Associations of a plant-centered diet and lung function across early to mid-adulthood: The CARDIA Lung Study

Robert C. Wharton; Jing Gennie Wang; Yuni Choi; Elliot Eisenberg; Mariah K. Jackson; Corrine Hanson; Bian Liu; George R. Washko; Ravi Kalhan; David R. Jacobs; Sonali Bose

doi:10.1186/s12931-023-02632-x

Associations of a plant-centered diet and lung function across early to mid-adulthood: The CARDIA Lung Study

Robert C. Wharton, Jing Gennie Wang, Yuni Choi, Elliot Eisenberg, Mariah K. Jackson, Corrine Hanson, Bian Liu, George R. Washko, Ravi Kalhan, David R. Jacobs, Sonali Bose^*

^*Corresponding author for this work

Medicine, Pulmonary Division

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

2 Scopus citations

Abstract

Background: Lung function throughout adulthood predicts morbidity and mortality even among adults without chronic respiratory disease. Diet quality may represent a modifiable risk factor for lung function impairment later in life. We investigated associations between nutritionally-rich plant-centered diet and lung function across early and middle adulthood from the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Methods: Diet was assessed at baseline and years 7 and 20 of follow-up using the validated CARDIA diet history questionnaire. Plant-centered diet quality was scored using the validated A Priori Diet Quality Score (APDQS), which weights food groups to measure adherence to a nutritionally-rich plant-centered diet for 20 beneficially rated foods and 13 adversely rated foods. Scores were cumulatively averaged over follow-up and categorized into quintiles. The primary outcome was lung function decline, including forced expiratory volume in 1 s (FEV₁) and forced vital capacity (FVC), measured at years 0, 2, 5, 10, 20, and 30. We estimated the association of APDQS with annual pulmonary function changes and cross-sectional differences in a repeated measures regression model, adjusting for clinically relevant covariates. Results: The study included 3,787 Black and White men and women aged 18–30 in 1985–86 and followed for 30 years. In multivariable repeated measures regression models, individuals in the lowest APDQS quintile (poorest diet) had declines in FEV₁ that were 1.6 ml/year greater than individuals in the highest quintile (35.0 vs. 33.4 ml/year, ß ± SE per 1 SD change APDQS 0.94 ± 0.36, p = 0.009). Additionally, declines in FVC were 2.4 ml/year greater in the lowest APDQS quintile than those in the highest quintile (37.0 vs 34.6 ml/year, ß ± SE per 1 SD change APDQS 1.71 ± 0.46, p < 0.001). The association was not different between never and ever smokers (p_int = 0.07 for FVC and 0.32 for FEV₁). In sensitivity analyses where current asthma diagnosis and cardiorespiratory fitness were further adjusted, results remained similar. Cross-sectional analysis at each exam year also showed significant differences in lung function according to diet after covariate adjustment. Conclusions: In this 30-year longitudinal cohort study, long-term adherence to a nutritionally-rich plant-centered diet was associated with cross-sectional differences in lung function as well as slower decline in lung function, highlighting diet quality as a potential treatable trait supporting long-term lung health.

Original language	English (US)
Article number	122
Journal	Respiratory Research
Volume	25
Issue number	1
DOIs	https://doi.org/10.1186/s12931-023-02632-x
State	Published - Dec 2024

Funding

Mariah K. Jackson, Yuni Choi, Elliot Eisenberg, Corrine Hanson, Bian 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; received research support from Boehringer Ingelheim, BTG and Janssen, all outside the submitted work; has ownership and investment interest in Quantitative Image Solutions; and his spouse is an employee of Biogen. 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 National Institutes of Health. 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 Institute (NHLBI). The CARDIA Lung Study was supported by a grant from the National Heart, Lung, and Blood Institute (R01 HL122477). The Coronary Artery Risk Development in Young Adults Study (CARDIA) is conducted and supported by the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with the University of Alabama at Birmingham (HHSN268201800005I & HHSN268201800007I), Northwestern University (HHSN268201800003I), University of Minnesota (HHSN268201800006I), and Kaiser Foundation Research Institute (HHSN268201800004I). This manuscript has been reviewed by CARDIA for scientific content.

Keywords

Diet
Epidemiological study
Longitudinal changes in lung function
Lung function
Lung function in epidemiology
Respiratory epidemiology

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine

UN SDGs

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

Access to Document

10.1186/s12931-023-02632-x

Cite this

@article{78b2621d21ab4b82a7a5a5759e520fba,

title = "Associations of a plant-centered diet and lung function across early to mid-adulthood: The CARDIA Lung Study",

abstract = "Background: Lung function throughout adulthood predicts morbidity and mortality even among adults without chronic respiratory disease. Diet quality may represent a modifiable risk factor for lung function impairment later in life. We investigated associations between nutritionally-rich plant-centered diet and lung function across early and middle adulthood from the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Methods: Diet was assessed at baseline and years 7 and 20 of follow-up using the validated CARDIA diet history questionnaire. Plant-centered diet quality was scored using the validated A Priori Diet Quality Score (APDQS), which weights food groups to measure adherence to a nutritionally-rich plant-centered diet for 20 beneficially rated foods and 13 adversely rated foods. Scores were cumulatively averaged over follow-up and categorized into quintiles. The primary outcome was lung function decline, including forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC), measured at years 0, 2, 5, 10, 20, and 30. We estimated the association of APDQS with annual pulmonary function changes and cross-sectional differences in a repeated measures regression model, adjusting for clinically relevant covariates. Results: The study included 3,787 Black and White men and women aged 18–30 in 1985–86 and followed for 30 years. In multivariable repeated measures regression models, individuals in the lowest APDQS quintile (poorest diet) had declines in FEV1 that were 1.6 ml/year greater than individuals in the highest quintile (35.0 vs. 33.4 ml/year, {\ss} ± SE per 1 SD change APDQS 0.94 ± 0.36, p = 0.009). Additionally, declines in FVC were 2.4 ml/year greater in the lowest APDQS quintile than those in the highest quintile (37.0 vs 34.6 ml/year, {\ss} ± SE per 1 SD change APDQS 1.71 ± 0.46, p < 0.001). The association was not different between never and ever smokers (pint = 0.07 for FVC and 0.32 for FEV1). In sensitivity analyses where current asthma diagnosis and cardiorespiratory fitness were further adjusted, results remained similar. Cross-sectional analysis at each exam year also showed significant differences in lung function according to diet after covariate adjustment. Conclusions: In this 30-year longitudinal cohort study, long-term adherence to a nutritionally-rich plant-centered diet was associated with cross-sectional differences in lung function as well as slower decline in lung function, highlighting diet quality as a potential treatable trait supporting long-term lung health.",

keywords = "Diet, Epidemiological study, Longitudinal changes in lung function, Lung function, Lung function in epidemiology, Respiratory epidemiology",

author = "Wharton, {Robert C.} and Wang, {Jing Gennie} and Yuni Choi and Elliot Eisenberg and Jackson, {Mariah K.} and Corrine Hanson and Bian Liu and Washko, {George R.} and Ravi Kalhan and Jacobs, {David R.} and Sonali Bose",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2024.",

year = "2024",

month = dec,

doi = "10.1186/s12931-023-02632-x",

language = "English (US)",

volume = "25",

journal = "Respiratory Research",

issn = "1465-9921",

publisher = "BioMed Central",

number = "1",

}

TY - JOUR

T1 - Associations of a plant-centered diet and lung function across early to mid-adulthood

T2 - The CARDIA Lung Study

AU - Wharton, Robert C.

AU - Wang, Jing Gennie

AU - Choi, Yuni

AU - Eisenberg, Elliot

AU - Jackson, Mariah K.

AU - Hanson, Corrine

AU - Liu, Bian

AU - Washko, George R.

AU - Kalhan, Ravi

AU - Jacobs, David R.

AU - Bose, Sonali

N1 - Publisher Copyright: © The Author(s) 2024.

PY - 2024/12

Y1 - 2024/12

N2 - Background: Lung function throughout adulthood predicts morbidity and mortality even among adults without chronic respiratory disease. Diet quality may represent a modifiable risk factor for lung function impairment later in life. We investigated associations between nutritionally-rich plant-centered diet and lung function across early and middle adulthood from the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Methods: Diet was assessed at baseline and years 7 and 20 of follow-up using the validated CARDIA diet history questionnaire. Plant-centered diet quality was scored using the validated A Priori Diet Quality Score (APDQS), which weights food groups to measure adherence to a nutritionally-rich plant-centered diet for 20 beneficially rated foods and 13 adversely rated foods. Scores were cumulatively averaged over follow-up and categorized into quintiles. The primary outcome was lung function decline, including forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC), measured at years 0, 2, 5, 10, 20, and 30. We estimated the association of APDQS with annual pulmonary function changes and cross-sectional differences in a repeated measures regression model, adjusting for clinically relevant covariates. Results: The study included 3,787 Black and White men and women aged 18–30 in 1985–86 and followed for 30 years. In multivariable repeated measures regression models, individuals in the lowest APDQS quintile (poorest diet) had declines in FEV1 that were 1.6 ml/year greater than individuals in the highest quintile (35.0 vs. 33.4 ml/year, ß ± SE per 1 SD change APDQS 0.94 ± 0.36, p = 0.009). Additionally, declines in FVC were 2.4 ml/year greater in the lowest APDQS quintile than those in the highest quintile (37.0 vs 34.6 ml/year, ß ± SE per 1 SD change APDQS 1.71 ± 0.46, p < 0.001). The association was not different between never and ever smokers (pint = 0.07 for FVC and 0.32 for FEV1). In sensitivity analyses where current asthma diagnosis and cardiorespiratory fitness were further adjusted, results remained similar. Cross-sectional analysis at each exam year also showed significant differences in lung function according to diet after covariate adjustment. Conclusions: In this 30-year longitudinal cohort study, long-term adherence to a nutritionally-rich plant-centered diet was associated with cross-sectional differences in lung function as well as slower decline in lung function, highlighting diet quality as a potential treatable trait supporting long-term lung health.

AB - Background: Lung function throughout adulthood predicts morbidity and mortality even among adults without chronic respiratory disease. Diet quality may represent a modifiable risk factor for lung function impairment later in life. We investigated associations between nutritionally-rich plant-centered diet and lung function across early and middle adulthood from the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Methods: Diet was assessed at baseline and years 7 and 20 of follow-up using the validated CARDIA diet history questionnaire. Plant-centered diet quality was scored using the validated A Priori Diet Quality Score (APDQS), which weights food groups to measure adherence to a nutritionally-rich plant-centered diet for 20 beneficially rated foods and 13 adversely rated foods. Scores were cumulatively averaged over follow-up and categorized into quintiles. The primary outcome was lung function decline, including forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC), measured at years 0, 2, 5, 10, 20, and 30. We estimated the association of APDQS with annual pulmonary function changes and cross-sectional differences in a repeated measures regression model, adjusting for clinically relevant covariates. Results: The study included 3,787 Black and White men and women aged 18–30 in 1985–86 and followed for 30 years. In multivariable repeated measures regression models, individuals in the lowest APDQS quintile (poorest diet) had declines in FEV1 that were 1.6 ml/year greater than individuals in the highest quintile (35.0 vs. 33.4 ml/year, ß ± SE per 1 SD change APDQS 0.94 ± 0.36, p = 0.009). Additionally, declines in FVC were 2.4 ml/year greater in the lowest APDQS quintile than those in the highest quintile (37.0 vs 34.6 ml/year, ß ± SE per 1 SD change APDQS 1.71 ± 0.46, p < 0.001). The association was not different between never and ever smokers (pint = 0.07 for FVC and 0.32 for FEV1). In sensitivity analyses where current asthma diagnosis and cardiorespiratory fitness were further adjusted, results remained similar. Cross-sectional analysis at each exam year also showed significant differences in lung function according to diet after covariate adjustment. Conclusions: In this 30-year longitudinal cohort study, long-term adherence to a nutritionally-rich plant-centered diet was associated with cross-sectional differences in lung function as well as slower decline in lung function, highlighting diet quality as a potential treatable trait supporting long-term lung health.

KW - Diet

KW - Epidemiological study

KW - Longitudinal changes in lung function

KW - Lung function

KW - Lung function in epidemiology

KW - Respiratory epidemiology

UR - http://www.scopus.com/inward/record.url?scp=85187427811&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85187427811&partnerID=8YFLogxK

U2 - 10.1186/s12931-023-02632-x

DO - 10.1186/s12931-023-02632-x

M3 - Article

C2 - 38468283

AN - SCOPUS:85187427811

SN - 1465-9921

VL - 25

JO - Respiratory Research

JF - Respiratory Research

IS - 1

M1 - 122

ER -

Associations of a plant-centered diet and lung function across early to mid-adulthood: The CARDIA Lung Study

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this