Respiratory health and dietary patterns in adults from ECRHS III

Abstract

We assessed the association of dietary patterns derived from principal component analysis with respiratory outcomes in adults participating in the European Community Respiratory Health Survey (ECRHS) III, using a standardized food frequency questionnaire. Data from 3,627 adults in 7 European countries and Australia were included in this cross-sectional analysis. Participants provided information on respiratory symptoms, and had forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) measured. An asthma score (0 to 5) was derived based on responses to 5 asthma symptom-related questions. Adjusted multivariable linear regression was used to examine the association of FEV1, FVC, and FEV1/FVC with dietary patterns (expressed as score quintiles). Negative binomial regression was used to examine the association with asthma score. Results were pooled across countries using meta-analysis. Two main dietary patterns were identified: a ‘prudent’ pattern associated with fruits, vegetables, olive oil and fish intake, and a ‘Western’ pattern associated with meat, potatoes and sweet intake. The meta-analysed effect estimates (adjusted ratio of mean scores [AR]) of all countries showed a positive association between asthma score and having a ‘Western pattern’ (AR 1.16 per quintile of dietary pattern score; 95% CI 1.00, 1.36), with no evidence of heterogeneity (I2=0.0%). FVC was unrelated to prudent or Western patterns (β-coefficient 6ml; 95% CI -49, 61; and β-coefficient 6ml; 95% CI -58, 46, respectively). A higher (worse) asthma score was associated with having a ‘Western’ dietary pattern in European adults. We found no evidence of an association of ventilatory function with dietary patterns in this population.