Risk Factors of Epstein-Barr Virus Infection Among United States Children: Data From the National Health and Nutrition Examination Survey (NHANES), 2009-2010.

BACKGROUND
Epstein-Barr virus (EBV) has become a common medical condition in adolescents and young children. The objective of this study was to examine the association of low dietary intake and food insecurity with EBV infection.

METHODS
Cross-sectional data were analyzed using the National Health and Nutrition Examination Survey 2009-2010 sample population (n = 1550) aged 6 to 15 years. Self-report data on dietary intake and food security were abstracted from data files. The outcome variable was measured using EBV index from the laboratory data. Multivariable logistic regression analysis was used to determine the association between exposure and outcome variables.

RESULTS
The prevalence of EBV in this population was 56.4%. In the unadjusted analyses, adolescents who consumed 100% fruit juice (OR = 1.49, 95% CI = 1.09-2.05), beans (OR = 2.35, 95% CI = 1.12-4.94), and red meat (OR = 1.57, 95% CI = 1.09-2.24) daily had statistically significant elevated odds of EBV as compared to adolescents who consumed them monthly. Furthermore, adolescents who sometimes did not get fed a balanced meal and had to rely on low-cost food had statistically significant increased odds of EBV. However, after adjusting for potential confounders the results for both dietary factors and food insecurity were no longer statistically significant.

CONCLUSIONS
Certain dietary factors and food insecurity may predispose children to EBV infection.