Joint analysis of diet quality, inflammatory potential of diet and ultra-processed food exposure in relation to chronic respiratory diseases and lung cancer mortality

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dc.contributor.authorMekonnen, T.C.
dc.contributor.authorMelaku, Y.A.
dc.contributor.authorShi, Z.
dc.contributor.authorGill, T.K.
dc.date.issued2025
dc.descriptionAvailable online 2 May 2025
dc.description.abstractOBJECTIVE: Examined the combined effects of ultra-processed food (UPF), Dietary Inflammatory Index (DII), Healthy Eating Index-2015 (HEI-2015), and Dietary Antioxidant Index (DAI) on mortality from chronic respiratory diseases (CRDs), chronic obstructive pulmonary disease (COPD), and lung cancer. METHODS: A prospective analysis included 96,607 participants (53% women). Diet intake was measured using food frequency questionnaire. Associations of dietary exposures with CRD, COPD, and lung cancer mortality were examined using Cox regression. RESULTS: During 1,459,299 person-years of follow-up, there were 30,623 all-cause deaths, including 5,218 from CRDs, 1,613 from COPD, and 2,127 from lung cancer. A 10% increase in UPF intake (% grams/day) showed a non-linear association with higher CRD and COPD mortality but not lung cancer. Stronger curvature was observed between DII and mortality from all three conditions. However, HEI-2015 was inversely associated with CRD, COPD, and lung cancer mortality, while DAI showed an inverse relationship with CRD and COPD mortality but not lung cancer. Adjusting for DII attenuated UPF-related mortality risks by 39% (CRD), 11% (COPD), and 18% (lung cancer), while HEI-2015 adjustment showed less attenuation. Additionally, the DII-mortality associations were less attenuated after adjusting for UPF intake but were offset after adjusting for HEI-2015. However, the HEI-2015-mortality associations remained unaffected when adjusted for UPF, DII, or DAI. CONCLUSIONS: The findings highlight that the UPF-mortality relationship is potentially explained by DII and, to a lesser extent, by HEI-2015. Adhering to HEI-2015 guidelines can counterbalance the effects of DII on respiratory health but may not offset the effects associated with UPF.
dc.description.statementofresponsibilityTefera Chane Mekonnen, Yohannes Adama Melaku, Zumin Shi, Tiffany K. Gill
dc.identifier.citationRespiratory Medicine, 2025; 243:108138-1-108138-14
dc.identifier.doi10.1016/j.rmed.2025.108138
dc.identifier.issn0954-6111
dc.identifier.issn1532-3064
dc.identifier.orcidMekonnen, T.C. [0000-0003-4680-3645]
dc.identifier.orcidMelaku, Y.A. [0000-0002-3051-7313]
dc.identifier.orcidShi, Z. [0000-0002-3099-3299]
dc.identifier.orcidGill, T.K. [0000-0002-2822-2436]
dc.identifier.urihttps://hdl.handle.net/2440/145843
dc.language.isoen
dc.publisherElsevier
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/2009776
dc.rightsCrown Copyright © 2025 Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
dc.source.urihttps://doi.org/10.1016/j.rmed.2025.108138
dc.subjectchronic respiratory diseases
dc.subjectCOPD
dc.subjectDietary indices
dc.subjectlung cancer
dc.subjectultra-processed food
dc.subject.meshHumans
dc.subject.meshLung Neoplasms
dc.subject.meshRespiratory Tract Diseases
dc.subject.meshPulmonary Disease, Chronic Obstructive
dc.subject.meshChronic Disease
dc.subject.meshInflammation
dc.subject.meshDiet
dc.subject.meshProspective Studies
dc.subject.meshAged
dc.subject.meshMiddle Aged
dc.subject.meshFemale
dc.subject.meshMale
dc.subject.meshFast Foods
dc.subject.meshDietary Exposure
dc.subject.meshFood, Processed
dc.titleJoint analysis of diet quality, inflammatory potential of diet and ultra-processed food exposure in relation to chronic respiratory diseases and lung cancer mortality
dc.typeJournal article
pubs.publication-statusPublished

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