Wen Jingli, Gu Shujun, Wang Xinyu, Qi Xu
Department of Respiratory and Critical Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.
Front Nutr. 2023 Feb 2;10:1031071. doi: 10.3389/fnut.2023.1031071. eCollection 2023.
The Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean diet are associated with reduced cardiovascular, tumor, and diabetes risk, but the effect on chronic obstructive pulmonary disease (COPD) is uncertain.
To investigate the association of the DASH diet and the Mediterranean diet with the risk of COPD in American adults.
This cross-sectional study included 28,605 participants from the National Health and Nutrition Examination Survey (NHANES) 1999-2018 survey cycle who had complete dietary and other questionnaire data. The scores of healthy eating patterns (the DASH diet and the Mediterranean diet) were derived from a 24-h dietary recall interview [individual food and total nutrient data from NHANES and food pattern equivalents data from the United States Department of Agriculture (USDA)]. The primary outcome was the prevalence of COPD. COPD was defined based on participants self-reported whether or not a doctor or health professional had diagnosed chronic bronchitis or emphysema. Secondary outcomes were lung function and respiratory symptoms. All analyses were adjusted for demographics and standard COPD risk factors (primary tobacco exposure, secondhand smoke exposure, and asthma).
This study included 2,488 COPD participants and 25,607 non-COPD participants. We found that a higher DASH diet score was associated with a lower risk of COPD [odds ratio (OR): 0.83; 95% confidence interval (CI): 0.71-0.97; = 0.021]. This association persisted in several subgroups [men (OR: 0.73; 95% CI: 0.58-0.93; = 0.010), relatively young (OR: 0.74; 95% CI: 0.55-1.01; = 0.050), and smoker (OR: 0.82; 95% CI: 0.67-0.99; = 0.038)]. In contrast, the Mediterranean diet score was not significantly associated with COPD prevalence in this large cross-sectional analysis representative of the US adult population (OR: 1.03; 95% CI: 0.88-1.20; = 0.697). In addition, we found a correlation between DASH diet adherence and lung function [β: -0.01; 95% CI: -0.01-0.00; = 0.003 (FEV1: FVC)] or respiratory symptoms [OR: 0.80; 95% CI: 0.73-0.89; < 0.001 (dyspnea); OR: 0.80; 95% CI: 0.70-0.91; = 0.002 (cough); OR: 0.86; 95% CI: 0.74-0.99; = 0.042 (expectoration)], especially in non-COPD populations.
A higher DASH diet score was associated with improved COPD prevalence, lung function and respiratory symptoms. This new finding supports the importance of diet in the pathogenesis of COPD and expands the scope of the association of the DASH diet score with major chronic diseases.
终止高血压膳食疗法（DASH）和地中海饮食与降低心血管疾病、肿瘤及糖尿病风险相关，但对慢性阻塞性肺疾病（COPD）的影响尚不确定。
研究美国成年人中DASH饮食和地中海饮食与COPD风险的关联。
这项横断面研究纳入了1999 - 2018年国家健康与营养检查调查（NHANES）周期中的28,605名参与者，他们有完整的饮食及其他问卷数据。健康饮食模式（DASH饮食和地中海饮食）得分源自24小时饮食回顾访谈[NHANES的个体食物和总营养数据以及美国农业部（USDA）的食物模式等效数据]。主要结局是COPD的患病率。COPD根据参与者自我报告医生或健康专业人员是否诊断为慢性支气管炎或肺气肿来定义。次要结局是肺功能和呼吸道症状。所有分析均针对人口统计学特征和标准COPD危险因素（主要烟草暴露、二手烟暴露和哮喘）进行了调整。
本研究包括2,488名COPD参与者和25,607名非COPD参与者。我们发现较高的DASH饮食得分与较低的COPD风险相关[比值比（OR）：0.83；95%置信区间（CI）：0.71 - 0.97；P = 0.021]。这种关联在几个亚组中持续存在[男性（OR：0.73；95% CI：0.58 - 0.93；P = 0.010）、相对年轻者（OR：0.74；95% CI：0.55 - 1.01；P = 0.050）和吸烟者（OR：0.82；95% CI：0.67 - 0.99；P = 0.038）]。相比之下，在这项代表美国成年人群的大型横断面分析中，地中海饮食得分与COPD患病率无显著关联（OR：1.03；95% CI：0.88 - 1.20；P = 0.697）。此外，我们发现DASH饮食依从性与肺功能[β： - 0.01；95% CI： - 0.01 - 0.00；P = 0.003（第一秒用力呼气容积：用力肺活量）]或呼吸道症状[OR：0.80；95% CI：0.73 - 0.89；P < 0.001（呼吸困难）；OR：0.80；95% CI：0.70 - 0.91；P = 0.002（咳嗽）；OR：0.86；95% CI：0.74 - 0.99；P = 0.042（咳痰）]之间存在相关性，尤其是在非COPD人群中。
较高的DASH饮食得分与改善COPD患病率、肺功能和呼吸道症状相关。这一新发现支持了饮食在COPD发病机制中的重要性，并扩大了DASH饮食得分与主要慢性病关联的范围。
