Department of Oncology Surgery, Fuzhou Hospital of Traditional Chinese Medicine Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou City, Fujian Province, China.
Graduate School of Tianjin, University of Traditional Chinese Medicine, Tianjin City, China.
BMC Public Health. 2024 Aug 26;24(1):2305. doi: 10.1186/s12889-024-19856-1.
Given the global shifts in environmental conditions and dietary habits, understanding the potential impact of dietary factors and body mass index (BMI) on respiratory diseases, including asthma, is paramount. Investigating these relationships can contribute to the formulation of more effective prevention strategies. The Planetary Health Diet Index (PHDI), a dietary scoring system that balances human health with environmental sustainability, underscores the importance of increasing the consumption of plant-based foods while reducing the intake of red meat, sugar, and highly processed foods. The objective of this study was to assess the association between PHDI and the prevalence of asthma and the mediation effect of BMI in a US general population.
This study utilized data from 32,388 participants in the National Health and Nutrition Examination Survey (NHANES) spanning from 2005 to 2018. Multivariate logistic regression and weighted quantile sum (WQS) regressions were employed to investigate the association between PHDI, individual nutrients, and asthma. Restricted cubic spline (RCS) analysis explored the linear or non-linear relationship between PHDI and asthma. Interaction analyses were conducted on subgroups to validate the findings. Mediation analysis was performed to examine the effect of BMI on the relationship between PHDI and asthma.
There was a significant negative association between PHDI and asthma. After adjusting for covariates, for every 10-point increase in PHDI, there was a 4% decrease in the prevalence of asthma (P = 0.025). Moreover, as PHDI increased, there was a trend towards lower asthma prevalence (P for trend < 0.05). WQS analyses showed consistent associations (OR = 0.93, 95%CI: 0.88, 0.98), with Fiber, Vitamin C, and Protein significant factors. The dose-response curve indicated a linear association between PHDI and asthma, with higher PHDI associated with lower asthma prevalence. Additionally, BMI is significantly positively associated with asthma (P < 0.001), and BMI decreases as the PHDI increases (β = -0.64, P < 0.001). Mediation analysis indicates that BMI significantly mediates the relationship between PHDI and asthma, with a mediation proportion of 33.85% (P < 0.001).
The results of this study show a strong negative correlation between PHDI and the prevalence of asthma. In addition, BMI mediated this negative relationship.
鉴于环境条件和饮食习惯的全球变化，了解饮食因素和体重指数（BMI）对包括哮喘在内的呼吸系统疾病的潜在影响至关重要。研究这些关系有助于制定更有效的预防策略。行星健康饮食指数（PHDI）是一种饮食评分系统，它平衡了人类健康和环境可持续性，强调增加植物性食物的摄入，同时减少红色肉类、糖和高度加工食品的摄入。本研究的目的是评估 PHDI 与美国一般人群中哮喘患病率之间的关联，并在 BMI 中进行中介效应分析。
本研究利用了 2005 年至 2018 年期间国家健康和营养调查（NHANES）中 32388 名参与者的数据。采用多变量逻辑回归和加权分位数总和（WQS）回归分析 PHDI、个体营养素与哮喘之间的关联。限制性立方样条（RCS）分析探讨了 PHDI 与哮喘之间的线性或非线性关系。对亚组进行交互分析以验证研究结果。进行中介分析以检验 BMI 对 PHDI 与哮喘之间关系的影响。
PHDI 与哮喘呈显著负相关。在调整了协变量后，PHDI 每增加 10 分，哮喘的患病率就会降低 4%（P=0.025）。此外，随着 PHDI 的增加，哮喘的患病率呈下降趋势（P 趋势<0.05）。WQS 分析显示出一致的关联（OR=0.93，95%CI：0.88，0.98），其中纤维、维生素 C 和蛋白质是显著因素。剂量反应曲线表明 PHDI 与哮喘之间存在线性关联，较高的 PHDI 与较低的哮喘患病率相关。此外，BMI 与哮喘显著正相关（P<0.001），并且随着 PHDI 的增加，BMI 降低（β=-0.64，P<0.001）。中介分析表明，BMI 显著中介了 PHDI 与哮喘之间的关系，中介比例为 33.85%（P<0.001）。
本研究结果表明 PHDI 与哮喘患病率之间存在强烈的负相关。此外，BMI 介导了这种负相关关系。
