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1. Mediterranean Diet and Lung Function in Adults Current Smokers: A Cross-Sectional Analysis in the MEDISTAR Project

Author

Catalin, Roxana-Elena, Martin-Lujan, Francisco, Salamanca-Gonzalez, Patricia, Palleja-Millan, Meritxell, Villalobos, Felipe, Santigosa-Ayala, Antoni, Pedret, Anna, Valls-Zamora, Rosa M., Sola, Rosa, Investigators, on behalf of the MEDISTAR Research Group Investigators on behalf of the MEDISTAR Research Group, [Catalin RE, Villalobos F] Research Support Unit Camp of Tarragona, Department of Primary Care Camp de Tarragona, Institut Català de la Salut, Reus, Spain. CENIT Research Group, Fundació Institut Universitari Per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain. [Martin-Lujan F, Palleja-Millan M, Santigosa-Ayala A] Research Support Unit Camp of Tarragona, Department of Primary Care Camp de Tarragona, Institut Català de la Salut, Reus, Spain. CENIT Research Group, Fundació Institut Universitari Per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain. Departament of Medicine and Surgery, Facultat de Medicina i Ciències de La Salut, Universitat Rovira i Virgili, Reus, Spain. [Salamanca-Gonzalez P] CENIT Research Group, Fundació Institut Universitari Per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain. [Pedret A, Valls-Zamora RM, Sola R] Functional Nutrition, Oxidation and Cardiovascular Disease Group (NFOC-SALUT), Universitat Rovira i Virgili, Reus, Spain, and IDIAP Jordi Gol

Subjects
Nutrition and Dietetics, Mediterranean Diet, personas::fumadores [DENOMINACIONES DE GRUPOS], lung function, terapéutica::terapia nutricional::dietoterapia::dieta mediterránea [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Dieta mediterrània, primary care centres, smoking, Pulmons - Malalties, Respiratory Tract Diseases::Lung Diseases [DISEASES], Fumadors, Persons::Smokers [NAMED GROUPS], enfermedades respiratorias::enfermedades pulmonares [ENFERMEDADES], Therapeutics::Nutrition Therapy::Diet Therapy::Diet, Mediterranean [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Food Science
Abstract

Mediterranean diet; Lung function; Smoking Dieta mediterrània; Funció pulmonar; Fumar Dieta mediterránea; Función pulmonar; Fumar Background: Previous studies have shown that adherence to the Mediterranean Diet (MeDi) has a positive impact on lung function in subjects with lung disease. In subjects free of respiratory diseases, but at risk, this association is not yet well established. Methods: Based on the reference data from the MEDISTAR clinical trial (Mediterranean Diet and Smoking in Tarragona and Reus; ISRCTN 03.362.372), an observational study was conducted with 403 middle-aged smokers without lung disease, treated at 20 centres of primary care in Tarragona (Catalonia, Spain). The degree of MeDi adherence was evaluated according to a 14-item questionnaire, and adherence was defined in three groups (low, medium, and high). Lung function were assessed by forced spirometry. Logistic regression and linear regression models were used to analyse the association between adherence to the MeDi and the presence of ventilatory defects. Results: Globally, the pulmonary alteration prevalence (impaired FEV1 and/or FVC) was 28.8%, although it was lower in participants with medium and high adherence to the MeDi, compared to those with a low score (24.2% and 27.4% vs. 38.5%, p = 0.004). Logistic regression models showed a significant and independent association between medium and high adherence to the MeDi and the presence of altered lung patterns (OR 0.467 [95%CI 0.266, 0.820] and 0.552 [95%CI 0.313, 0.973], respectively). Conclusions: MeDi adherence is inversely associated with the risk impaired lung function. These results indicate that healthy diet behaviours can be modifiable risk factors to protect lung function and reinforce the possibility of a nutritional intervention to increase adherence to MeDi, in addition to promoting smoking cessation.

Published
2023
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2. Effectiveness of a Motivational Nutritional Intervention through Social Networks 2.0 to Increase Adherence to the Mediterranean Diet and Improve Lung Function in Active Smokers: The DIET Study, a Randomized, Controlled and Parallel Clinical Trial in Primary Care.

Author

Salamanca-González P, Valls-Zamora RM, Pedret-Figuerola A, Sorlí-Aguilar M, Santigosa-Ayala A, Catalin RE, Pallejà-Millán M, Solà-Alberich R, Martin-Lujan F, and The Cenit Research Group Investigators

Subjects
Female, Follow-Up Studies, Humans, Male, Middle Aged, Diet, Mediterranean, Lung physiopathology, Motivation, Patient Compliance, Respiratory Function Tests, Smokers, Social Networking
Abstract

Background: Diet can help preserve lung function in smokers, as well as aid individuals who avoid smoking. This study aimed to evaluate the effectiveness of a nutritional intervention, using the Social Networks 2.0 tool, to increase adherence to the Mediterranean diet (MD) and improve lung function in smokers without prior respiratory disease., Methods: A randomized controlled parallel design was used. The participants were assigned to either the intervention or control group. Data from representative smokers without respiratory disease ( n = 77) aged 18-70 years were analyzed. The participants completed a validated semi-quantitative food-frequency questionnaire, and their adherence to the diet was evaluated by using the questionnaire called the Mediterranean Diet Adherence Score (MEDAS, with 14 items), which considers ≥9 points to indicate high adherence. The lung function was assessed by spirometry. Associations among variables were determined by logistic regression., Results: A comparison of the variables at the end of the study between the control and intervention groups showed that the intervention significantly increased adherence to the MD based on the MEDAS questionnaire (0.69 (2.1) vs. 2.05 (2.03); p = 0.009). Specifically, the consumption of fruits was increased after two years in both groups; however, a more significant increase was detected in the intervention group (121 (178) vs. 12.7 (167) in the control group; p -value = 0.008). In the unadjusted analysis, the intervention only showed a statistical significant increase in the score of adherence to the MD (β: 1.36; 95% CI 0.35; 2.3; p = 0.009), and this increase was maintained after adjusting for age and sex (β: 1.15; 95% CI 0.05; 2.2; p = 0.040) and after adjusting for various sociodemographic, lifestyle and anthropometric variables (β: 1.17; 95% CI 0.02; 2.31; p = 0.046). The pulmonary function parameters improved more in the intervention group; however, no significant differences were observed between the two groups., Conclusions: A nutritional intervention based on a dietetic-nutritional education program resulted in a significant increase in adherence to the MD. However, some evidence suggests that an MD dietary intervention can improve lung function, but in our study, we were not able to demonstrate this. Further research is needed to obtain more robust data and confirm a possible benefit of the program before it can be extended to general practice.

Published
2021
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