Prenatal and Early Life Fructose, Fructose-Containing Beverages, and Midchildhood Asthma

Ann Am Thorac Soc. 2018 Feb;15(2):217-224. doi: 10.1513/AnnalsATS.201707-530OC.


Rationale: Cross-sectional studies have linked intake of high-fructose corn syrup-sweetened beverages with asthma in schoolchildren.

Objectives: To examine associations of maternal prenatal and early childhood intake of sugar-sweetened beverages and fructose with current asthma in midchildhood (median age, 7.7 yr).

Methods: We assessed maternal pregnancy (first- and second-trimester average) and child (median age, 3.3 yr) intake of sugar-sweetened beverages and total fructose using food frequency questionnaires in 1,068 mother-child pairs from Project Viva, a prospective prebirth cohort. In a multivariable analysis, we examined associations of quartiles of maternal and child sugar-sweetened beverage, juice, and total fructose intake with child current asthma in midchildhood, assessed by questionnaire as ever having doctor-diagnosed asthma plus taking asthma medications or reporting wheezing in the past 12 months.

Results: Higher maternal pregnancy sugar-sweetened beverage consumption (mean, 0.6 servings/d; range, 0-5) was associated with younger maternal age, nonwhite race/ethnicity, lower education and income, and higher prepregnancy body mass index. Adjusting for prepregnancy body mass index and other covariates, comparing quartile 4 with quartile 1, higher maternal pregnancy intake of sugar-sweetened beverages (odds ratio, 1.70; 95% confidence interval, 1.08-2.67) and total fructose (odds ratio, 1.58; 95% confidence interval, 0.98-2.53) were associated with greater odds of midchildhood current asthma (prevalence, 19%). Higher early childhood fructose intake (quartile 4 vs. quartile 1) was also associated with midchildhood current asthma in models adjusted for maternal sugar-sweetened beverages (odds ratio, 1.79; 95% confidence interval, 1.07-2.97) and after additional adjustment for midchildhood body mass index z-score (odds ratio, 1.77; 95% confidence interval, 1.06-2.95).

Conclusions: Higher sugar-sweetened beverage and fructose intake during pregnancy and in early childhood was associated with childhood asthma development independent of adiposity.

Keywords: asthma; childhood; fructose; pregnancy; sugar-sweetened beverages.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Asthma* / diagnosis
  • Asthma* / epidemiology
  • Beverages / analysis
  • Child, Preschool
  • Cohort Studies
  • Correlation of Data
  • Eating / physiology*
  • Female
  • Fructose / metabolism
  • High Fructose Corn Syrup / metabolism*
  • Humans
  • Male
  • Pregnancy
  • Pregnancy Trimesters / metabolism
  • Prenatal Exposure Delayed Effects* / diagnosis
  • Prenatal Exposure Delayed Effects* / epidemiology
  • Prospective Studies
  • Risk Factors
  • Sweetening Agents / metabolism
  • United States / epidemiology


  • High Fructose Corn Syrup
  • Sweetening Agents
  • Fructose