This Article Full Text Full Text (PDF) OnlineSupplement All Versions of this Article: 200306-789OCv1 170/3/279    most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Butler, L. M. Articles by London, S. J. Search for Related Content PubMed PubMed Citation Articles by Butler, L. M. Articles by London, S. J.

Dietary Fiber and Reduced Cough with Phlegm

A Cohort Study in Singapore

Epidemiology Branch, National Institute of Environmental Health Sciences, Department of Health and Human Services, National Institutes of Health, Research Triangle Park, North Carolina; Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, California; and National University of Singapore, Singapore

Correspondence and requests for reprints should be addressed to Lesley M. Butler, M.S.P.H., Ph.D., Department of Epidemiology and Preventive Medicine, University of California, One Shields Avenue, Davis, CA 95616. E-mail: lmbutler{at}ucdavis.edu

Smoking is the major risk factor for chronic respiratory symptoms, but dietary factors may also play a role. Most studies of diet and lung disease have been cross-sectional and conducted in populations with a Western-style diet. We analyzed the relation between dietary intake at baseline and new onset of cough with phlegm in a population-based cohort of 63,257 middle-aged Chinese men and women initiated in Singapore between 1993 and 1998. Beginning in 1999, we ascertained respiratory symptoms by telephone interview and have identified 571 incident cases of cough with phlegm among the 49,140 cohort members with completed follow-up. Nonstarch polysaccharides, a major component of dietary fiber, total fruit, and soy isoflavones had the strongest associations. Odds ratios comparing highest and lowest quartiles after adjustment for age, sex, dialect group, total energy intake, and smoking were 0.61 (95% confidence interval [CI]: 0.47, 0.78; p for trend < 0.001) for nonstarch polysaccharides, 0.67 (95% CI: 0.52, 0.87; p for trend = 0.006) for fruit, and 0.67 (95% CI: 0.53, 0.86; p for trend = 0.001) for soy isoflavones. These data suggest that a diet high in fiber from fruit and, possibly, soyfoods may reduce the incidence of chronic respiratory symptoms. Associated nutrients, such as flavonoids, may contribute to this association.

Key Words: chronic bronchitis • chronic obstructive pulmonary disease • dietary fiber • fruit • soy

This article has been cited by other articles:

				H. Kan, J. Stevens, G. Heiss, K. M. Rose, and S. J. London Dietary Fiber, Lung Function, and Chronic Obstructive Pulmonary Disease in the Atherosclerosis Risk in Communities Study Am. J. Epidemiol., March 1, 2008; 167(5): 570 - 578. [Abstract] [Full Text] [PDF]

				R. Varraso, T. T Fung, F. B Hu, W. Willett, and C. A Camargo Prospective study of dietary patterns and chronic obstructive pulmonary disease among US men Thorax, September 1, 2007; 62(9): 786 - 791. [Abstract] [Full Text] [PDF]

				L. M. Butler, W.-P. Koh, H.-P. Lee, M. Tseng, M. C. Yu, and S. J. London On Previous Findings Concerning Preserved Meat Intake and Respiratory Disease Am. J. Respir. Crit. Care Med., August 1, 2007; 176(3): 315 - 315. [Full Text] [PDF]

				S. J. London Gene-Air Pollution Interactions in Asthma Proceedings of the ATS, July 1, 2007; 4(3): 217 - 220. [Abstract] [Full Text] [PDF]

				J. S. Burns, D. W. Dockery, L. M. Neas, J. Schwartz, B. A. Coull, M. Raizenne, and F. E. Speizer Low Dietary Nutrient Intakes and Respiratory Health in Adolescents Chest, July 1, 2007; 132(1): 238 - 245. [Abstract] [Full Text] [PDF]

				T. D. LeVan, W.-P. Koh, H.-P. Lee, D. Koh, M. C. Yu, and S. J. London Vapor, Dust, and Smoke Exposure in Relation to Adult-Onset Asthma and Chronic Respiratory Symptoms: The Singapore Chinese Health Study Am. J. Epidemiol., June 15, 2006; 163(12): 1118 - 1128. [Abstract] [Full Text] [PDF]

				L. M. Butler, W.-P. Koh, H.-P. Lee, M. Tseng, M. C. Yu, and S. J. London Prospective Study of Dietary Patterns and Persistent Cough with Phlegm among Chinese Singaporeans Am. J. Respir. Crit. Care Med., February 1, 2006; 173(3): 264 - 270. [Abstract] [Full Text] [PDF]

				G L David, W-P Koh, H-P Lee, M C Yu, and S J London Childhood exposure to environmental tobacco smoke and chronic respiratory symptoms in non-smoking adults: The Singapore Chinese Health Study Thorax, December 1, 2005; 60(12): 1052 - 1058. [Abstract] [Full Text] [PDF]

				B. Nemery, W. W. Yew, R. Albert, C. Brun-Buisson, W. MacNee, F. J. Martinez, D. C. Angus, and E. Abraham Tuberculosis, Nontuberculous Lung Infection, Pleural Disorders, Pulmonary Function, Respiratory Muscles, Occupational Lung Disease, Pulmonary Infections, and Social Issues in AJRCCM in 2004 Am. J. Respir. Crit. Care Med., March 15, 2005; 171(6): 554 - 562. [Full Text] [PDF]