSTRACT FROM AUTHOR]

Background: Inhalation of fine particulate matter (PM) can cause systematic inflammation and oxidative stress, which may further aggravate the development and progression of asthma. Although nutritional intake of fatty acids and antioxidants may attenuate some effects of fine PM, the role of the inflammatory potential of diet has not been addressed. Therefore, we aimed to investigate possible modulatory effects of dietary inflammatory potential on the association between indoor air pollution and childhood asthma–related outcomes. Methods: In a sample of 501 children (48.1% females, aged 7‐12 years) from 20 public schools located in Porto, Portugal, we evaluated airway reversibility, exhaled nitric oxide levels, atopy, and current respiratory symptoms. Dietary inflammatory index was calculated based on information collected through a reported 24‐hour recall questionnaire, and participants were categorized as having an anti‐inflammatory or pro‐inflammatory diet. Concentrations of indoor PM2.5 and PM10 were measured to assess indoor air quality. Generalized linear mixed models were used to investigate the proportion of effects explained by the exposure to PM2.5 and PM10. Results: After adjustment, the exposure effect of PM2.5 and PM10 levels on children with asthma was higher for those having a pro‐inflammatory diet (OR = 1.44, 95% CI: 1.01‐2.21; and OR = 1.29, 95% CI: 1.03‐1.68, respectively) compared to those having an anti‐inflammatory diet. Conclusion: These findings suggest that the quality of diet might affect the association between indoor pollution and asthma in children, highlighting the relevance of children's diet as a potential protective factor to pollutant exposure in childhood asthma. [ABSTRACT FROM AUTHOR]

Background: Indoor air contaminants may act as endocrine‐disrupting chemicals (EDCs). However, to what extent these contaminants affect health is poorly known. We aimed to assess the association between EDCs exposure and asthma, respiratory symptoms and obesity in schoolchildren. Methods: Data from a cross‐sectional analysis of 815 participants from 20 schools in Porto, Portugal, were analysed. Symptoms were assessed, asthma was defined on lung function, and airway reversibility and body mass index (BMI) were calculated. The concentrations of 13 volatile organic compounds and 2 aldehydes identified as EDCs were measured in 71 classrooms throughout 1 week. Principal component analysis (PCA) was used to assess the effect of co‐exposure. Associations were estimated by regression coefficients using linear and logistic regression models. Results: Increased individual and combined EDCs levels were found in classrooms having more children with asthma and obesity. Higher levels of hexane, styrene, cyclohexanone, butylated hydroxytoluene and 2‐butoxyethanol were associated with obesity, and higher levels of cyclohexanone were associated with increased child BMI. Toluene, o‐xylene, m/p‐xylene and ethylbenzene were significantly associated with nasal obstruction. A positive association was found between PC1 and the risk of obese asthma (OR = 1.43, 95% CI 1.01, 1.98) and between PC2 and overweight (OR = 1.51, 95% CI 1.28, 1.79). PC1 and PC2 were also associated with nasal obstruction, and PC2 was associated with breathing difficulties and lean body mass, although EDCs concentrations were low. Conclusions: Our findings further support the role of EDCs in asthma and obesity development. Moreover, even low levels of indoor exposure may influence the risk of asthma, respiratory symptoms and obesity. [ABSTRACT FROM AUTHOR]

[Display omitted] Since children are far more vulnerable than adults to the effects of air pollution and spend about a third of their day in school, strict control of indoor environments in educational buildings is paramount to properly identify, manage and mitigate putative environmental risks for children. In this context, this work aimed to provide a holistic view on the outcomes obtained from the national ARIA project, which was focused on broadening the knowledge on the effects on children's health of the exposure to schools' indoor air. In particular, this work performed a comprehensive investigation of the indoor air quality (IAQ) in 20 public primary schools located in Porto (Northern Region, Portugal). This paper presents the results of the investigation along with the recently published main outcomes of ARIA on (1) the characteristics of the environment surrounding the surveyed buildings, and (2) the school's environment-related health effects in school-age children from the studied classrooms. The investigation consisted in an extensive assessment plan conducted in 71 classrooms to assess temperature, relative humidity, carbon monoxide and dioxide, particulate matter (PM 2.5 , PM 10 , and ultrafine particles), nitrogen dioxide, ozone, volatile organic compounds, formaldehyde, acetaldehyde, airborne fungi, bacteria and endotoxins, and investigate their respective sources, during the cold seasons of 2014–2015. A series of studies was also launched to investigate school environment-related health detriments in 916 children. The results showed that comfort and ventilation issues and/or indoor pollutant levels that exceeded recommended limits were found in a substantial number of the classrooms surveyed. The high density of occupants, deficient ventilation, soil characteristics, presence of indoor pollution sources (e.g. classroom materials and consumer products) and outdoor pollution were some of the factors that seemed to explain the high air stuffiness and/or indoor pollution load identified in classrooms. In fact, some of indoor pollutants detected, even at low exposure levels, were associated with the development of respiratory symptoms in school-age children. Moreover, results from this work have also shown that the characteristics of the environment surrounding the schools, namely the presence of green spaces and species richness, can be major determinants of respiratory health among school-age children. Overall, the body of evidence generated from the ARIA project can support new evidence-based perspectives for promotion of health in educational buildings. [ABSTRACT FROM AUTHOR]