The relationship between gut microbiota‐friendly diet and the prevalence and severity of asthma in children

Objectives Dietary factors may impact asthma indirectly by modulating the composition and activity of the gut microbiota. This study aimed to explore the potential relationship between gut microbiota‐friendly diet and both the prevalence and severity of asthma in children. Methods We selected a total of 2256 children from the 2021–2023 National Health and Nutrition Examination Survey. The gut microbiota‐friendly diet was assessed using the Diet‐Gut Microbiome Index (DI‐GM), which incorporates 14 specific food constituents. To calculate the DI‐GM, two non‐consecutive 24‐h dietary recalls data were used, from which the relevant food constituents were derived. A higher DI‐GM score indicates greater alignment with a gut microbiota‐friendly diet. Results Among the 2256 U.S. children, the weighted prevalence of asthma is 13.36%. In fully adjusted models, DI‐GM was not significantly associated with asthma prevalence overall or within any subgroups. However, higher DI‐GM (T2) was significantly associated with a lower risk of the mild asthma phenotype in the 5–16 age group. In contrast, no significant associations were observed between DI‐GM and asthma severity in the other age groups. Subgroup analysis showed a higher DI‐GM score was significantly correlated with a lower risk for asthma in subgroups stratified by obesity status. Conclusions Higher DI‐GM scores were significantly inversely associated with asthma severity risk in children aged 5–16 years and in obese individuals. These cross‐sectional findings support the need for longitudinal studies to determine whether dietary modulation may affect asthma severity via microbiota‐dependent mechanisms.