Abstract
PurposeUntil now, only two prospective cohort studies have investigated dietary fiber intake in relation to risk of chronic obstructive pulmonary disease (COPD), but neither examined long-term fiber intake. Both studies reported that total fiber intake was associated with decreased COPD risk; however, results for specific fiber sources were inconsistent. Thus, we prospectively evaluated the association between baseline and long-term intake of dietary fiber and COPD risk in a population-based prospective cohort of 35,339 Swedish women.MethodsDietary fiber intake was assessed in 1987 and 1997 with a food frequency questionnaire. Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).ResultsDuring follow-up (2002–2014), 1557 COPD cases were identified via linkage to the Swedish National Patient Register. Long-term high dietary fiber intake (≥ 26.5 vs. < 17.6 g/day) was associated with a 30% (95% CI 17–41%) lower risk of COPD. For specific fiber sources, cereal (≥ 16.3 vs. < 9.4 g/day; HR 0.67, 95% CI 0.55–0.81) and fruit fiber (≥ 7.6 vs. < 2.6 g/day; HR 0.65, 95% CI 0.5–0.81), but not vegetable fiber intake (≥ 5.4 vs. < 2.2 g/day; HR 1.03, 95% CI 0.81–1.28) were associated with lower COPD risk. Current and ex-smokers with low long-term total fiber intake (< 17.6 g/day) compared to never smokers with high intake (≥ 26.5 g/day) had a 33-fold (95% CI 23.6–46.6) and tenfold (95% CI 7.0–16.3), respectively, higher risk of COPD.ConclusionsOur findings indicate that high fiber intake is a modifiable lifestyle factor which may decrease COPD risk primarily in current and ex-smokers.
Highlights
Chronic obstructive pulmonary disease (COPD) is predicted by the World Health Organisation to become the third most common disease-related cause of mortality by the year 2030 [1]
A similar suggestion was observed in never smokers, with hazard ratios (HRs) 0.66
In the dose–response analysis, each 1-g increment in long-term dietary fiber intake up to 25 g/day was associated with 5% decreased risk in current smokers, 7% in ex-smokers, and 3% in never smokers
Summary
Chronic obstructive pulmonary disease (COPD) is predicted by the World Health Organisation to become the third most common disease-related cause of mortality by the year 2030 [1]. The health benefits of dietary fiber in relation to inflammatory diseases such as type 2 diabetes [6], metabolic syndrome [7] and cardiovascular diseases [8] have been well documented. It is feasible that dietary fiber intake, through anti-inflammatory [9,10,11] as well as indirect antioxidant properties [12], may protect lungs against inflammation and prevent COPD, especially through modulation of the innate immune system via the gut–liver–lung axis [13] and enhancing the bioavailability of antioxidants [14]
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