Overall diet quality and proinflammatory diet in relation to risk of obstructive sleep apnea in 3 prospective US cohorts

Yue Liu; Fred K Tabung; Meir J Stampfer; Susan Redline; Tianyi Huang

doi:10.1093/ajcn/nqac257

Overall diet quality and proinflammatory diet in relation to risk of obstructive sleep apnea in 3 prospective US cohorts

Am J Clin Nutr. 2022 Dec 19;116(6):1738-1747. doi: 10.1093/ajcn/nqac257.

Authors

Yue Liu^{1

2}, Fred K Tabung^{3

4

5

6}, Meir J Stampfer^{1

6

7}, Susan Redline^{8

9}, Tianyi Huang^{1

8}

Affiliations

¹ Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
² Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
³ James Cancer Hospital and Solove Research Institute, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
⁴ Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
⁵ Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA.
⁶ Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA.
⁷ Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA.
⁸ Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.
⁹ Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.

Abstract

Background: Inflammation-related mechanisms may be important in the development of obstructive sleep apnea (OSA), and diet plays a crucial role in modulating inflammation. Current epidemiologic evidence for the associations between dietary patterns and OSA risk is limited to cross-sectional studies.

Objectives: We investigated prospectively the associations of overall diet quality and proinflammatory diet with OSA risk.

Methods: We followed 145,801 participants in the Nurses' Health Study (NHS) (2002-2012), NHS II (1995-2013), and Health Professionals Follow-up Study (1996-2012). Alternative Healthy Eating Index 2010 (AHEI) and Empirical Dietary Inflammatory Pattern (EDIP) scores were calculated based on validated FFQs administered every 4 y. Cox models were used to estimate HRs and 95% CIs.

Results: We documented 8856 incident OSA cases during follow-up. In pooled analyses adjusted for potential confounders, higher diet quality (higher AHEI scores) was associated with lower OSA risk (HR comparing the highest with the lowest quintile of AHEI: 0.76; 95% CI: 0.71, 0.82; P-trend < 0.001), and higher dietary inflammatory potential (higher EDIP scores) was associated with significantly increased risk (HR comparing the highest with the lowest quintile of EDIP: 1.94; 95% CI: 1.81, 2.08; P-trend < 0.001). Additional adjustment for metabolic factors attenuated both associations. The association with AHEI score was no longer statistically significant (comparable HR: 0.98; 95% CI: 0.91, 1.05; P-trend = 0.54), whereas the association with EDIP score remained statistically significant (comparable HR: 1.31; 95% CI: 1.22, 1.41; P-trend < 0.001).

Conclusions: A healthier diet, particularly one with anti-inflammatory potential, was associated with lower OSA risk.

Keywords: Alternative Healthy Eating Index; Empirical Dietary Inflammatory Pattern; diet quality; obstructive sleep apnea; proinflammatory diet; prospective cohort study.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Cross-Sectional Studies
Diet* / adverse effects
Follow-Up Studies
Humans
Inflammation
Prospective Studies
Risk Factors
Sleep Apnea, Obstructive* / epidemiology

Abstract

Publication types

MeSH terms

Grants and funding