Abstract
Data on the association between lung function and some dietary patterns have been published. However, it is not yet well known if whether the Mediterranean Diet (MD) pattern can preserve or improve lung function. Our purpose is to evaluate the effect of increased MD adherence on lung function in smokers. A multicenter, parallel, cluster-randomized, controlled clinical trial is proposed. A total of 566 active smokers (>10 packs-year), aged 25–75 years will be included, without previous respiratory disease and who sign an informed consent to participate. Twenty Primary Care Centres in Tarragona (Spain) will be randomly assigned to a control or an intervention group (1:1). All participants will receive advice to quit smoking, and the intervention group, a nutritional intervention (2 years) designed to increase MD adherence by: (1) annual visit to deliver personalized nutritional education, (2) annual telephone contact to reinforce the intervention, and (3) access to an online dietary blog. We will evaluate (annually for 2 years): pulmonary function by forced spirometry and MD adherence by a 14-item questionnaire and medical tests (oxidation, inflammation and consumption biomarkers). In a statistical analysis by intention-to-treat basis, with the individual smoker as unit of analysis, pulmonary function and MD adherence in both groups will be compared; logistic regression models will be applied to analyze their associations. We hope to observe an increased MD adherence that may prevent the deterioration of lung function in smokers without previous respiratory disease. This population may benefit from a dietary intervention, together with the recommendation of smoking cessation.
Highlights
Nutrition and dietary habits are recognized factors in the development, progression and prevention of chronic pathologies such as cancer and cardiovascular diseases.[1,2] the impact of diet on lung function and respiratory diseases is not as well established.[3]Tobacco smoke is the most important factor in the etiopathogenesis of respiratory pathology, other factors may be involved, such as environmental agents, respiratory infections, genetic and epigenetic disorders, and dietary habits.[4]
Regarding the role of vitamins, they have been associated with improvement in features of chronic obstructive pulmonary disease (COPD) such as symptoms and exacerbations, and high intake would probably reduce the annual decline of pulmonary function.[10]
Available evidence shows that the “western-unhealthy” diet with high consumption of fried and processed foods, processed meats, refined sugars and sweets increases the risk of COPD,[17,18] whereas a “prudent-healthy” diet rich in whole grains, vegetables, fruits and fish is associated with better lung function.[19]
Summary
Nutrition and dietary habits are recognized factors in the development, progression and prevention of chronic pathologies such as cancer and cardiovascular diseases.[1,2] the impact of diet on lung function and respiratory diseases is not as well established.[3]. Data on the study variables will be collected and medical tests will be variate analysis associated a higher probability of lung functional performed This data gathering will be repeated annually for 2 years (V3 impairment with the mixed-alcohol pattern in both men and women (OR 4.56, 95% CI 1.58–13.18) and with the westernizedstyle pattern only in women (OR 5.62, 95% CI 1.17–27.02), compared to the Mediterranean-like pattern (OR 0.71, 95% CI 0.28–1.79).[24] In contrast, a smaller sample power caused very wide and V5); (b) Clarify any doubts about following the MD pattern and other advice received, in a telephone conversation. Access will be restricted and controlled by a personal password for each researcher, who will be responsible for entering participant data
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