饮食质量、食物摄入量和成人哮喘发病率：一项生命线队列研究
2023/02/20
摘要
目的：饮食因素被认为是成人哮喘发病率上升的驱动因素，但证据尚不明确，这可能是由于与肥胖的复杂相关性。我们的目的是探讨饮食质量和食物摄入量与正常体重和超重成年人哮喘发病的关系。
方法：事件性成人发病哮喘被定义为在±4年的随访中自我报告的哮喘，成人在基线时没有气道疾病。饮食质量评分和食物组的摄入量在基线上被评估。对数二项式回归分析被用来估计饮食摄入量（每份）和成人发病哮喘之间的调整相对风险（RR），按BMI分类（分界点：25 kg/m2）。
结果：确定了477个发病的哮喘病例（75%为女性，62%为超重）和34,698个对照组（60%为女性，53%为超重）。饮食质量--通过生命线饮食评分和地中海饮食评分来评估--与两个BMI组的成人发病哮喘没有关系。尽管病例和对照组之间的几个食物组的饮食摄入量不同，但在调整了混杂因素后，只有少数食物与成人发病的哮喘有关，包括正常体重组的红肉和加工肉（RR：每15克摄入0.93；95% CI 0.86-0.99），以及超重组的奶酪（RR每20克摄入1.09；95% CI 1.00-1.17）和蔬菜（RR每50克摄入1.10；95% CI 1.00-1.21）。
结论：这项研究的结果对食物作为成人哮喘“简单”预测因子的作用提出了质疑，并呼吁采取综合方法，包括一系列可改变的生活方式因素和进一步的哮喘表型。
Diet quality, food intake and incident adult-onset asthma: a Lifelines Cohort Study
Visser, E., de Jong, K., Pepels, J. J. S., Kerstjens, H. A. M., Ten Brinke, A., & van Zutphen, T. (2023)
Abstract
PURPOSE:Dietary factors have been suggested as drivers of the rising prevalence of adult-onset asthma, but evidence is inconclusive, possibly due to the complex interrelation with obesity. We aim to explore the relation of diet quality and food intake with incident adult-onset asthma in normal weight and overweight adults of the prospective population-based Lifelines Cohort Study.
METHODS:Incident adult-onset asthma was defined as self-reported asthma at ± 4-year follow-up, in adults free of airway disease at baseline. Diet quality scores and food group intake were assessed at baseline. Log-binomial regression analyses were used to estimate adjusted relative risks (RR) between dietary intake (per portion) and incident adult-onset asthma, in categories of BMI (cutoff: 25 kg/m2).
RESULTS:477 incident asthma cases (75% female, 62% overweight) and 34,698 controls (60% female, 53% overweight) were identified. Diet quality-assessed by the Lifelines Diet Score and Mediterranean Diet Score-was not associated with incident adult-onset asthma in the two BMI groups. Although the dietary intake of several food groups differed between cases and controls, after adjustment for confounders only few remained associated with adult-onset asthma, including red and processed meat (RR: 0.93 per 15 g intake; 95% CI 0.86-0.99) in the normal weight group and intake of cheese (RR 1.09 per 20 g intake; 95% CI 1.00-1.17) and vegetables (RR 1.10 per 50 g intake; 95% CI 1.00-1.21) in the overweight group.
CONCLUSION:The results of this study question the role of food as a 'simple' predictor of adult-onset asthma and call for an integrative approach, including a range of modifiable lifestyle factors and further asthma phenotyping.
目的：饮食因素被认为是成人哮喘发病率上升的驱动因素，但证据尚不明确，这可能是由于与肥胖的复杂相关性。我们的目的是探讨饮食质量和食物摄入量与正常体重和超重成年人哮喘发病的关系。
方法：事件性成人发病哮喘被定义为在±4年的随访中自我报告的哮喘，成人在基线时没有气道疾病。饮食质量评分和食物组的摄入量在基线上被评估。对数二项式回归分析被用来估计饮食摄入量（每份）和成人发病哮喘之间的调整相对风险（RR），按BMI分类（分界点：25 kg/m2）。
结果：确定了477个发病的哮喘病例（75%为女性，62%为超重）和34,698个对照组（60%为女性，53%为超重）。饮食质量--通过生命线饮食评分和地中海饮食评分来评估--与两个BMI组的成人发病哮喘没有关系。尽管病例和对照组之间的几个食物组的饮食摄入量不同，但在调整了混杂因素后，只有少数食物与成人发病的哮喘有关，包括正常体重组的红肉和加工肉（RR：每15克摄入0.93；95% CI 0.86-0.99），以及超重组的奶酪（RR每20克摄入1.09；95% CI 1.00-1.17）和蔬菜（RR每50克摄入1.10；95% CI 1.00-1.21）。
结论：这项研究的结果对食物作为成人哮喘“简单”预测因子的作用提出了质疑，并呼吁采取综合方法，包括一系列可改变的生活方式因素和进一步的哮喘表型。
(中日友好医院呼吸与危重症医学科 沈焜路 摘译 林江涛 审校)
(Eur J Nutr. 2023 Feb 4; DOI: 10.1007/s00394-023-03091-2)
(Eur J Nutr. 2023 Feb 4; DOI: 10.1007/s00394-023-03091-2)
Diet quality, food intake and incident adult-onset asthma: a Lifelines Cohort Study
Visser, E., de Jong, K., Pepels, J. J. S., Kerstjens, H. A. M., Ten Brinke, A., & van Zutphen, T. (2023)
Abstract
PURPOSE:Dietary factors have been suggested as drivers of the rising prevalence of adult-onset asthma, but evidence is inconclusive, possibly due to the complex interrelation with obesity. We aim to explore the relation of diet quality and food intake with incident adult-onset asthma in normal weight and overweight adults of the prospective population-based Lifelines Cohort Study.
METHODS:Incident adult-onset asthma was defined as self-reported asthma at ± 4-year follow-up, in adults free of airway disease at baseline. Diet quality scores and food group intake were assessed at baseline. Log-binomial regression analyses were used to estimate adjusted relative risks (RR) between dietary intake (per portion) and incident adult-onset asthma, in categories of BMI (cutoff: 25 kg/m2).
RESULTS:477 incident asthma cases (75% female, 62% overweight) and 34,698 controls (60% female, 53% overweight) were identified. Diet quality-assessed by the Lifelines Diet Score and Mediterranean Diet Score-was not associated with incident adult-onset asthma in the two BMI groups. Although the dietary intake of several food groups differed between cases and controls, after adjustment for confounders only few remained associated with adult-onset asthma, including red and processed meat (RR: 0.93 per 15 g intake; 95% CI 0.86-0.99) in the normal weight group and intake of cheese (RR 1.09 per 20 g intake; 95% CI 1.00-1.17) and vegetables (RR 1.10 per 50 g intake; 95% CI 1.00-1.21) in the overweight group.
CONCLUSION:The results of this study question the role of food as a 'simple' predictor of adult-onset asthma and call for an integrative approach, including a range of modifiable lifestyle factors and further asthma phenotyping.
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合并症与哮喘之间的关联强度：一项荟萃分析
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产前和早期接触空气污染与幼儿肺功能的关系：探索暴露对肺发育的影响窗口
