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Zhang T, Ye R, Shen Z, Chang Q, Zhao Y, Chen L, Zhao L, Xia Y. Joint association of serum urate and healthy diet with chronic obstructive pulmonary disease incidence: results from the UK Biobank study. Food Funct 2024; 15:4642-4651. [PMID: 38595152 DOI: 10.1039/d3fo02750c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
Background: The role of serum urate (SU) levels in the development of chronic obstructive pulmonary disease (COPD) remains a topic of debate, and it is unclear whether a healthy diet can mitigate the impact of SU on COPD risk. The objective of this study is to examine whether and to what extent a healthy diet can reduce the risk of COPD in relation to SU levels. Methods: The cohort analysis included 155 403 participants from the UK Biobank. SU levels were measured at the time of recruitment. A healthy diet score was calculated based on the consumption of vegetables, fruits, fish, processed meats, unprocessed red meat, whole grains, and refined grains. The Cox proportional hazards model was used to analyze the associations between SU levels, a healthy diet score, and the risk of COPD. Results: During a follow-up period of 1 409 969 person-years, 2918 incident cases of COPD were identified. Compared with the lowest SU level group, the hazard ratio (HR) and 95% confidence interval (CI) for COPD were 1.17 (1.03, 1.34) for participants with the highest SU level (hyperuricemia), indicating a positive association. Additionally, a dose-response relationship was observed between SU levels and the incidence of COPD (P-value for overall <0.0001). In the combined effect analysis, compared to individuals with high SU (hyperuricemia) + a low diet score (diet score <4), those with normal SU + a high diet score (diet score ≥4) had a HR (95% CI) of 0.75 (0.65, 0.87) for COPD. Conclusions: In summary, there is a positive association between SU levels and the risk of COPD. Furthermore, a healthier diet can mitigate the risk of COPD associated with high SU levels.
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Affiliation(s)
- Tingjing Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Wannan Medical College, Wuhu, China
- Institutes of Brain Science, Wannan Medical College
| | - Rui Ye
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Zhenfei Shen
- Department of Clinical Nutrition, Yijishan Hospital of Wannan Medical College, Wuhu, China
| | - Qing Chang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, China
| | - Yuhong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, China
| | - Liangkai Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Zhao
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Yang Xia
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, China
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Beijers RJHCG, Steiner MC, Schols AMWJ. The role of diet and nutrition in the management of COPD. Eur Respir Rev 2023; 32:32/168/230003. [PMID: 37286221 DOI: 10.1183/16000617.0003-2023] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 03/27/2023] [Indexed: 06/09/2023] Open
Abstract
In 2014, the European Respiratory Society published a statement on nutritional assessment and therapy in COPD. Since then, increasing research has been performed on the role of diet and nutrition in the prevention and management of COPD. Here, we provide an overview of recent scientific advances and clinical implications. Evidence for a potential role of diet and nutrition as a risk factor in the development of COPD has been accumulating and is reflected in the dietary patterns of patients with COPD. Consuming a healthy diet should, therefore, be promoted in patients with COPD. Distinct COPD phenotypes have been identified incorporating nutritional status, ranging from cachexia and frailty to obesity. The importance of body composition assessment and the need for tailored nutritional screening instruments is further highlighted. Dietary interventions and targeted single or multi-nutrient supplementation can be beneficial when optimal timing is considered. The therapeutic window of opportunity for nutritional interventions during and recovering from an acute exacerbation and hospitalisation is underexplored.
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Affiliation(s)
- Rosanne J H C G Beijers
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Michael C Steiner
- Leicester NIHR Biomedical Research Centre - Respiratory, Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Annemie M W J Schols
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
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3
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Yu W, Pan L, Cao W, Lv J, Guo Y, Pei P, Xia Q, Du H, Chen Y, Yang L, Chen J, Yu C, Chen Z, Li L. Dietary Patterns and Risk of Chronic Obstructive Pulmonary Disease among Chinese Adults: An 11-Year Prospective Study. Nutrients 2022; 14:996. [PMID: 35267971 PMCID: PMC8912729 DOI: 10.3390/nu14050996] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/21/2022] [Accepted: 02/24/2022] [Indexed: 11/16/2022] Open
Abstract
The evidence about the association between dietary patterns and the incidence of chronic obstructive pulmonary disease (COPD) among Chinese adults is limited. In the present study, we analyzed the prospective data of 421,426 participants aged 30−79 years from the China Kadoorie Biobank. Factor analysis with a principal component method was employed to identify dietary patterns. Cox proportional hazard regression models were performed to explore the association between dietary patterns and incident COPD. Two dietary patterns were identified: the traditional northern dietary pattern was characterized by a low intake of rice and a high intake of wheat and other staple foods, while the balanced dietary pattern was characterized by a high intake of fresh fruit and protein-rich foods (soybean, meat, poultry, fish, eggs, and dairy products). During a median follow-up of 11.13 years, 5542 men and 5750 women developed COPD. After adjustments for potential confounders, the balanced dietary pattern was associated with a lower risk of COPD (p for trend <0.001), with a hazard ratio (95% confidence interval) of 0.75 (0.67, 0.84) for those in the highest quintile compared with those in the lowest quintile. Such association was modified by sex, smoking status, and adiposity level.
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Affiliation(s)
- Wei Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (W.Y.); (L.P.); (W.C.); (J.L.); (L.L.)
| | - Lang Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (W.Y.); (L.P.); (W.C.); (J.L.); (L.L.)
| | - Weihua Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (W.Y.); (L.P.); (W.C.); (J.L.); (L.L.)
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (W.Y.); (L.P.); (W.C.); (J.L.); (L.L.)
- Center for Public Health and Epidemic Preparedness & Response, Peking University, Beijing 100191, China
- Key Laboratory of Molecular Cardiovascular Sciences, Peking University, Ministry of Education, Beijing 100191, China
| | - Yu Guo
- National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing 100037, China;
| | - Pei Pei
- Chinese Academy of Medical Sciences, Beijing 100730, China; (P.P.); (Q.X.)
| | - Qingmei Xia
- Chinese Academy of Medical Sciences, Beijing 100730, China; (P.P.); (Q.X.)
| | - Huaidong Du
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK; (H.D.); (Y.C.); (L.Y.); (Z.C.)
- Medical Research Council Population Health Research Unit, University of Oxford, Oxford OX3 7LF, UK
| | - Yiping Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK; (H.D.); (Y.C.); (L.Y.); (Z.C.)
- Medical Research Council Population Health Research Unit, University of Oxford, Oxford OX3 7LF, UK
| | - Ling Yang
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK; (H.D.); (Y.C.); (L.Y.); (Z.C.)
- Medical Research Council Population Health Research Unit, University of Oxford, Oxford OX3 7LF, UK
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing 100022, China;
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (W.Y.); (L.P.); (W.C.); (J.L.); (L.L.)
- Center for Public Health and Epidemic Preparedness & Response, Peking University, Beijing 100191, China
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK; (H.D.); (Y.C.); (L.Y.); (Z.C.)
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (W.Y.); (L.P.); (W.C.); (J.L.); (L.L.)
- Center for Public Health and Epidemic Preparedness & Response, Peking University, Beijing 100191, China
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Association between Dietary Patterns and Chronic Obstructive Pulmonary Disease in Korean Adults: The Korean Genome and Epidemiology Study. Nutrients 2021; 13:nu13124348. [PMID: 34959900 PMCID: PMC8707827 DOI: 10.3390/nu13124348] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 02/07/2023] Open
Abstract
In addition to smoking, dietary habits may contribute to the development of chronic obstructive pulmonary disease (COPD). This study aimed to examine the association between dietary patterns and lung function in a Korean community cohort. A total of 5436 participants were included from the Ansan–Ansung cohort study. To identify the dietary patterns, we performed principal component factor analysis using the results of a semi-quantitative food frequency questionnaire. The forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio were measured by spirometry. Multiple logistic regression models were used to evaluate the association between dietary patterns and lung function after adjusting for confounders. We identified four major dietary patterns; ‘prudent’, ‘coffee, fat, and sweet’, ‘westernized’, and ‘white rice’. After adjusting for potential confounders, the ‘coffee, fat, and sweet’ dietary pattern was negatively associated with lung function, particularly the FEV1/FVC ratio. Participants with high scores for the ‘coffee, fat and sweet’ pattern had a higher risk of COPD among men but not women. Therefore, these results indicate that the ‘coffee, fat and sweet’ dietary pattern is inversely related to lung function in Korean adults. Our results indicate that dietary habits may be modifiable risk factors for COPD.
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Ducharme-Smith K, Mora-Garcia G, de Castro Mendes F, Ruiz-Diaz MS, Moreira A, Villegas R, Garcia-Larsen V. Lung function, COPD and Alternative Healthy Eating Index in US adults. ERJ Open Res 2021; 7:00927-2020. [PMID: 34765673 PMCID: PMC8577879 DOI: 10.1183/23120541.00927-2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 07/25/2021] [Indexed: 11/05/2022] Open
Abstract
Background There is a large burden of COPD in the US. The purpose of this study was to investigate the association between diet quality with lung function, spirometric restriction and spirometrically defined COPD in a nationally representative sample of US adults. Methods Adults (19–70 years of age) from the National Health and Nutrition Examination Survey 2007–2012 cycles were included (n=10 428). Diet quality was determined using the Alternative Healthy Eating Index (AHEI-2010). Pre-bronchodilator measurements of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and the FEV1/FVC were described. Calibrated lower limit of normal (LLN) estimates were derived to determine prevalence of spirometric restriction (FVC<LLN) and COPD (FEV1/FVC ratio<LLN). Population-weighted linear and logistic regression models were used to investigate the association of AHEI-2010 and respiratory outcomes. Results The mean±SD AHEI was 45.3±12.2, equivalent to meeting 41% of the daily recommendations for optimal diet quality. Those in the highest quartile of AHEI had better FEV1 (adjusted (a)β 47.92, 95% CI 2.27–93.57) and FVC (aβ 80.23, 95% CI 34.03–126.42; p-value interaction (*) of AHEI and smoking >0.05) compared to those in quartile 1. Higher AHEI was also associated with lower odds of spirometric restriction (OR 0.23, 95% CI 0.08–0.67; p-value AHEI*ethnicity >0.05). Conclusions Diet quality was independently associated with better FEV1 and FVC and with lower odds of spirometric restriction. These findings highlight the need for research to further elucidate the possible beneficial role of diet in the preservation of lung function. In this nationally representative population-based study of US adults, diet quality measured by the AHEI-2010 was low. Better diet quality was associated with better lung function, and with lower prevalence of spirometric restriction.https://bit.ly/3you2Tf
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Affiliation(s)
- Kirstie Ducharme-Smith
- Dept of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Gustavo Mora-Garcia
- Dept of Family Medicine and Public Health, Faculty of Medicine, Universidad de Cartagena, Cartagena de Indias, Colombia
| | - Francisca de Castro Mendes
- Program in Human Nutrition, Dept of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Maria Stephany Ruiz-Diaz
- Center for Innovation and Research in Diabetes and Metabolism (INNOVATID), Cartagena de Indias, Colombia
| | - Andre Moreira
- Serviço de Imunologia Básica e Clínica, Departamento de Patologia, Faculdade de Medicina; EPI Unit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Rodrigo Villegas
- Biostatistics Unit, School of Public Health, University of Chile, Santiago, Chile
| | - Vanessa Garcia-Larsen
- Program in Human Nutrition, Dept of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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van Iersel LEJ, Beijers RJHCG, Gosker HR, Schols AMWJ. Nutrition as a modifiable factor in the onset and progression of pulmonary function impairment in COPD: a systematic review. Nutr Rev 2021; 80:1434-1444. [PMID: 34537848 PMCID: PMC9086787 DOI: 10.1093/nutrit/nuab077] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
CONTEXT Chronic obstructive lung disease (COPD) is a progressive lung disease characterized by persistent airflow limitation. An increasing amount of evidence suggests an effect of dietary quality on the risk of COPD in the general population and pulmonary function decline in patients with COPD. OBJECTIVE The association of dietary intake and nutrient status with COPD risk and onset, as well as pulmonary function decline (change in forced expiratory volume in 1 second, forced vital capacity, or the ratio of the former to the latter) in patients with COPD was investigated in this systematic review. DATA SOURCES The PubMed database was searched by combining terms of pulmonary function or COPD with diet, nutrient status, or nutritional supplementation. DATA EXTRACTION Original studies and systematic reviews and meta-analyses were included. Articles obtained were independently screened for relevance on the bases of title and abstract by 2 researchers. Eventually, 89 articles were included in the analysis. RESULTS The unhealthy Western-style diet is associated with an increased risk of COPD and an accelerated decline of pulmonary function. Intake of fruit, vegetables, dietary fibers, vitamins C and E, polyphenols, and β-carotene were individually associated with lower COPD risk, whereas consumption of processed meat was associated with higher COPD risk. Data on the effect of dietary quality on pulmonary function decline in patients with COPD are limited and inconsistent. Strong evidence for beneficial effects on pulmonary function decline was found only for vitamin D supplementation. CONCLUSION Considering the increasing burden of COPD, more attention should be given to dietary quality as a modifiable factor in disease development and progression in patients with COPD. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42021240183.
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Affiliation(s)
- Lieke E J van Iersel
- Lieke E.J. van Iersel, Rosanne J.H.C.G. Beijers, Harry R. Gosker, and Annemie M.W.J. Schols are with the Department of Respiratory Medicine, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Rosanne J H C G Beijers
- Lieke E.J. van Iersel, Rosanne J.H.C.G. Beijers, Harry R. Gosker, and Annemie M.W.J. Schols are with the Department of Respiratory Medicine, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Harry R Gosker
- Lieke E.J. van Iersel, Rosanne J.H.C.G. Beijers, Harry R. Gosker, and Annemie M.W.J. Schols are with the Department of Respiratory Medicine, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Annemie M W J Schols
- Lieke E.J. van Iersel, Rosanne J.H.C.G. Beijers, Harry R. Gosker, and Annemie M.W.J. Schols are with the Department of Respiratory Medicine, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
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Lee SA, Joshi P, Kim Y, Kang D, Kim WJ. The Association of Dietary Macronutrients with Lung Function in Healthy Adults Using the Ansan-Ansung Cohort Study. Nutrients 2020; 12:nu12092688. [PMID: 32899146 PMCID: PMC7551845 DOI: 10.3390/nu12092688] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/31/2020] [Accepted: 08/31/2020] [Indexed: 12/14/2022] Open
Abstract
This study is aimed to examine the association between macronutrient intake and lung function in healthy adults (n = 5880) using the Ansan-Ansung cohort study. To identify the index of lung function, we used the percentage difference of predicted Forced Expiratory Volume (%FEV1_diff) between baseline and follow-up. Based on the median %FEV1_diff, subjects were classified by two groups as “decreased vs. unchanged/improved”. The dietary macronutrients were estimated and validated using the food-frequency questionnaire. Multiple logistic regression models were used to evaluate the association after adjusting for confounders. Advanced analysis examined the association after stratifying by age and obesity. The average of %FEV1 is 114.1 and 112.5 at baseline and follow-up, respectively. The positive association of protein and fiber intake with lung function was observed in men. Low fat and high carbohydrate intake decreased the lung function in women only. After stratification by age, the association of protein, fat, and carbohydrate intake with lung function was observed in young men and old women only. Otherwise, the association of protein and fiber with lung function was influenced by abdominal obesity. In conclusion, the lung function was positively associated with high protein and fat intake, but was negatively associated with high carbohydrate intake, which could be influenced by age and obesity.
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Affiliation(s)
- Sang-Ah Lee
- Department of Preventive Medicine, Kangwon National University School of Medicine, 1, Kangwondaehak-gil, Chuncheon-si, Gangwon-do 24341, Korea; (P.J.); (Y.K.)
- Division of Epidemiology, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashuville, TN 37232, USA
- Correspondence: (S.-A.L.); (W.J.K.); Tel.: +84-33-250-8871 (S.-A.L.)
| | - Pankaj Joshi
- Department of Preventive Medicine, Kangwon National University School of Medicine, 1, Kangwondaehak-gil, Chuncheon-si, Gangwon-do 24341, Korea; (P.J.); (Y.K.)
| | - Yeonjin Kim
- Department of Preventive Medicine, Kangwon National University School of Medicine, 1, Kangwondaehak-gil, Chuncheon-si, Gangwon-do 24341, Korea; (P.J.); (Y.K.)
| | - Daehee Kang
- Department of Preventive Medicine, Seoul National University College of Medicine, 103, Daehak-ro, Jongno-gu, Seoul 03080, Korea;
| | - Woo Jin Kim
- Department of Internal Medicine, School of Medicine, Kangwon National University, 1, Kangwondaehak-gil, Chuncheon-si, Gangwon-do 24341, Korea
- Environmental Health Center, 156, Baengnyeong-ro, Chuncheon-si, Gangwon-do 24289, Korea
- Correspondence: (S.-A.L.); (W.J.K.); Tel.: +84-33-250-8871 (S.-A.L.)
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Papassotiriou I, Shariful Islam SM. Adherence to Mediterranean Diet Is Associated With Lung Function in Older Adults: Data From the Health and Retirement Study. J Am Coll Nutr 2020; 40:119-124. [PMID: 32202968 DOI: 10.1080/07315724.2020.1740114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Objective: The aim of this work was to examine the association between adherence to a Mediterranean diet (MD) and lung function in older adults.Design: This was an observational and cross-sectional study.Setting: This research was conducted among community-dwelling older adults from the 2014 Health and Retirement Study (HRS).Subjects: Subjects were 2108 adults aged 50 years or older, 1234 (58.5%) of whom were female.Measures: Dietary intakes from respondents of the Health and Retirement Study (HRS) were used for the current analysis. Adherence to MD was evaluated using the MedDietScore, while lung function was evaluated through peak expiratory flow rate (PEF; l/min). Multiple linear regression and logistic regression were performed, adjusted for potential confounders, to examine the relation between adherence to MD and lung function.Results: Mean MedDietScore was 28.0 (± 5.0), indicating a moderate adherence to MD. Multiple linear regression showed a significant association between the MedDietScore and lung function (β = 0.072, 95% confidence interval [CI]: 0.039-0.104) after adjusting for age, gender, body mass index, race, comorbidities, education, height, grip strength, smoking history, physical activity, and daily caloric intake. Specific food groups such as grains, dairy products, and fish consumption were also associated with PEF rate (p < 0.05). Logistic regression confirmed these findings, and high adherence to MD was associated with reduced risk of having PEF rate < 80% of its peak predictive value (odds ratio: 0.65, 95% CI: 0.48-0.89).Conclusions: The results of this study indicate that adherence to MD is an independent predictor of lung function in older adults, and dietary interventions could be a possible preventive measure in adults with a high risk of developing lung function decline.
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Affiliation(s)
- Ionas Papassotiriou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
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Bakolis I, Hooper R, Bachert C, Lange B, Haahtela T, Keil T, Hofmaier S, Fokkens W, Rymarczyk B, Janson C, Burney PG, Garcia-Larsen V. Dietary patterns and respiratory health in adults from nine European countries-Evidence from the GA 2 LEN study. Clin Exp Allergy 2018; 48:1474-1482. [PMID: 30091213 DOI: 10.1111/cea.13243] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 05/30/2018] [Accepted: 07/02/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Dietary patterns defined using principal component analysis (PCA) offer an alternative to the analysis of individual foods and nutrients and have been linked with asthma and allergic disease. However, results have not been reproducible in different settings. OBJECTIVE To identify dietary patterns common to different European countries and examine their associations with asthma and allergic symptoms. METHODS In sixteen study centers in nine European countries, 3206 individuals aged 15-77 years completed a common, internationally validated, food frequency questionnaire and a respiratory symptoms questionnaire. The outcomes of interest were current asthma, asthma symptoms score (derived based on responses to 5 asthma symptom-related questions), atopy (positive skin prick test). Spirometry was used to estimate forced expiratory volume in 1 second (FEV1 ), forced vital capacity (FVC), the FEV1 /FVC, spirometric restriction (FVC below the lower limit of normal (<LLN)) and FEV1 /FVC < LLN. A novel meta-analytic approach was used to identify dietary patterns using PCA and to examine associations with asthma and allergic symptoms. RESULTS Two dietary patterns emerged, generally correlating with the same foods in different countries: one associated with intake of animal proteins and carbohydrates; the other with fruit and vegetables. There was evidence that the former pattern was associated with a higher asthma score (RR 1.63, 95% CI: 1.33-2.01), current asthma (RR 2.03, 95% CI: 1.52-2.71), wheeze (RR 1.84, 95% CI: 1.30-2.60), atopic status (RR 1.68, 95% CI: 1.16-2.44) and with decreased lung function, including an FVC <LLN (RR 4.57, 95% CI: 2.27-9.21). CONCLUSIONS AND CLINICAL RELEVANCE Our findings suggest an increase in sensitisation to common allergens, an increase in asthma symptoms, and a reduction in lung function in those eating a diet rich in animal proteins and carbohydrates. We found little evidence of an association between these outcomes and eating a diet rich in fruits and vegetables.
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Affiliation(s)
- Ioannis Bakolis
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Centre for Implementation Science, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Richard Hooper
- Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK
| | - Claus Bachert
- Upper Airway Research Laboratory, Ghent University, Ghent, Belgium
| | - Bibi Lange
- Department of Otorhinolaryngology, Odense University Hospital, Odense, Denmark
| | - Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Lodz, Germany.,Institute of Clinical Epidemiology and Biometry, Würzburg University, Würzburg, Germany
| | - Stephanie Hofmaier
- Department of Paediatric Pneumology& Immunology, Charite - Universitaatsmedizin Berlin, Berlin, Germany
| | - Wytske Fokkens
- Otorhinolaryngology Department, Academic Medical Centre, Amsterdam, The Netherlands
| | - Barbara Rymarczyk
- Clinical Department of Internal Diseases, Allergology and Clinical Immunology, Medical University of Silesia, Katowice, Poland
| | - Christer Janson
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Peter Gj Burney
- Population Health and Occupational Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - Vanessa Garcia-Larsen
- Population Health and Occupational Medicine, National Heart and Lung Institute, Imperial College London, London, UK.,Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland
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Han YY, Forno E, Alvarez M, Colón-Semidey A, Acosta-Perez E, Canino G, Celedón JC. Diet, Lung Function, and Asthma Exacerbations in Puerto Rican Children. PEDIATRIC ALLERGY IMMUNOLOGY AND PULMONOLOGY 2017; 30:202-209. [PMID: 29279788 DOI: 10.1089/ped.2017.0803] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 09/11/2017] [Indexed: 12/20/2022]
Abstract
Changes in dietary patterns may partly explain the epidemic of asthma in industrialized countries. The objective of this study was to examine the relationship between dietary patterns and lung function and asthma exacerbations in Puerto Rican children. This is a case-control study of 678 Puerto Rican children (ages 6-14 years) in San Juan (Puerto Rico). All participants completed a respiratory health questionnaire and a 75-item food frequency questionnaire. Food items were aggregated into 7 groups: fruits, vegetables, grains, protein, dairy, fats, and sweets. Logistic regression was used to evaluate consumption frequency of each group and asthma. Based on the results, a dietary score was created [range from -2 (unhealthy diet: high consumption of dairy and sweets, low consumption of vegetables and grains) to 2 (healthy diet: high consumption of vegetables and grains and low consumption of dairy and sweet)]. Multivariable linear or logistic regression was used to assess the relationship between dietary score and lung function or asthma exacerbations. After adjustment for covariates, a healthier diet (each 1-point increment in dietary score) was associated with significantly higher %predicted forced expiratory volume in the first second (FEV1) and %predicted forced vital capacity (FVC) in control subjects. Dietary pattern alone was not associated with asthma exacerbations, but children with an unhealthy diet and vitamin D insufficiency (plasma 25(OH)D <30 ng/mL) had higher odds of ≥1 severe asthma exacerbation [odds ratio (OR) = 3.4, 95% confidence interval (CI) = 1.5-7.5] or ≥1 hospitalization due to asthma (OR = 3.9, 95% CI = 1.6-9.8, OR = 3.4, 95% CI = 1.5-7.5) than children who ate a healthy diet and were vitamin D sufficient. A healthy diet, with frequent consumption of vegetables and grains and low consumption of dairy products and sweets, was associated with higher lung function (as measured by FEV1 and FVC). Vitamin D insufficiency, together with an unhealthy diet, may have detrimental effects on asthma exacerbations in children.
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Affiliation(s)
- Yueh-Ying Han
- Division of Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Erick Forno
- Division of Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Maria Alvarez
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico
| | - Angel Colón-Semidey
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico
| | - Edna Acosta-Perez
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico
| | - Glorisa Canino
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico
| | - Juan C Celedón
- Division of Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pennsylvania
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