Emily P Brigham1, Lyn M Steffen2, Stephanie J London3, Danielle Boyce1, Gregory B Diette1,4, Nadia N Hansel1,4, Jessica Rice5, Meredith C McCormack1,4. 1. 1 Division of Pulmonary and Critical Care Medicine, School of Medicine. 2. 2 Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota; and. 3. 3 Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, U.S. Department of Health and Human Services, Research Triangle Park, North Carolina. 4. 4 Bloomberg School of Public Health, and. 5. 5 Division of Pediatric Pulmonary Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
Abstract
RATIONALE: Dietary intake is a potential risk factor for respiratory morbidity in adult populations. Few studies capture the effect of dietary patterns, representative of the combination of nutrients consumed, on self-reported respiratory morbidity in combination with objective measures of lung function. OBJECTIVES: To evaluate patterns of dietary intake in relation to respiratory morbidity and objective measures of lung function in a U.S. METHODS: The ARIC (Atherosclerosis Risk in Communities) study investigators enrolled 15,792 participants from four U.S. communities between 1987 and 1989 and collected data using a validated food frequency questionnaire to assess diet. Principal component analysis was applied, and patterns representative of "Western" and "Prudent" diets emerged. We investigated cross-sectional associations between dietary patterns and pulmonary assessments that included asthma and chronic obstructive pulmonary disease (COPD) diagnosis, respiratory symptoms, and lung function. Multivariable Poisson regression models included quintiles of dietary patterns and potential confounders. Interaction of dietary patterns with obesity, sex, and smoking status was assessed in relation to all outcomes. RESULTS: Higher scores in the "Western" dietary pattern (quintile 5 vs. quintile 1) were associated with higher prevalence of COPD (prevalence ratio [PR], 1.62; 95% confidence ratio [CI], 1.33-1.97), wheeze (PR, 1.37; 95% CI, 1.11-1.69), cough (PR, 1.32; 95% CI, 1.32-1.59), and phlegm (PR, 1.27; 95% CI, 1.05-1.54) and lower percent predicted forced expiratory volume in 1 second (FEV1), percent predicted forced vital capacity (FVC), and FEV1/FVC ratio. Higher scores in the "Prudent" dietary pattern (quintile 5 vs. quintile 1) were associated with lower prevalence of COPD (PR, 0.82; 95% CI, 0.70-0.95) and cough (PR, 0.77; 95% CI, 0.67-0.89) and higher percent predicted FEV1 and FEV1/FVC ratio. The prevalence of asthma was not related to dietary intake. CONCLUSIONS: A "Western" dietary pattern was associated with respiratory symptoms, lower lung function, and COPD in ARIC participants.
RATIONALE: Dietary intake is a potential risk factor for respiratory morbidity in adult populations. Few studies capture the effect of dietary patterns, representative of the combination of nutrients consumed, on self-reported respiratory morbidity in combination with objective measures of lung function. OBJECTIVES: To evaluate patterns of dietary intake in relation to respiratory morbidity and objective measures of lung function in a U.S. METHODS: The ARIC (Atherosclerosis Risk in Communities) study investigators enrolled 15,792 participants from four U.S. communities between 1987 and 1989 and collected data using a validated food frequency questionnaire to assess diet. Principal component analysis was applied, and patterns representative of "Western" and "Prudent" diets emerged. We investigated cross-sectional associations between dietary patterns and pulmonary assessments that included asthma and chronic obstructive pulmonary disease (COPD) diagnosis, respiratory symptoms, and lung function. Multivariable Poisson regression models included quintiles of dietary patterns and potential confounders. Interaction of dietary patterns with obesity, sex, and smoking status was assessed in relation to all outcomes. RESULTS: Higher scores in the "Western" dietary pattern (quintile 5 vs. quintile 1) were associated with higher prevalence of COPD (prevalence ratio [PR], 1.62; 95% confidence ratio [CI], 1.33-1.97), wheeze (PR, 1.37; 95% CI, 1.11-1.69), cough (PR, 1.32; 95% CI, 1.32-1.59), and phlegm (PR, 1.27; 95% CI, 1.05-1.54) and lower percent predicted forced expiratory volume in 1 second (FEV1), percent predicted forced vital capacity (FVC), and FEV1/FVC ratio. Higher scores in the "Prudent" dietary pattern (quintile 5 vs. quintile 1) were associated with lower prevalence of COPD (PR, 0.82; 95% CI, 0.70-0.95) and cough (PR, 0.77; 95% CI, 0.67-0.89) and higher percent predicted FEV1 and FEV1/FVC ratio. The prevalence of asthma was not related to dietary intake. CONCLUSIONS: A "Western" dietary pattern was associated with respiratory symptoms, lower lung function, and COPD in ARIC participants.
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