Diet and Respiratory Infections: Specific or Generalized Associations?

Linda Van Horn,Chad J Achenbach,Kelsey J Rydland,Marilyn C Cornelis,Thanh-Huyen T Vu

doi:10.3390/nu14061195

Abstract

Background: Based on our recently reported associations between specific dietary behaviors and the risk of COVID-19 infection in the UK Biobank (UKB) cohort, we further investigate whether these associations are specific to COVID-19 or extend to other respiratory infections. Methods: Pneumonia and influenza diagnoses were retrieved from hospital and death record data linked to the UKB. Baseline, self-reported (2006–2010) dietary behaviors included being breastfed as a baby and intakes of coffee, tea, oily fish, processed meat, red meat (unprocessed), fruit, and vegetables. Logistic regression estimated the odds of pneumonia/influenza from baseline to 31 December 2019 with each dietary component, adjusting for baseline socio-demographic factors, medical history, and other lifestyle behaviors. We considered effect modification by sex and genetic factors related to pneumonia, COVID-19, and caffeine metabolism. Results: Of 470,853 UKB participants, 4.0% had pneumonia and 0.2% had influenza during follow up. Increased consumption of coffee, tea, oily fish, and fruit at baseline were significantly and independently associated with a lower risk of future pneumonia events. Increased consumption of red meat was associated with a significantly higher risk. After multivariable adjustment, the odds of pneumonia (p ≤ 0.001 for all) were lower by 6–9% when consuming 1–3 cups of coffee/day (vs. <1 cup/day), 8–11% when consuming 1+ cups of tea/day (vs. <1 cup/day), 10–12% when consuming oily fish in higher quartiles (vs. the lowest quartile—Q1), and 9–14% when consuming fruit in higher quartiles (vs. Q1); it was 9% higher when consuming red meat in the fourth quartile (vs. Q1). Similar patterns of associations were observed for influenza but only associations with tea and oily fish met statistical significance. The association between fruit and pneumonia risk was stronger in women than in men (p = 0.001 for interaction). Conclusions: In the UKB, consumption of coffee, tea, oily fish, and fruit were favorably associated with incident pneumonia/influenza and red meat was adversely associated. Findings for coffee parallel those we reported previously for COVID-19 infection, while other findings are specific to these more common respiratory infections.

Highlights

Lower respiratory tract infections are among the leading causes of death and illness in people of all ages globally [1]
Regardless, the findings suggest the mechanism linking coffee consumption to lower pneumonia/influenza risk is different than that linking coffee to COVID-19 risk; an argument strengthened by the use of the same cohort and similar statistical models
In a subsample of UK Biobank (UKB) participants providing more detailed tea data, we previously reported that black tea was much more commonly consumed than green tea [53], and other constituents of tea may underlie the benefits of tea drinking against respiratory infections

Summary

Introduction

Lower respiratory tract infections are among the leading causes of death and illness in people of all ages globally [1]. We recently reported that being breastfed as a baby, as well as dietary intakes of more coffee and vegetables but less processed meat, was independently associated with lower odds of COVID-19 infection [9]. Whether these associations are specific to COVID-19 or general to viral or bacterial respiratory infections is unclear. Self-reported (2006–2010) dietary behaviors included being breastfed as a baby and intakes of coffee, tea, oily fish, processed meat, red meat (unprocessed), fruit, and vegetables. Conclusions: In the UKB, consumption of coffee, tea, oily fish, and fruit were favorably associated with incident pneumonia/influenza and red meat was adversely associated. Findings for coffee parallel those we reported previously for COVID-19 infection, while other findings are specific to these more common respiratory infections

Methods

Results

Conclusion