Ambient air pollution, dietary patterns, and the risk of incident cerebrovascular diseases: A prospective cohort study

IF 8.2 1区环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES

Science of the Total Environment Pub Date : 2025-07-08 DOI:10.1016/j.scitotenv.2025.180030

Bolun Cheng , Wenming Wei , Chuyu Pan , Li Liu , Shiqiang Cheng , Xuena Yang , Peilin Meng , Boyue Zhao , Jinyu Xia , Yan Wen , Feng Zhang

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Abstract

While recent research suggests air pollution and diet interactively influence cerebrovascular health, prospective studies integrating socioeconomic and geographic factors remain limited. We investigated associations between air pollutants and cerebrovascular diseases, emphasizing modification effects of dietary patterns across stratified populations. In a cohort of 249,044 UK Biobank participants, Cox proportional hazard models and restricted cubic spline regressions were used to evaluate associations of four air pollutants (PM_2.5, PM_2.5_–₁₀, NO_2, and NO_X) with seven cerebrovascular outcomes. Stratification analyses included sociodemographic (sex, age, body mass index, Townsend Deprivation Index (TDI), occupation), lifestyle (smoking, alcohol), and geographic factors. Dietary interactions were assessed via pollutant-diet cross-product terms across five food groups. Over a median follow-up of 10.8 years, 11,369 cases of cerebrovascular diseases were identified. PM_2.5 increased sequelae risk (HR = 1.102, 95 % CI: 1.039–1.169), particularly among males (1.132, 1.034–1.239) and adults ≥65 years (1.211, 1.098–1.335). PM_2.5_–₁₀ reduced transient cerebral ischaemic attacks risk in non-drinkers (0.746, 0.577–0.964). Stratified analyses revealed heightened PM_2.5-cerebrovascular diseases association in high-TDI populations (1.079, 1.058–1.101), manual workers (1.065, 1.010–1.121), and urban residents (1.096, 1.026–1.172). Regarding dietary patterns, grain product intake attenuated PM_2.5 effects on cerebrovascular diseases risk (0.938, 0.893–0.986). Fruit intake reduced PM_2.5_–₁₀-related sequelae risk (0.844, 0.748–0.952), particularly among high-TDI populations (0.833, 0.727–0.954) and urban residents (0.846, 0.738–0.969). This study indicates that prolonged exposure to ambient air pollutants may elevate the risk of cerebrovascular diseases, highlighting the importance of adhering to a healthy diet to mitigate the risk associated with air pollution.

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环境空气污染、饮食模式和脑血管疾病发生风险：一项前瞻性队列研究

虽然最近的研究表明空气污染和饮食相互作用影响脑血管健康，但整合社会经济和地理因素的前瞻性研究仍然有限。我们调查了空气污染物与脑血管疾病之间的关系，强调了饮食模式在分层人群中的改变作用。在249,044名英国生物银行参与者的队列中，使用Cox比例风险模型和限制三次样条回归来评估四种空气污染物（PM2.5, PM2.5 - 10， NO2和NOX）与七种脑血管结局的关系。分层分析包括社会人口学（性别、年龄、体重指数、汤森剥夺指数（TDI）、职业）、生活方式（吸烟、饮酒）和地理因素。通过污染物-饮食跨产品术语对五种食物组的饮食相互作用进行了评估。在中位10.8年的随访中，发现11,369例脑血管疾病。PM2.5增加了后遗症风险（HR = 1.102, 95% CI: 1.039-1.169），尤其是男性（1.132,1.034-1.239）和≥65岁的成年人（1.211,1.098-1.335）。PM2.5-10降低了非饮酒者短暂性脑缺血发作的风险（0.746,0.577-0.964）。分层分析显示，高tdi人群（1.079,1.058-1.101）、体力劳动者（1.065,1.010-1.121）和城市居民（1.096,1.026-1.172）pm2.5与脑血管疾病的相关性增高。在饮食模式方面，粮食产品摄入降低PM2.5对脑血管疾病风险的影响（0.938,0.893-0.986）。水果摄入量降低了pm2.5 - 10相关的后遗症风险（0.844,0.748-0.952），特别是在高tdi人群（0.833,0.727-0.954）和城市居民（0.846,0.738-0.969）中。这项研究表明，长期暴露于环境空气污染物可能会增加脑血管疾病的风险，强调坚持健康饮食以减轻与空气污染相关的风险的重要性。

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来源期刊

Science of the Total Environment 环境科学-环境科学

CiteScore

17.60

自引率

10.20%

发文量

8726

审稿时长

2.4 months

期刊介绍： The Science of the Total Environment is an international journal dedicated to scientific research on the environment and its interaction with humanity. It covers a wide range of disciplines and seeks to publish innovative, hypothesis-driven, and impactful research that explores the entire environment, including the atmosphere, lithosphere, hydrosphere, biosphere, and anthroposphere. The journal's updated Aims & Scope emphasizes the importance of interdisciplinary environmental research with broad impact. Priority is given to studies that advance fundamental understanding and explore the interconnectedness of multiple environmental spheres. Field studies are preferred, while laboratory experiments must demonstrate significant methodological advancements or mechanistic insights with direct relevance to the environment.