Division of Pulmonary, Critical Care, and Sleep, Department of Internal Medicine, College of Medicine.
Department of Epidemiology, College of Public Health.
Ann Am Thorac Soc. 2020 Sep;17(9):1062-1068. doi: 10.1513/AnnalsATS.201910-776OC.
High intake of dietary fiber may have antiinflammatory properties and be protective against respiratory morbidity. We examined the relationship between dietary fiber intake and asthma, respiratory symptoms, and inflammation among adults who participated in the 2007 to 2012 NHANES (National Health and Nutrition Examination Survey). We analyzed data from adults 20 to 79 years of age ( = 13,147) with complete information on fiber intake, total calorie intake, body mass index, smoking status, and poverty level. Fiber intake was categorized into quartiles, with Q1 being lowest quartile of intake and Q4 being the highest quartile. Respiratory morbidities included asthma, wheeze, cough, and phlegm. Self-report questionnaires were used to define asthma, wheeze, cough, and phlegm production. Serum C-reactive protein (CRP) was used as a biomarker of inflammation. Exclusion criteria included current pregnancy and implausible intake of total calories. A total of 69.5% of participants were non-Hispanic white; 54.5% were nonsmokers, and 7.8% had current asthma. After adjusting for covariates, fiber intake was associated with asthma ( = 0.01), with an increased odds of asthma with lower fiber intake (Q1 vs. Q4: odds ratio [OR], 1.4; 95% confidence interval [CI], 1.0-1.8; = 0.027). There were significant interactions between fiber and sex and fiber and race/ethnicity; stronger associations were seen for women and for non-Hispanic white adults. Low fiber intake (Q1) was associated with increased odds of wheeze (OR, 1.3; 95% CI, 1.0-1.6; = 0.018), cough (OR, 1.7; 95% CI, 1.2-2.3; = 0.002), and phlegm (OR, 1.4; 95% CI, 1.1-2.0; = 0.021) compared with high fiber intake. The odds of having high CRP versus nondetectable CRP were 1.6 times higher in the low-fiber group (Q1) compared with high-fiber group (Q4; OR, 1.6; 95% CI, 1.0-2.5). High-fiber diet may mediate an inflammatory response and decrease odds of having asthma, especially for women and specific racial groups, cough, wheeze, and phlegm production when compared with low-fiber diet.
高膳食纤维的摄入可能具有抗炎特性,并能预防呼吸道疾病。我们研究了膳食纤维摄入与成年人哮喘、呼吸道症状和炎症之间的关系,这些成年人参加了 2007 年至 2012 年的 NHANES(国家健康和营养检查调查)。我们分析了年龄在 20 至 79 岁之间( = 13147)、完整信息包括纤维摄入量、总卡路里摄入量、体重指数、吸烟状况和贫困水平的成年人的数据。纤维摄入量分为四等份,Q1 为摄入量最低的四分之一,Q4 为摄入量最高的四分之一。呼吸道疾病包括哮喘、喘息、咳嗽和咳痰。自我报告问卷用于定义哮喘、喘息、咳嗽和咳痰。血清 C 反应蛋白(CRP)被用作炎症的生物标志物。排除标准包括当前怀孕和总卡路里摄入不合理。共有 69.5%的参与者是非西班牙裔白人;54.5%不吸烟,7.8%患有当前哮喘。在调整了混杂因素后,纤维摄入量与哮喘有关( = 0.01),与纤维摄入量较低的哮喘患者的比值比(OR)为 1.4(95%置信区间 [CI],1.0-1.8; = 0.027)。纤维与性别和纤维与种族/民族之间存在显著的相互作用;对于女性和非西班牙裔白人成年人,相关性更强。低纤维摄入(Q1)与喘息(OR,1.3;95%CI,1.0-1.6; = 0.018)、咳嗽(OR,1.7;95%CI,1.2-2.3; = 0.002)和咳痰(OR,1.4;95%CI,1.1-2.0; = 0.021)的几率增加有关。与高纤维摄入相比,低纤维组(Q1)高 C 反应蛋白(CRP)与无法检测到 CRP 的几率高 1.6 倍(OR,1.6;95%CI,1.0-2.5)。高纤维饮食可能介导炎症反应,降低哮喘的几率,特别是对于女性和特定种族群体,与低纤维饮食相比,还能降低咳嗽、喘息和咳痰的几率。