Ducharme-Smith Kirstie, Mora-Garcia Gustavo, de Castro Mendes Francisca, Ruiz-Diaz Maria Stephany, Moreira Andre, Villegas Rodrigo, Garcia-Larsen Vanessa
Dept of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Dept of Family Medicine and Public Health, Faculty of Medicine, Universidad de Cartagena, Cartagena de Indias, Colombia.
ERJ Open Res. 2021 Oct 11;7(4). doi: 10.1183/23120541.00927-2020. eCollection 2021 Oct.
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.
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 (FEV), forced vital capacity (FVC) and the FEV/FVC were described. Calibrated lower limit of normal (LLN) estimates were derived to determine prevalence of spirometric restriction (FVC<LLN) and COPD (FEV/FVC ratio<LLN). Population-weighted linear and logistic regression models were used to investigate the association of AHEI-2010 and respiratory outcomes.
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 FEV (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 AHEIethnicity >0.05).
Diet quality was independently associated with better FEV 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.
慢性阻塞性肺疾病（COPD）在美国造成的负担很大。本研究的目的是在具有全国代表性的美国成年人样本中，调查饮食质量与肺功能、肺量计测定的受限情况以及肺量计定义的COPD之间的关联。
纳入2007 - 2012年国家健康与营养检查调查周期中的成年人（19 - 70岁）（n = 10428）。使用替代健康饮食指数（AHEI - 2010）来确定饮食质量。描述了支气管扩张剂使用前1秒用力呼气量（FEV）、用力肺活量（FVC）以及FEV/FVC的测量值。得出校准后的正常下限（LLN）估计值，以确定肺量计测定受限（FVC < LLN）和COPD（FEV/FVC比值 < LLN）的患病率。采用总体加权线性和逻辑回归模型来研究AHEI - 2010与呼吸结局之间的关联。
AHEI的均值±标准差为45.3±12.2，相当于达到了最佳饮食质量每日推荐量的41%。与第一四分位数的人相比，AHEI处于最高四分位数的人具有更好的FEV（校正后（a）β 47.92，95%置信区间2.27 - 93.57）和FVC（aβ 80.23，95%置信区间34.03 - 126.42；AHEI与吸烟的p值交互作用（）>0.05）。较高的AHEI还与肺量计测定受限的较低几率相关（比值比0.23，95%置信区间0.08 - 0.67；AHEI种族的p值>0.05）。
饮食质量与更好的FEV和FVC以及肺量计测定受限的较低几率独立相关。这些发现凸显了开展研究以进一步阐明饮食在维持肺功能方面可能的有益作用的必要性。
