Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, SE 171-77 Stockholm, Sweden.
Nutrition Research Laboratory, Department of Human Nutrition, Warsaw University of Life Sciences-SGGW, Warsaw, Poland.
Int J Epidemiol. 2018 Dec 1;47(6):1897-1909. doi: 10.1093/ije/dyy178.
Fruits and vegetables, due to high antioxidant capacity, may protect the lung from oxidative damage caused by tobacco smoke and potentially prevent chronic obstructive pulmonary disease (COPD). Only one study based on baseline diet has examined fruit and vegetable consumption in relation to risk of COPD, and no previous studies have examined long-term diet.
We investigated whether long-term fruit and vegetable consumption was associated with COPD incidence among 34 739 women (age 48-83 years) in the population-based prospective Swedish Mammography Cohort. Fruit and vegetable consumption was assessed twice (1987, 1997) with a self-administered questionnaire. Cases of COPD were identified by linkage to the Swedish health register. Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
During follow-up from 2002 to 2014, 1512 women were diagnosed with COPD. Long-term fruit was associated with lower risk of COPD; women in the highest vs lowest quintile of consumption (≥2.5 vs <0.8 servings/day) had a 37% lower risk of COPD (95% CI: 25-48%; P-trend < 0.0001). No association was observed with long-term vegetable intake. Current and ex-smokers with low long-term consumption of fruits (<1 serving/day) in comparison to never smokers with high consumption (≥3 servings/day) had a 38-fold (HR: 38.1; 95% CI: 20.2-71.7) and 13-fold (HR: 12.5, 95% CI: 6.5-24.1) higher risk of COPD, respectively. However, no significant interaction between smoking status and fruit intake in relation to COPD incidence was observed (P-interaction = 0.95).
In this prospective cohort of middle-age and older women, long-term consumption of fruits but not vegetables was inversely associated with COPD incidence.
水果和蔬菜由于具有较高的抗氧化能力，可能会保护肺部免受烟草烟雾引起的氧化损伤，并有可能预防慢性阻塞性肺疾病（COPD）。仅有一项基于基线饮食的研究探讨了水果和蔬菜的摄入与 COPD 风险的关系，而之前没有研究探讨过长期饮食。
我们调查了在基于人群的前瞻性瑞典乳腺队列中，34739 名（年龄 48-83 岁）女性中，长期水果和蔬菜的摄入与 COPD 发病率之间是否存在关联。水果和蔬菜的摄入量通过两次自我管理的问卷调查（1987 年和 1997 年）进行评估。通过与瑞典健康登记处的链接来确定 COPD 病例。使用 Cox 比例风险回归模型来估计危险比（HR）和 95%置信区间（CI）。
在 2002 年至 2014 年的随访期间，有 1512 名女性被诊断为 COPD。长期摄入水果与 COPD 风险降低相关；与最低五分位数（<0.8 份/天）相比，最高五分位数（≥2.5 份/天）的女性 COPD 风险降低了 37%（95%CI：25-48%；P-trend<0.0001）。与长期蔬菜摄入无关。与从不吸烟者（高摄入量≥3 份/天）相比，当前吸烟者和前吸烟者（低摄入量<1 份/天）患 COPD 的风险分别高出 38 倍（HR：38.1；95%CI：20.2-71.7）和 13 倍（HR：12.5，95%CI：6.5-24.1）。然而，吸烟状况与水果摄入量与 COPD 发病率之间的交互作用没有显著差异（P 交互=0.95）。
在这项针对中年和老年女性的前瞻性队列研究中，长期摄入水果与 COPD 发病率呈负相关，但与蔬菜摄入无关。
