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. 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. 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. 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.

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以植物为中心的饮食与成年早期至中期肺功能的关联：CARDIA 肺研究

即使在没有慢性呼吸道疾病的成年人中，整个成年期的肺功能也可以预测发病率和死亡率。饮食质量可能是晚年肺功能损伤的一个可改变的危险因素。我们通过年轻人冠状动脉风险发展 (CARDIA) 研究调查了营养丰富的植物性饮食与成年早期和中期肺功能之间的关联。使用经过验证的 CARDIA 饮食历史调查问卷在基线以及随访第 7 年和第 20 年对饮食进行评估。以植物为中心的饮食质量是使用经过验证的先验饮食质量评分 (APDQS) 进行评分，该评分对食物组进行加权，以衡量对 20 种有益评级食物和 13 种不利评级食物的营养丰富的以植物为中心的饮食的遵守情况。在随访过程中对分数进行累积平均并分为五分位数。主要结果是肺功能下降，包括第 0、2、5、10、20 和 30 年测量的 1 秒用力呼气量 (FEV1) 和用力肺活量 (FVC)。我们估计了 APDQS 与年重复测量回归模型中的肺功能变化和横截面差异，调整临床相关协变量。该研究包括 1985-86 年 3,787 名 18-30 岁的黑人和白人男性和女性，并跟踪了 30 年。在多变量重复测量回归模型中，APDQS 最低五分位数（最差饮食）的个体的 FEV1 下降幅度比最高五分位数的个体高 1.6 毫升/年（35.0 与 33.4 毫升/年，每 1 个 SD 变化 ß ± SE APDQS 0.94 ± 0.36，p = 0.009）。此外，APDQS 最低五分位数的 FVC 下降量比最高五分位数的 FVC 下降幅度大 2.4 毫升/年（37.0 vs 34.6 毫升/年，每 1 个 SD 变化 ß ± SE APDQS 1.71 ± 0.46，p < 0.001）。从不吸烟者和曾经吸烟者之间的相关性没有差异（FVC 为 0.07 品脱，FEV1 为 0.32）。在进一步调整当前哮喘诊断和心肺健康的敏感性分析中，结果仍然相似。每个考试年份的横断面分析也显示，协变量调整后，根据饮食，肺功能存在显着差异。在这项为期 30 年的纵向队列研究中，长期坚持以营养丰富的植物为中心的饮食与肺功能的横截面差异以及肺功能较慢的下降有关，这凸显了饮食质量是一种潜在的可治疗特征，支持长期的肺部健康。