Associations of Dietary Patterns and Allergies With Asthma Among University Students in Bangladesh: A Cross-Sectional Study.

Background and Aims: Asthma is a major public health problem worldwide, with a growing burden among young adults in low- and middle-income countries, including Bangladesh. Dietary patterns and allergic conditions may influence asthma-related outcomes; however, evidence among university students is limited. This study aimed to determine the prevalence of asthma-related respiratory symptoms and allergic conditions among Bangladeshi university students and to examine their associations with dietary intake and dietary patterns. Methods: A cross-sectional study was conducted among 469 students at Jahangirnagar University, Savar, Dhaka, Bangladesh, using a non-probability sampling approach across different faculties and academic years. Data was collected between March and June 2025 via a structured Bangla questionnaire based on the European Community Respiratory Health Survey and a food-frequency questionnaire. An asthma symptom score (0-9) was derived from nine respiratory items. Multivariable logistic regression models were used to assess associations between dietary factors, allergic conditions, and asthma-related outcomes after adjustment for sociodemographic and lifestyle variables. Dietary patterns were identified via principal component analysis. Results: Among the participants, 50.3% were female, and most were aged 21-25 years. Ever asthma was reported by 17.7% of the participants, and wheezing during the previous 12 months was reported by 16.4%. Dust allergies (54.5%) and food-induced hypersensitivity (36.4%) were common. According to the adjusted analyses, seafood intake was associated with increasing odds of wheezing (aOR 3.04), whereas fruit intake (aOR 0.53) and butter consumption (aOR 0.46) were protective. Cold-induced hypersensitivity, mustard oil intake and frequent antihistamine use were associated with nocturnal symptom. Fast food, meat, milk, almond oil intake, food allergies, and cold-induced hypersensitivity were associated with antibiotic-treated airway infections. Dietary pattern analysis revealed that a fruit-vegetable pattern was inversely associated with wheezing, whereas meat-dominant and milk-product patterns showed mixed associations with nocturnal symptoms and infections. Conclusion: Asthma-related symptoms and allergic conditions are common among Bangladeshi university students. Dietary habits, cooking oils, and allergic conditions were significantly associated with respiratory outcomes. Many of these factors are potentially modifiable, highlighting opportunities for campus-based prevention strategies and dietary interventions to reduce respiratory morbidity in young adults.