Mekonnen Tefera Chane, Melaku Yohannes Adama, Shi Zumin, Gill Tiffany K
Adelaide Medical School, The University of Adelaide, South Australian Health and Medical Research Institute, North Terrace, Adelaide, SA, 5000, Australia; School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, 1145, Ethiopia.
Adelaide Medical School, The University of Adelaide, South Australian Health and Medical Research Institute, North Terrace, Adelaide, SA, 5000, Australia; Flinders Health and Medical Institute, Flinders University, Adelaide, 5001, South Australia, Australia.
Respir Med. 2025 Jul;243:108138. doi: 10.1016/j.rmed.2025.108138. Epub 2025 May 2.
Examined the combined effects of ultra-processed food (UPF), Dietary Inflammatory Index (DII), Healthy Eating Index-2015 (HEI-2015), and Dietary Antioxidant Index (DAI) on mortality from chronic respiratory diseases (CRDs), chronic obstructive pulmonary disease (COPD), and lung cancer.
A prospective analysis included 96,607 participants (53 % women). Diet intake was measured using food frequency questionnaire. Associations of dietary exposures with CRD, COPD, and lung cancer mortality were examined using Cox regression.
During 1,459,299 person-years of follow-up, there were 30,623 all-cause deaths, including 5218 from CRDs, 1613 from COPD, and 2127 from lung cancer. A 10 % increase in UPF intake (% grams/day) showed a non-linear association with higher CRD and COPD mortality but not lung cancer. Stronger curvature was observed between DII and mortality from all three conditions. However, HEI-2015 was inversely associated with CRD, COPD, and lung cancer mortality, while DAI showed an inverse relationship with CRD and COPD mortality but not lung cancer. Adjusting for DII attenuated UPF-related mortality risks by 39 % (CRD), 11 % (COPD), and 18 % (lung cancer), while HEI-2015 adjustment showed less attenuation. Additionally, the DII-mortality associations were less attenuated after adjusting for UPF intake but were offset after adjusting for HEI-2015. However, the HEI-2015-mortality associations remained unaffected when adjusted for UPF, DII, or DAI.
The findings highlight that the UPF-mortality relationship is potentially explained by DII and, to a lesser extent, by HEI-2015. Adhering to HEI-2015 guidelines can counterbalance the effects of DII on respiratory health but may not offset the effects associated with UPF.
研究超加工食品（UPF）、饮食炎症指数（DII）、2015年健康饮食指数（HEI - 2015）和饮食抗氧化指数（DAI）对慢性呼吸道疾病（CRD）、慢性阻塞性肺疾病（COPD）和肺癌死亡率的综合影响。
一项前瞻性分析纳入了96,607名参与者（53%为女性）。使用食物频率问卷测量饮食摄入量。采用Cox回归分析饮食暴露与CRD、COPD和肺癌死亡率之间的关联。
在1,459,299人年的随访期间，共有30,623例全因死亡，其中5218例死于CRD，1613例死于COPD，2127例死于肺癌。UPF摄入量增加10%（克/天）与CRD和COPD死亡率升高呈非线性关联，但与肺癌死亡率无关。在DII与所有三种疾病的死亡率之间观察到更强的曲线关系。然而，HEI - 2015与CRD、COPD和肺癌死亡率呈负相关，而DAI与CRD和COPD死亡率呈负相关，但与肺癌死亡率无关。调整DII后，UPF相关的死亡率风险降低了39%（CRD）、11%（COPD）和18%（肺癌），而调整HEI - 2015后显示降低幅度较小。此外，调整UPF摄入量后，DII与死亡率的关联减弱程度较小，但在调整HEI - 2015后被抵消。然而，调整UPF、DII或DAI后，HEI - 2015与死亡率的关联仍然不受影响。
研究结果表明，UPF与死亡率之间的关系可能由DII解释，在较小程度上由HEI - 2015解释。遵循HEI - 2015指南可以抵消DII对呼吸健康的影响，但可能无法抵消与UPF相关的影响。
