title: Dietary anthocyanin intake and age-related decline in lung function: longitudinal findings from the VA Normative Aging Study.
abstract: BACKGROUND
  It is unknown whether habitual intake of dietary flavonoids, known for their antioxidative and anti-inflammatory properties, affects longitudinal change in lung function.
  
  
  OBJECTIVE
  We investigated whether different flavonoid subclasses present in the habitual diet were associated with beneficial changes in lung function over time in the elderly.
  
  
  METHODS
  This longitudinal analysis included 839 participants from the VA (Veterans Affairs) Normative Aging Study whose lung function [forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC)] was measured at 2 and up to 5 visits between 1992 and 2008 (n = 2623 measurements). Yearly average intake of major flavonoid subclasses (anthocyanins, flavanones, flavan-3-ols, flavonols, flavones, and polymers) was calculated from food-frequency questionnaires at each visit. We estimated adjusted differences in annual change in lung function associated with each flavonoid subclass, categorized into quartiles, in linear mixed-effects regression models after adjustment for lifestyle and dietary confounders.
  
  
  RESULTS
  Strong inverse associations were found between anthocyanin intake and age-related decline in lung function. Independent of dietary and nondietary risk factors, slower rates of FEV1 and FVC decline by 23.6 (95% CI: 16.6, 30.7) and 37.3 (95% CI: 27.8, 46.8) mL/y, respectively, were observed in participants in the fourth quartile of intake compared with participants in the first quartile (P-trend < 0.0001). The protective associations observed for anthocyanin intake were present in both current/former and never smokers. Compared with no or very low intakes, an intake of ≥2 servings of anthocyanin-rich blueberries/wk was associated with slower decline in FEV1 and FVC by 22.5 (95% CI: 10.8, 34.2) and 37.9 (95% CI: 22.1, 53.7) mL/y, respectively. To a lesser extent, higher flavan-3-ol intake was also associated with slower lung function decline.
  
  
  CONCLUSIONS
  An attenuation of age-related lung function decline was associated with higher dietary anthocyanin intake in this longitudinal sample of predominantly elderly men. Further prospective studies are needed to confirm these novel associations.
authors.affiliation: Department of Environmental Health, Harvard School of Public Health, Boston, MA; amehta@hsph.harvard.edu.
authors.forename: Amar J
authors.initials: AJ
authors.lastname: Mehta
authors.affiliation: Department of Nutrition, Norwich Medical School, University of East Anglia, Norwich, United Kingdom;
authors.forename: Aedín
authors.initials: A
authors.lastname: Cassidy
authors.affiliation: Channing Division of Network Medicine and Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA;
authors.forename: Augusto A
authors.initials: AA
authors.lastname: Litonjua
authors.affiliation: Channing Division of Network Medicine and The VA Normative Aging Study, VA Boston Healthcare System, Boston, MA; and Department of Medicine, Boston University School of Medicine, Boston, MA.
authors.forename: David
authors.initials: D
authors.lastname: Sparrow
authors.affiliation: The VA Normative Aging Study, VA Boston Healthcare System, Boston, MA; and Department of Medicine, Boston University School of Medicine, Boston, MA.
authors.forename: Pantel
authors.initials: P
authors.lastname: Vokonas
authors.affiliation: Department of Environmental Health, Harvard School of Public Health, Boston, MA;
authors.forename: Joel
authors.initials: J
authors.lastname: Schwartz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000872:Anthocyanins / Q000008:administration & dosage / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D000975:Antioxidants / Q000008:administration & dosage / Q000627:therapeutic use*; D001900:Boston / Q000453:epidemiology; D015331:Cohort Studies; D004032:Diet; D005247:Feeding Behavior; D005541:Forced Expiratory Volume; D006801:Humans; D008137:Longitudinal Studies; D008168:Lung / Q000254:growth & development* / Q000502:physiology / Q000503:physiopathology; D008171:Lung Diseases / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D012307:Risk Factors; D014728:Veterans; D014797:Vital Capacity
chemical_list: D000872:Anthocyanins; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000975:Antioxidants
keywords: anthocyanins; clinical epidemiology; diet; flavonoids; lung function tests