Dietary phenotype and advanced glycation end-products predict WTC-obstructive airways disease: a longitudinal observational study

Rachel Lam,Hilary Colbeth,David J Prezant,Allison Halpren,Mengling Liu,Maria Sunseri,George Crowley,Rachel Zeig-Owens,Sophia Kwon,Anna Nolan,Jessica Riggs,Theresa Schwartz

doi:10.1186/s12931-020-01596-6

Abstract

BackgroundDiet is a modifier of metabolic syndrome which in turn is associated with World Trade Center obstructive airways disease (WTC-OAD). We have designed this study to (1) assess the dietary phenotype (food types, physical activity, and dietary habits) of the Fire Department of New York (FDNY) WTC-Health Program (WTC-HP) cohort and (2) quantify the association of dietary quality and its advanced glycation end product (AGE) content with the development of WTC-OAD.MethodsWTC-OAD, defined as developing WTC-Lung Injury (WTC-LI; FEV1 < LLN) and/or airway hyperreactivity (AHR; positive methacholine and/or positive bronchodilator response). Rapid Eating and Activity Assessment for Participants-Short Version (REAP-S) deployed on 3/1/2018 in the WTC-HP annual monitoring assessment. Clinical and REAP-S data of consented subjects was extracted (7/17/2019). Diet quality [low-(15–19), moderate-(20–29), and high-(30–39)] and AGE content per REAP-S questionnaire were assessed for association with WTC-OAD. Regression models adjusted for smoking, hyperglycemia, hypertension, age on 9/11, WTC-exposure, BMI, and job description.ResultsN = 9508 completed the annual questionnaire, while N = 4015 completed REAP-S and had spirometry. WTC-OAD developed in N = 921, while N = 3094 never developed WTC-OAD. Low- and moderate-dietary quality, eating more (processed meats, fried foods, sugary drinks), fewer (vegetables, whole-grains),and having a diet abundant in AGEs were significantly associated with WTC-OAD. Smoking was not a significant risk factor of WTC-OAD.ConclusionsREAP-S was successfully implemented in the FDNY WTC-HP monitoring questionnaire and produced valuable dietary phenotyping. Our observational study has identified low dietary quality and AGE abundant dietary habits as risk factors for pulmonary disease in the context of WTC-exposure. Dietary phenotyping, not only focuses our metabolomic/biomarker profiling but also further informs future dietary interventions that may positively impact particulate matter associated lung disease.

Highlights

Diet is a modifier of metabolic syndrome which in turn is associated with World Trade Center obstruc‐ tive airways disease (WTC-obstructive airways disease (OAD))
Age at 9/11, smoking status, and race were no different in the WTCOAD and never World Trade Center obstruc‐ tive airways disease (WTC-OAD) populations, Table 1
Clinical measures Time to reach WTC-OAD case definition was 6.37 ± 7.23 years for the study cohort. For both ever WTC-OAD cases and never WTC-OAD subjects, Body Mass Index (BMI), blood pressure, and high density lipoprotein (HDL) were found to be significantly higher at time of Rapid Eating and Activity Assessment for Patients (REAP)-S compared to immediately post-9/11, Table 1

Summary

Introduction

Diet is a modifier of metabolic syndrome which in turn is associated with World Trade Center obstruc‐ tive airways disease (WTC-OAD). We have designed this study to (1) assess the dietary phenotype (food types, physical activity, and dietary habits) of the Fire Department of New York (FDNY) WTC-Health Program (WTC-HP) cohort and (2) quantify the association of dietary quality and its advanced glycation end product (AGE) content with the develop‐ ment of WTC-OAD. Diets focused on reducing inflammation and increasing vegetable and fish consumption reduced the risk of chronic obstructive pulmonary disease (COPD), whereas diets with increased. Metabolic syndrome (MetSyn) is a risk factor of cardiovascular, lung disease, and World Trade Center-OAD (WTC-OAD) [15, 16]. Metabolic biomarkers, elevated BMI, and a > 2 kg/m2 BMI increase predicted WTC-OAD [16, 20,21,22,23]

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