A Plant-Centered Diet is Inversely Associated With Radiographic Emphysema: Findings from the CARDIA Lung Study

Mariah K. Jackson; Yuni Choi; Elliot Eisenberg; Corrine Hanson; Ann Wang; Jing Gennie Wang; George R. Washko; Samuel Ash; Raul San Jose Estepar; Gabrielle Liu; James M. Shikany; Lyn M. Steffen; Robert Wharton; Ravi Kalhan; David R. Jacobs; Sonali Bose

doi:10.15326/jcopdf.2023.0437

A Plant-Centered Diet is Inversely Associated With Radiographic Emphysema: Findings from the CARDIA Lung Study

Mariah K. Jackson^*, Yuni Choi, Elliot Eisenberg, Corrine Hanson, Ann Wang, Jing Gennie Wang, George R. Washko, Samuel Ash, Raul San Jose Estepar, Gabrielle Liu, James M. Shikany, Lyn M. Steffen, Robert Wharton, Ravi Kalhan, David R. Jacobs, Sonali Bose

^*Corresponding author for this work

Medicine, Pulmonary Division

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a significant public health concern and intercepting the development of emphysema is vital for COPD prevention. Smokers are a high-risk population for emphysema with limited prevention strategies. We aimed to determine if adherence to a nutritionally rich, plant-centered diet among young ever-smokers is associated with reduced risk of future radiographic emphysema. Methods: We studied participants from the Coronary Artery Risk Development in Young Adults (CARDIA) Lung Prospective Cohort Study who were 18-30 years old at enrollment and followed for 30 years. We analyzed 1706 adults who reported current or former smoking by year 20. Repeated measures of diet history were used to calculate A Priori Diet Quality Scores (APDQSs), and categorized into quintiles, with higher quintiles representing higher nutritionally rich plant-centered food intake. Emphysema was assessed at year 25 (n=1351) by computed tomography (CT). Critical covariates were selected, acknowledging potential residual confounding. Results: Emphysema was observed in 13.0% of the cohort, with a mean age of 50.4±3.5 years. The prevalence of emphysema was 4.5% in the highest APDQS quintile (nutritionally rich), compared with 25.4% in the lowest quintile. After adjustment for multiple covariates, including smoking, greater adherence to a plant-centered diet was inversely associated with emphysema (highest versus lowest quintile odds ratio: 0.44, 95% CI 0.19-0.99, ptrend=0.008). Conclusion: Longitudinal adherence to a nutritionally rich, plant-centered diet was associated with a decreased risk of emphysema development in middle adulthood, warranting further examination of diet as a strategy for emphysema prevention in a high-risk smoking population.

Original language	English (US)
Pages (from-to)	164-173
Number of pages	10
Journal	Chronic Obstructive Pulmonary Diseases
Volume	11
Issue number	2
DOIs	https://doi.org/10.15326/jcopdf.2023.0437
State	Published - Mar 2024

Funding

Mariah K. Jackson, Yuni Choi, Elliot Eisenberg, Corrine Hanson, Ann Wang, Gabrielle Liu, Robert Wharton, and David R. Jacobs have no interests to disclose. Jing Gennie Wang has received funding from the American Lung Association Early Career Investigator Award. George R. Washko reports serving on an advisory committee for Boehringer Ingelheim, CSL Behring, GlaxoSmithKline, and Vertex; personal fees from Boehringer Ingelheim, CSL Behring, Janssen, Novartis, PulmonX, and Vertex; serving on a data safety and monitoring board for PulmonX; receiving research support from Boehringer Ingelheim, BTG and Janssen, all outside the submitted work; ownership and investment interest in Quantitative Image Solutions; and his spouse is an employee of Biogen. Samuel Ash has received funding from the NIH (K08HL145118) and has stock/ownership related to Quantitative Imaging Solutions. Raul San Jose Estepar has received funding from the National Heart, Lung, and Blood Institute and contracts with Lung Biotechnology, Insmed, and Boehringer Ingelheim. Dr. San Jose Estepar has received royalties from Imbio, consulting fees from Leuko Labs, speaker fees from Chiesi, and has pending patents related to lung cancer risk technology, and stock/ownership in Quantitative Imaging Solutions. James Shikany is the principal investigator of the contract for the CARDIA study Coordinating Center at the University of Alabama at Birmingham. Lyn M. Steffen has received grant funding from the University of Minnesota. Ravi Kalhan reports receiving grant support, consulting fees, and lecture fees from Boehringer Ingelheim and GlaxoSmithKline; grant support from PneumRx/BTG and Spiration; grant support and consulting fees from Astra-Zeneca; and consulting fees from CVS Caremark, Aptus Health, Boston Scientific, and Boston Consulting Group. Sonali Bose has received funding from the NIH. She also receives research support from 4D Medical and the American Lung Association. The Coronary Artery Risk Development in Young Adults Study (CARDIA) is supported by contracts HHSN268201800003I, HHSN268201800004I, HHSN268201800005I, HHSN268201800006I, and HHSN268201800007I from the National Heart, Lung, and Blood. This manuscript has been reviewed by CARDIA for scientific content but holds no restrictions regarding publication.

Keywords

dietary intake
emphysema
life course
plant-centered diet
smoking

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.15326/jcopdf.2023.0437

Cite this

Jackson, M. K., Choi, Y., Eisenberg, E., Hanson, C., Wang, A., Wang, J. G., Washko, G. R., Ash, S., Estepar, R. S. J., Liu, G., Shikany, J. M., Steffen, L. M., Wharton, R., Kalhan, R., Jacobs, D. R., & Bose, S. (2024). A Plant-Centered Diet is Inversely Associated With Radiographic Emphysema: Findings from the CARDIA Lung Study. Chronic Obstructive Pulmonary Diseases, 11(2), 164-173. https://doi.org/10.15326/jcopdf.2023.0437

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abstract = "Background: Chronic obstructive pulmonary disease (COPD) is a significant public health concern and intercepting the development of emphysema is vital for COPD prevention. Smokers are a high-risk population for emphysema with limited prevention strategies. We aimed to determine if adherence to a nutritionally rich, plant-centered diet among young ever-smokers is associated with reduced risk of future radiographic emphysema. Methods: We studied participants from the Coronary Artery Risk Development in Young Adults (CARDIA) Lung Prospective Cohort Study who were 18-30 years old at enrollment and followed for 30 years. We analyzed 1706 adults who reported current or former smoking by year 20. Repeated measures of diet history were used to calculate A Priori Diet Quality Scores (APDQSs), and categorized into quintiles, with higher quintiles representing higher nutritionally rich plant-centered food intake. Emphysema was assessed at year 25 (n=1351) by computed tomography (CT). Critical covariates were selected, acknowledging potential residual confounding. Results: Emphysema was observed in 13.0% of the cohort, with a mean age of 50.4±3.5 years. The prevalence of emphysema was 4.5% in the highest APDQS quintile (nutritionally rich), compared with 25.4% in the lowest quintile. After adjustment for multiple covariates, including smoking, greater adherence to a plant-centered diet was inversely associated with emphysema (highest versus lowest quintile odds ratio: 0.44, 95% CI 0.19-0.99, ptrend=0.008). Conclusion: Longitudinal adherence to a nutritionally rich, plant-centered diet was associated with a decreased risk of emphysema development in middle adulthood, warranting further examination of diet as a strategy for emphysema prevention in a high-risk smoking population.",

keywords = "dietary intake, emphysema, life course, plant-centered diet, smoking",

author = "Jackson, {Mariah K.} and Yuni Choi and Elliot Eisenberg and Corrine Hanson and Ann Wang and Wang, {Jing Gennie} and Washko, {George R.} and Samuel Ash and Estepar, {Raul San Jose} and Gabrielle Liu and Shikany, {James M.} and Steffen, {Lyn M.} and Robert Wharton and Ravi Kalhan and Jacobs, {David R.} and Sonali Bose",

note = "Publisher Copyright: {\textcopyright} JCOPDF 2024.",

year = "2024",

month = mar,

doi = "10.15326/jcopdf.2023.0437",

language = "English (US)",

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Jackson, MK, Choi, Y, Eisenberg, E, Hanson, C, Wang, A, Wang, JG, Washko, GR, Ash, S, Estepar, RSJ, Liu, G, Shikany, JM, Steffen, LM, Wharton, R, Kalhan, R, Jacobs, DR & Bose, S 2024, 'A Plant-Centered Diet is Inversely Associated With Radiographic Emphysema: Findings from the CARDIA Lung Study', Chronic Obstructive Pulmonary Diseases, vol. 11, no. 2, pp. 164-173. https://doi.org/10.15326/jcopdf.2023.0437

TY - JOUR

T1 - A Plant-Centered Diet is Inversely Associated With Radiographic Emphysema

T2 - Findings from the CARDIA Lung Study

AU - Jackson, Mariah K.

AU - Choi, Yuni

AU - Eisenberg, Elliot

AU - Hanson, Corrine

AU - Wang, Ann

AU - Wang, Jing Gennie

AU - Washko, George R.

AU - Ash, Samuel

AU - Estepar, Raul San Jose

AU - Liu, Gabrielle

AU - Shikany, James M.

AU - Steffen, Lyn M.

AU - Wharton, Robert

AU - Kalhan, Ravi

AU - Jacobs, David R.

AU - Bose, Sonali

PY - 2024/3

Y1 - 2024/3

N2 - Background: Chronic obstructive pulmonary disease (COPD) is a significant public health concern and intercepting the development of emphysema is vital for COPD prevention. Smokers are a high-risk population for emphysema with limited prevention strategies. We aimed to determine if adherence to a nutritionally rich, plant-centered diet among young ever-smokers is associated with reduced risk of future radiographic emphysema. Methods: We studied participants from the Coronary Artery Risk Development in Young Adults (CARDIA) Lung Prospective Cohort Study who were 18-30 years old at enrollment and followed for 30 years. We analyzed 1706 adults who reported current or former smoking by year 20. Repeated measures of diet history were used to calculate A Priori Diet Quality Scores (APDQSs), and categorized into quintiles, with higher quintiles representing higher nutritionally rich plant-centered food intake. Emphysema was assessed at year 25 (n=1351) by computed tomography (CT). Critical covariates were selected, acknowledging potential residual confounding. Results: Emphysema was observed in 13.0% of the cohort, with a mean age of 50.4±3.5 years. The prevalence of emphysema was 4.5% in the highest APDQS quintile (nutritionally rich), compared with 25.4% in the lowest quintile. After adjustment for multiple covariates, including smoking, greater adherence to a plant-centered diet was inversely associated with emphysema (highest versus lowest quintile odds ratio: 0.44, 95% CI 0.19-0.99, ptrend=0.008). Conclusion: Longitudinal adherence to a nutritionally rich, plant-centered diet was associated with a decreased risk of emphysema development in middle adulthood, warranting further examination of diet as a strategy for emphysema prevention in a high-risk smoking population.

AB - Background: Chronic obstructive pulmonary disease (COPD) is a significant public health concern and intercepting the development of emphysema is vital for COPD prevention. Smokers are a high-risk population for emphysema with limited prevention strategies. We aimed to determine if adherence to a nutritionally rich, plant-centered diet among young ever-smokers is associated with reduced risk of future radiographic emphysema. Methods: We studied participants from the Coronary Artery Risk Development in Young Adults (CARDIA) Lung Prospective Cohort Study who were 18-30 years old at enrollment and followed for 30 years. We analyzed 1706 adults who reported current or former smoking by year 20. Repeated measures of diet history were used to calculate A Priori Diet Quality Scores (APDQSs), and categorized into quintiles, with higher quintiles representing higher nutritionally rich plant-centered food intake. Emphysema was assessed at year 25 (n=1351) by computed tomography (CT). Critical covariates were selected, acknowledging potential residual confounding. Results: Emphysema was observed in 13.0% of the cohort, with a mean age of 50.4±3.5 years. The prevalence of emphysema was 4.5% in the highest APDQS quintile (nutritionally rich), compared with 25.4% in the lowest quintile. After adjustment for multiple covariates, including smoking, greater adherence to a plant-centered diet was inversely associated with emphysema (highest versus lowest quintile odds ratio: 0.44, 95% CI 0.19-0.99, ptrend=0.008). Conclusion: Longitudinal adherence to a nutritionally rich, plant-centered diet was associated with a decreased risk of emphysema development in middle adulthood, warranting further examination of diet as a strategy for emphysema prevention in a high-risk smoking population.

KW - dietary intake

KW - emphysema

KW - life course

KW - plant-centered diet

KW - smoking

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A Plant-Centered Diet is Inversely Associated With Radiographic Emphysema: Findings from the CARDIA Lung Study

Abstract

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ASJC Scopus subject areas

UN SDGs

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