Diet and Respiratory Infections: Specific or Generalized Associations?

Abstract

Background: Based on our recently reported associations between specific dietary behaviors and the risk of COVID-19 infection in the UK Biobank (UKB) cohort, we further investigate whether these associations are specific to COVID-19 or extend to other respiratory infections. Methods: Pneumonia and influenza diagnoses were retrieved from hospital and death record data linked to the UKB. Baseline, self-reported (2006–2010) dietary behaviors included being breastfed as a baby and intakes of coffee, tea, oily fish, processed meat, red meat (unprocessed), fruit, and vegetables. Logistic regression estimated the odds of pneumonia/influenza from baseline to 31 December 2019 with each dietary component, adjusting for baseline socio-demographic factors, medical history, and other lifestyle behaviors. We considered effect modification by sex and genetic factors related to pneumonia, COVID-19, and caffeine metabolism. Results: Of 470,853 UKB participants, 4.0% had pneumonia and 0.2% had influenza during follow up. Increased consumption of coffee, tea, oily fish, and fruit at baseline were significantly and independently associated with a lower risk of future pneumonia events. Increased consumption of red meat was associated with a significantly higher risk. After multivariable adjustment, the odds of pneumonia (p ≤ 0.001 for all) were lower by 6–9% when consuming 1–3 cups of coffee/day (vs. <1 cup/day), 8–11% when consuming 1+ cups of tea/day (vs. <1 cup/day), 10–12% when consuming oily fish in higher quartiles (vs. the lowest quartile—Q1), and 9–14% when consuming fruit in higher quartiles (vs. Q1); it was 9% higher when consuming red meat in the fourth quartile (vs. Q1). Similar patterns of associations were observed for influenza but only associations with tea and oily fish met statistical significance. The association between fruit and pneumonia risk was stronger in women than in men (p = 0.001 for interaction). Conclusions: In the UKB, consumption of coffee, tea, oily fish, and fruit were favorably associated with incident pneumonia/influenza and red meat was adversely associated. Findings for coffee parallel those we reported previously for COVID-19 infection, while other findings are specific to these more common respiratory infections.

Mediation of Healthy Behaviour on the Association of Frailty with Respiratory Diseases Mortality among 0.4 Million Participants: A Prospective Cohort Study from UK Biobank

“…Sufficient physical activity was considered to be ≥735 MET min/week [ 15 ]. A touchscreen food frequency questionnaire, which included the six main food groups, was created to create diet scores (theoretical range: zero to seven); those with a score greater than or equal to four were considered to have a healthy diet [ 15 , 23 ].…”

Mutual Associations of Healthy Behaviours and Socioeconomic Status with Respiratory Diseases Mortality: A Large Prospective Cohort Study

“…Either equal or more than 735 MET min/week was considered sufficient physical activity [14]. Diet scores (theoretical range: zero to seven) were constructed based on six main food groups from a touchscreen food frequency questionnaire, in which values greater than three were viewed as a healthy diet [14,20]. For each behavioural component, we assigned one point for a healthy level (zero points for an unhealthy level), then added up the points that ranged between zero and five, and classified the healthy behaviour index into three groups (no or one, two or three, and four or five).…”

Causal effects of dietary habits on COVID-19 susceptibility, hospitalisation and severity: a comprehensive Mendelian randomisation study

“…For instance, Vu et al discovered that in the UK Biobank (UKB) cohort, consuming coffee, tea, fish and fruit independently was associated with a decreased risk of future pneumonia or influenza events. On the other hand, consuming red meat was correlated with an increased risk ( 6 ) . Additionally, they also reported that higher consumption of coffee and vegetables, being breastfed and reducing intake of processed meat were associated with a reduced risk of COVID-19 infection ( 7 ) .…”