This Article Full Text Full Text (PDF) Online Supplement All Versions of this Article: 200506-901OCv1 200506-901OCv2 173/3/264    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.

Prospective Study of Dietary Patterns and Persistent Cough with Phlegm among Chinese Singaporeans

Division of Epidemiology, Department of Public Health Sciences, University of California, Davis, California; Department of Community, Occupational, and Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Population Science, Fox Chase Cancer Center, Philadelphia, Pennsylvania; University of Minnesota Cancer Center, Minneapolis, Minnesota; and Epidemiology Branch, National Institute of Environmental Health Sciences, Department of Health and Human Services, National Institutes of Health, Research Triangle Park, North Carolina

Correspondence and request for reprints should be addressed to Stephanie London, M.D., Dr.P.H., National Institute of Environmental Health Sciences, P.O. Box 12233, Mail Drop A3-05, Research Triangle Park, NC 27709. E-mail: london2{at}niehs.nih.gov

Rationale: Using principal components analysis to examine dietary patterns complements the evaluation of individual food and nutrient intake in relation to health outcomes, but has not yet been applied to nonmalignant respiratory disease or symptoms. Objective: To examine the relation between patterns of dietary intake at baseline and new onset of persistent cough with phlegm in a population-based cohort of Singapore Chinese. Methods: A 165-item validated food frequency questionnaire was administered in-person at baseline in 1993. We identified 623 cases of incident cough with phlegm among 52,325 subjects by telephone interview from 1999 through 2004. We identified two distinct food patterns: a "meat-dim sum" pattern characterized by pork and chicken dim sum foods and noodle dishes, and a "vegetable-fruit-soy" pattern characterized by vegetables, fruit, and soyfood items. Main Results: The meat-dim sum pattern was positively associated with new-onset cough with phlegm (odds ratio, 1.43; 95% confidence interval, 1.08, 1.89; comparing fourth to first quartile, p for trend = 0.02), after adjustment for age, sex, total energy intake, smoking, education, and nonstarch polysaccharide intake, a protective factor for cough with phlegm in this cohort. Weaker associations were seen for more chronic symptoms and for incident asthma. A weak inverse association for the vegetable-fruit-soy pattern disappeared after adjustment for nonstarch polysaccharide intake. Conclusion: A diet rich in meats, sodium, and refined carbohydrates may increase risk of developing cough with phlegm, independently of the apparent beneficial effects of a diet high in fiber in this Singapore Chinese cohort.

Key Words: asthma • chronic bronchitis • chronic obstructive pulmonary disease • diet • respiratory, signs and symptoms

This article has been cited by other articles:

				C. Heidemann, M. B. Schulze, O. H. Franco, R. M. van Dam, C. S. Mantzoros, and F. B. Hu Dietary Patterns and Risk of Mortality From Cardiovascular Disease, Cancer, and All Causes in a Prospective Cohort of Women Circulation, July 15, 2008; 118(3): 230 - 237. [Abstract] [Full Text] [PDF]

				C. Nagata, K. Nakamura, K. Fujii, T. Kawachi, N. Takatsuka, S. Oba, and H. Shimizu Soy Isoflavone Intake Is Not Associated with the Development of Cedar Pollinosis in Adults J. Nutr., July 1, 2008; 138(7): 1372 - 1376. [Abstract] [Full Text] [PDF]

				R. Jiang, C. A Camargo Jr, R. Varraso, D. C Paik, W. C Willett, and R G. Barr Consumption of cured meats and prospective risk of chronic obstructive pulmonary disease in women Am. J. Clinical Nutrition, April 1, 2008; 87(4): 1002 - 1008. [Abstract] [Full Text] [PDF]

				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]

				R. Varraso, T. T Fung, R G. Barr, F. B Hu, W. Willett, and C. A Camargo Jr Prospective study of dietary patterns and chronic obstructive pulmonary disease among US women Am. J. Clinical Nutrition, August 1, 2007; 86(2): 488 - 495. [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]

				R. Jiang, D. C. Paik, J. L. Hankinson, and R. G. Barr On Previous Findings Concerning Preserved Meat Intake and Respiratory Disease Am. J. Respir. Crit. Care Med., August 1, 2007; 176(3): 316 - 316. [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]

				X. Cui, Q. Dai, M. Tseng, X.-O. Shu, Y.-T. Gao, and W. Zheng Dietary Patterns and Breast Cancer Risk in the Shanghai Breast Cancer Study Cancer Epidemiol. Biomarkers Prev., July 1, 2007; 16(7): 1443 - 1448. [Abstract] [Full Text] [PDF]

				W. C. Moore and S. P. Peters Update in Asthma 2006 Am. J. Respir. Crit. Care Med., April 1, 2007; 175(7): 649 - 654. [Full Text] [PDF]

				Y. Y. Teo and F. F. M. Chong On the usage of principal components analysis and multiple testing. Am. J. Respir. Crit. Care Med., March 1, 2006; 173(5): 574 - 574. [Full Text] [PDF]

				L. M. Butler, S. J. London, M. C. Yu, M. Tseng, W.-P. Koh, and H.-P. Lee On the Usage of Principal Components Analysis and Multiple Testing Am. J. Respir. Crit. Care Med., March 1, 2006; 173(5): 574a - 575. [Full Text] [PDF]