Lung function, COPD and Alternative Healthy Eating Index (AHEI-2010) in US adults
- Kirstie Ducharme-Smith1,
- Gustavo Mora-Garcia2,
- Francisca de Castro Mendes3,
- Maria Stephany Ruiz-Diaz4,
- Andre Moreira5,
- Rodrigo Villegas6 and
- Vanessa Garcia-Larsen7⇑
- 1Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, US
- 2Department of Family Medicine and Public Health, Faculty of Medicine, Universidad de Cartagena, Cartagena de Indias, Colombia
- 3Program in Human Nutrition, Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, US
- 4Center for Innovation and Research in Diabetes and Metabolism –INNOVATID, Cartagena de Indias, Colombia
- 5Serviço de Imunologia Básica e Clínica, Departamento de Patologia, Faculdade de Medicina; EPI Unit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- 6Biostatistics Unit, School of Public Health, University of Chile, Santiago, Chile
- 7Program in Human Nutrition, Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
- Vanessa Garcia-Larsen (vgla{at}jhu.edu)
Abstract
Background There is a large burden of chronic obstructive pulmonary disease (COPD) in the United States (US). The purpose of this study was to investigate the association between diet quality with lung function, airway 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 (NHANES) 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 airway 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 average 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 airway 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, 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.
Footnotes
This manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.
Conflict of interest: Dr. Ducharme-Smith has nothing to disclose.
Conflict of interest: Dr. Mora-Garcia has nothing to disclose.
Conflict of interest: Dr. De Castro Mendes has nothing to disclose.
Conflict of interest: Dr. Ruiz-Diaz has nothing to disclose.
Conflict of interest: Dr. Moreira has nothing to disclose.
Conflict of interest: Dr. Villegas has nothing to disclose.
Conflict of interest: Dr. Garcia-Larsen has nothing to disclose.
This is a PDF-only article. Please click on the PDF link above to read it.
- Received December 9, 2020.
- Accepted July 25, 2021.
- Copyright ©The authors 2021
This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions{at}ersnet.org