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

Author

Universitat Rovira i Virgili, Catalin, RE; Martin-Lujan, F; Salamanca-Gonzalez, P; Palleja-Millan, M; Villalobos, F; Santigosa-Ayala, A; Pedret, A; Valls-Zamora, RM; Sola, R, Universitat Rovira i Virgili, and Catalin, RE; Martin-Lujan, F; Salamanca-Gonzalez, P; Palleja-Millan, M; Villalobos, F; Santigosa-Ayala, A; Pedret, A; Valls-Zamora, RM; Sola, R

Abstract

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

2. 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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3. A clinical trial to evaluate the effect of the Mediterranean diet on smokers lung function

Author

Mar Sorlí-Aguilar, Teresa Canela-Armengol, Rosa Maria Valls-Zamora, Victoria Arija-Val, Rosa Solà-Alberich, Antoni Santigosa-Ayala, Patricia Salamanca-González, Roxana-Elena Catalin, Francisco Martin-Lujan, Nuria Martin-Vergara, [Martín-Luján F] Institut Català de la Salut, CAP El Morell, Institut Universitari d'Investigació en Atenció Primària-IDIAP Jordi Gol, School of Medicine and Health Sciences, Universitat Rovira i Virgili, Reus, Spain. [Catalin RE] Institut Català de la Salut, CAP Bonavista, Tarragona, Spain. [Salamanca-González P, Sorlí-Aguilar M] Research Support Unit Tarragona-Reus, Institut Universitari d'Investigació en Atenció Primària-IDIAP Jordi Gol, Tarragona, Spain. [Santigosa-Ayala A] Institut Català de la Salut, CAP Sant Salvador, Institut Universitari d'Investigació en Atenció Primària-IDIAP Jordi Gol, School of Medicine and Health Sciences, Universitat Rovira i Virgili, Reus, Spain. [Valls-Zamora RM, Solà-Alberich R] Hospital Universitari Sant Joan, Institut d'Investigació Sanitària Pere Virgili (IISPV), Functional Nutrition, Oxidation and Cardiovascular Disease (NFOC-SALUT) group, Universitat Rovira i Virgili, Reus, Spain. [Martín-Vergara N] Institut Català de la Salut, CAP Horts de Miró, Tarragona, Spain. [Canela-Armengol T] Institut Català de la Salut, CAP Dr Sarro, Tarragona, Spain. [Arija-Val V] Institut Universitari d'Investigació en Atenció Primària-IDIAP Jordi Gol, School of Medicine and Health Sciences, Universitat Rovira i Virgili, Reus, Spain, and IDIAP Jordi Gol

Subjects
Male, Mediterranean diet, medicine.medical_treatment, Pilot Projects, Diet, Mediterranean, Dieta mediterrània, Pulmonary function testing, law.invention, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Randomized controlled trial, Informed consent, law, Nutritional supplements, Protocol, 030212 general & internal medicine, Fumadors, Lung, education.field_of_study, medicine.diagnostic_test, Smoking, personas::fumadores [DENOMINACIONES DE GRUPOS], Middle Aged, Clinical trial design, Female, Pulmonary and Respiratory Medicine, Spirometry, Adult, medicine.medical_specialty, Population, terapéutica::terapia nutricional::dietoterapia::dieta mediterránea [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], 03 medical and health sciences, Internal medicine, sistema respiratorio::pulmón [ANATOMÍA], medicine, Humans, education, Therapeutics::Nutrition Therapy::Diet Therapy::Diet, Mediterranean [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Aged, lcsh:RC705-779, Primary Health Care, business.industry, Public Health, Environmental and Occupational Health, lcsh:Diseases of the respiratory system, Respiratory System::Lung [ANATOMY], Clinical trial, 030228 respiratory system, Pulmons, Smoking cessation, Smoking Cessation, Persons::Smokers [NAMED GROUPS], business
Abstract

Mediterranian diet; Smoke; Lung function Dieta mediterránea; Fumar; Función pulmonar Dieta mediterrània; Fumar; Funció pulmonar Data on the association between lung function and some dietary patterns have been published. However, it is not yet well known if whether the Mediterranean Diet (MD) pattern can preserve or improve lung function. Our purpose is to evaluate the effect of increased MD adherence on lung function in smokers. A multicenter, parallel, cluster-randomized, controlled clinical trial is proposed. A total of 566 active smokers (>10 packs-year), aged 25-75 years will be included, without previous respiratory disease and who sign an informed consent to participate. Twenty Primary Care Centres in Tarragona (Spain) will be randomly assigned to a control or an intervention group (1:1). All participants will receive advice to quit smoking, and the intervention group, a nutritional intervention (2 years) designed to increase MD adherence by: (1) annual visit to deliver personalized nutritional education, (2) annual telephone contact to reinforce the intervention, and (3) access to an online dietary blog. We will evaluate (annually for 2 years): pulmonary function by forced spirometry and MD adherence by a 14-item questionnaire and medical tests (oxidation, inflammation and consumption biomarkers). In a statistical analysis by intention-to-treat basis, with the individual smoker as unit of analysis, pulmonary function and MD adherence in both groups will be compared; logistic regression models will be applied to analyze their associations. We hope to observe an increased MD adherence that may prevent the deterioration of lung function in smokers without previous respiratory disease. This population may benefit from a dietary intervention, together with the recommendation of smoking cessation.

Published
2018

4. 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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5. A clinical trial to evaluate the effect of the Mediterranean diet on smokers lung function.

Author

Martín-Luján F, Catalin RE, Salamanca-González P, Sorlí-Aguilar M, Santigosa-Ayala A, Valls-Zamora RM, Martín-Vergara N, Canela-Armengol T, Arija-Val V, and Solà-Alberich R

Subjects
Adult, Aged, Female, Humans, Male, Middle Aged, Pilot Projects, Spirometry, Diet, Mediterranean, Lung physiopathology, Primary Health Care methods, Pulmonary Disease, Chronic Obstructive diet therapy, Smoking therapy, Smoking Cessation methods
Abstract

Data on the association between lung function and some dietary patterns have been published. However, it is not yet well known if whether the Mediterranean Diet (MD) pattern can preserve or improve lung function. Our purpose is to evaluate the effect of increased MD adherence on lung function in smokers. A multicenter, parallel, cluster-randomized, controlled clinical trial is proposed. A total of 566 active smokers (>10 packs-year), aged 25-75 years will be included, without previous respiratory disease and who sign an informed consent to participate. Twenty Primary Care Centres in Tarragona (Spain) will be randomly assigned to a control or an intervention group (1:1). All participants will receive advice to quit smoking, and the intervention group, a nutritional intervention (2 years) designed to increase MD adherence by: (1) annual visit to deliver personalized nutritional education, (2) annual telephone contact to reinforce the intervention, and (3) access to an online dietary blog. We will evaluate (annually for 2 years): pulmonary function by forced spirometry and MD adherence by a 14-item questionnaire and medical tests (oxidation, inflammation and consumption biomarkers). In a statistical analysis by intention-to-treat basis, with the individual smoker as unit of analysis, pulmonary function and MD adherence in both groups will be compared; logistic regression models will be applied to analyze their associations. We hope to observe an increased MD adherence that may prevent the deterioration of lung function in smokers without previous respiratory disease. This population may benefit from a dietary intervention, together with the recommendation of smoking cessation.

Published
2019
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