Associations of diet with infectious diseases in UK Biobank

Abstract

The current study used multivariable logistic regression analysis to investigate associations between the intake frequencies of 13 food groups (or four diet groups) and infectious diseases. The analysis included 487849 participants from the UK Biobank, with 75209 participants diagnosed with infectious diseases. Participants reporting the highest intake frequency of processed meat (odds ratio [OR] = 1.0964, 95% confidence interval [CI]: 1.0622-1.1318) and red meat (OR = 1.0895, 95% CI: 1.0563-1.1239) had a higher risk of infectious diseases, compared with those with the lowest intake frequency. Consuming fish 2.0-2.9 times (OR = 0.8221, 95% CI: 0.7955-0.8496), cheese ≥ 5.0 times (OR = 0.882 2, 95% CI: 0.855 9-0.9092), fruit 3.0-3.9 servings (OR = 0.8867, 95% CI: 0.8661-0.9078), and vegetables 2.0-2.9 servings (OR = 0.9372, 95% CI: 0.9189-0.9559) per week were associated with a lower risk of infection. Low meat-eaters (OR = 0.9404, 95% CI: 0.9243-0.9567), fish-eaters (OR = 0.8391, 95% CI: 0.7887-0.8919), and vegetarians (OR = 0.9154, 95% CI: 0.8561-0.9778) had a lower risk of infectious diseases, compared with regular meat-eaters. The mediation analysis revealed that glycosylated hemoglobin, white blood cell count, and body mass index served as the mediators in the associations between diet and infectious diseases. The current study indicates that the intake frequency of food groups is a risk factor for infectious diseases, and fish-eaters have a lower risk of infection.

Keywords

infectious diseases / diet / food groups / UK Biobank / mediation analysis

Fundings

This work was supported by the National Natural Science Foundation of China (Grant Nos. 82173585 and 82273741), the Natural Science Foundation of Jiangsu Higher Education Institutions of China (Grant Nos. 21KJB330005 and 22KJB330007), the Nanjing Major Science and Technology Project (Grant No. 2021-11005), and the Priority Academic Program Development of Jiangsu Higher Education Institutions.

Acknowledgments

The current study was conducted using UK Biobank resources under Application Number 67665 (http://www.ukbiobank.ac.uk). We sincerely thank the participants and investigators of the UK Biobank for providing us with the publicly available data used in the current research.

References

[1] Strich JR, Chertow DS. CRISPR-cas biology and its application to infectious diseases[J]. J Clin Microbiol, 2019, 57(4): e01307-18. doi: 10.1128/jcm.01307-18

[2] De Martel C, Georges D, Bray F, et al. Global burden of cancer attributable to infections in 2018: a worldwide incidence analysis[J]. Lancet Glob Health, 2020, 8(2): e180-e190. doi: 10.1016/S2214-109X(19)30488-7

[3] Gao Z, Xu Y, Sun C, et al. A systematic review of asymptomatic infections with COVID-19[J]. J Microbiol Immunol Infect, 2021, 54(1): 12-16. doi: 10.1016/j.jmii.2020.05.001

[4] Nii-Trebi NI. Emerging and neglected infectious diseases: insights, advances, and challenges[J]. Biomed Res Int, 2017, 2017: 5245021. https://www.hindawi.com/journals/bmri/2017/5245021/

[5] Ye X, Wang Y, Zou Y, et al. Associations of socioeconomic status with infectious diseases mediated by lifestyle, environmental pollution and chronic comorbidities: a comprehensive evaluation based on UK Biobank[J]. Infect Dis Poverty, 2023, 12(1): 5. doi: 10.1186/s40249-023-01056-5

[6] Liu Q, Xu W, Lu S, et al. Landscape of emerging and re-emerging infectious diseases in China: impact of ecology, climate, and behavior[J]. Front Med, 2018, 12(1): 3-22. doi: 10.1007/s11684-017-0605-9

[7] GBD 2017 Diet Collaborators. Health effects of dietary risks in 195 countries, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet, 2019, 393(10184): 1958-1972. doi: 10.1016/S0140-6736(19)30041-8

[8] Key TJ, Bradbury KE, Perez-Cornago A, et al. Diet, nutrition, and cancer risk: what do we know and what is the way forward?[J]. BMJ, 2020, 368: m511. doi: 10.1136/bmj.m996

[9] Zinöcker MK, Lindseth IA. The western diet-microbiome-host interaction and its role in metabolic disease[J]. Nutrients, 2018, 10(3): 365. doi: 10.3390/nu10030365

[10] Chao AM, Quigley KM, Wadden TA. Dietary interventions for obesity: clinical and mechanistic findings[J]. J Clin Invest, 2021, 131(1): e140065. doi: 10.1172/JCI140065

[11] Pazoki R, Dehghan A, Evangelou E, et al. Genetic predisposition to high blood pressure and lifestyle factors: associations with midlife blood pressure levels and cardiovascular events[J]. Circulation, 2018, 137(7): 653-661. doi: 10.1161/CIRCULATIONAHA.117.030898

[12] Merino J, Joshi AD, Nguyen LH, et al. Diet quality and risk and severity of COVID-19: a prospective cohort study[J]. Gut, 2021, 70(11): 2096-2104. doi: 10.1136/gutjnl-2021-325353

[13] Weiss JJ, Sanchez L, Hubbard J, et al. Diet quality is low and differs by sex in people with HIV[J]. J Nutr, 2019, 149(1): 78-87. doi: 10.1093/jn/nxy241

[14] Pfeiffer AFH, Pedersen E, Schwab U, et al. The effects of different quantities and qualities of protein intake in people with diabetes mellitus[J]. Nutrients, 2020, 12(2): 365. doi: 10.3390/nu12020365

[15] Ludwig DS, Hu FB, Tappy L, et al. Dietary carbohydrates: role of quality and quantity in chronic disease[J]. BMJ, 2018, 361: k2340. doi: 10.1136/bmj.k2340

[16] Kaelin Jr WG, Mcknight SL. Influence of metabolism on epigenetics and disease[J]. Cell, 2013, 153(1): 56-69. doi: 10.1016/j.cell.2013.03.004

[17] Li X, Li C, Shang D, et al. The implications of relationships between human diseases and metabolic subpathways[J]. PLoS One, 2011, 6(6): e21131. doi: 10.1371/journal.pone.0021131

[18] Di Renzo L, Gualtieri P, Romano L, et al. Role of personalized nutrition in chronic-degenerative diseases[J]. Nutrients, 2019, 11(8): 1707. doi: 10.3390/nu11081707

[19] Smith TJ, McClung JP. Nutrition, immune function, and infectious disease[J]. Med J (Ft Sam Houst Tex), 2021, ( PB 8-21-01/02/03): 133-136.

[20] Park S, Zhang T. A positive association of overactivated immunity with metabolic syndrome risk and mitigation of its association by a plant-based diet and physical activity in a large cohort study[J]. Nutrients, 2021, 13(7): 2308. doi: 10.3390/nu13072308

[21] Mullard A. The UK biobank at 20[J]. Nat Rev Drug Discov, 2022, 21(9): 628-629. doi: 10.1038/d41573-022-00137-8

[22] Sudlow C, Gallacher J, Allen N, et al. UK biobank: an open access resource for identifying the causes of a wide range of complex diseases of middle and old age[J]. PLoS Med, 2015, 12(3): e1001779. doi: 10.1371/journal.pmed.1001779

[23] Yang S, Zhou X. Accurate and scalable construction of polygenic scores in large biobank data sets[J]. Am J Hum Genet, 2020, 106(5): 679-693. doi: 10.1016/j.ajhg.2020.03.013

[24] Bradbury KE, Murphy N, Key TJ. Diet and colorectal cancer in UK Biobank: a prospective study[J]. Int J Epidemiol, 2020, 49(1): 246-258. doi: 10.1093/ije/dyz064

[25] Watling CZ, Schmidt JA, Dunneram Y, et al. Risk of cancer in regular and low meat-eaters, fish-eaters, and vegetarians: a prospective analysis of UK Biobank participants[J]. BMC Med, 2022, 20(1): 73. doi: 10.1186/s12916-022-02256-w

[26] Chung MG, Li Y, Liu J. Global red and processed meat trade and non-communicable diseases[J]. BMJ Glob Health, 2021, 6(11): e006394. doi: 10.1136/bmjgh-2021-006394

[27] Boxman ILA, Jansen CCC, Zwartkruis-Nahuis AJT, et al. Detection and quantification of hepatitis E virus RNA in ready to eat raw pork sausages in the netherlands[J]. Int J Food Microbiol, 2020, 333: 108791. doi: 10.1016/j.ijfoodmicro.2020.108791

[28] Scollan ND, Price EM, Morgan SA, et al. Can we improve the nutritional quality of meat?[J]. Proc Nutr Soc, 2017, 76(4): 603-618. doi: 10.1017/S0029665117001112

[29] Jurek J, Owczarek M, Godos J, et al. Fish and human health: an umbrella review of observational studies[J]. Int J Food Sci Nutr, 2022, 73(7): 851-860. doi: 10.1080/09637486.2022.2090520

[30] Byrd KA, Shieh J, Mork S, et al. Fish and fish-based products for nutrition and health in the first 1000 days: a systematic review of the evidence from low and middle-income countries[J]. Adv Nutr, 2022, 13(6): 2458-2487. doi: 10.1093/advances/nmac102

[31] Santiago-López L, Aguilar-Toalá JE, Hernández-Mendoza A, et al. Invited review: bioactive compounds produced during cheese ripening and health effects associated with aged cheese consumption[J]. J Dairy Sci, 2018, 101(5): 3742-3757. doi: 10.3168/jds.2017-13465

[32] Herforth A, Arimond M, Álvarez-Sánchez C, et al. A global review of food-based dietary guidelines[J]. Adv Nutr, 2019, 10(4): 590-605. doi: 10.1093/advances/nmy130

[33] Wang DD, Li Y, Bhupathiraju SN, et al. Fruit and vegetable intake and mortality: results from 2 prospective cohort studies of us men and women and a meta-analysis of 26 cohort studies[J]. Circulation, 2021, 143(17): 1642-1654. doi: 10.1161/CIRCULATIONAHA.120.048996

[34] Torbica A, Radosavljević M, Belović M, et al. Overview of nature, frequency and technological role of dietary fibre from cereals and pseudocereals from grain to bread[J]. Carbohydr Polym, 2022, 290: 119470. doi: 10.1016/j.carbpol.2022.119470

[35] Weegels PL. The future of bread in view of its contribution to nutrient intake as a starchy staple food[J]. Plant Foods Hum Nutr, 2019, 74(1): 1-9. doi: 10.1007/s11130-019-0713-6

[36] Ng KW, Cao ZJ, Chen HB, et al. Oolong tea: a critical review of processing methods, chemical composition, health effects, and risk[J]. Crit Rev Food Sci Nutr, 2018, 58(17): 2957-2980. doi: 10.1080/10408398.2017.1347556

[37] Gerdes ME, Miko S, Kunz JM, et al. Estimating waterborne infectious disease burden by exposure route, United States, 2014[J]. Emerg Infect Dis, 2023, 29(7): 1357-1366. doi: 10.3201/eid2907.230231

[38] Jena S, Gaur D, Dubey NC, et al. Advances in paper based isothermal nucleic acid amplification tests for water-related infectious diseases[J]. Int J Biol Macromol, 2023, 242(Pt 3): 125089. doi: 10.1016/j.ijbiomac.2023.125089

[39] Ashbolt NJ. Microbial contamination of drinking water and human health from community water systems[J]. Curr Environ Health Rep, 2015, 2(1): 95-106. doi: 10.1007/s40572-014-0037-5

[40] Novak Babič M, Gostinčar C, Gunde-Cimerman N. Microorganisms populating the water-related indoor biome[J]. Appl Microbiol Biotechnol, 2020, 104(15): 6443-6462. doi: 10.1007/s00253-020-10719-4

[41] Cederholm T, Barazzoni R, Austin P, et al. ESPEN guidelines on definitions and terminology of clinical nutrition[J]. Clin Nutr, 2017, 36(1): 49-64. doi: 10.1016/j.clnu.2016.09.004

[42] Dhakal S, Chaulagain S, Klein SL. Sex biases in infectious diseases research[J]. J Exp Med, 2022, 219(6): e20211486. doi: 10.1084/jem.20211486

[43] Jenks JD, Aneke CI, Al-Obaidi MM, et al. Race and ethnicity: risk factors for fungal infections?[J]. PLoS Pathog, 2023, 19(1): e1011025. doi: 10.1371/journal.ppat.1011025