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Background <p>The potential of dietary patterns to modify the associations between long-term ambient fine particulate matter (PM<sub>2.5</sub>) exposure and all-cause, respiratory, and circulatory mortality remains unclear.</p> Methods <p>A total of 3,937 older adults (≥ 65 years) living in the community were enrolled in a prospective cohort study from 2001 to 2003 in Hong Kong. Assessment of the Diet Quality Index-International (DQI-I), Dietary Inflammatory Index (DII), the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet was carried out utilizing a 280-item food frequency questionnaire. Annual PM<sub>2.5</sub> concentrations were estimated via land use regression models. Mortality outcomes were sourced from official death registry. Time-varying Cox proportional hazards models were applied to estimate hazard ratios (HRs) and their 95% confidence intervals (CIs).</p> Results <p>During a median of 16.8 years follow-up, 1,856 deaths were recorded. PM<sub>2.5</sub> exposure significantly increased the risks of all-cause mortality, respiratory and circulatory mortality. The MIND diet interacted with PM<sub>2.5</sub> exposure on all-cause (<i>p</i>-interaction = 0.008) and respiratory mortality (<i>p</i>-interaction = 0.022). Higher MIND diet scores (≥ median) attenuated the adverse PM<sub>2.5</sub> exposure-mortality association, showing lower risks for all-cause (HR: 1.18, 95% CI: 1.06–1.32) and respiratory mortality (HR: 1.14, 95% CI: 0.91–1.41). In contrast, those with lower MIND scores (&lt; median) had elevated mortality risks, with HRs of 1.45 (95% CI: 1.27–1.65) for all-cause mortality and 1.60 (95% CI: 1.24–2.06) for respiratory mortality. No significant interaction was observed for circulatory mortality. Besides, no interaction was found between PM<sub>2.5</sub> exposure with DQI-I or DII in relation to mortality.</p> Conclusions <p>Adherence to MIND diet may mitigate the detrimental effects of long-term exposure to PM<sub>2.5</sub> on all-cause and respiratory mortality in older adults, whereas overall diet quality or an anti-inflammatory diet showed no protective effects.</p>

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The potential role of dietary patterns in modifying the association between ambient PM2.5 exposure and mortality in elderly Hong Kong Chinese

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月17日

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  • Shu-Yi Li,
  • Jason Leung,
  • Zhi-Hui Lu,
  • Kin-Fai Ho,
  • Yi Su,
  • Blanche Yu,
  • Timothy Kwok

摘要

Background

The potential of dietary patterns to modify the associations between long-term ambient fine particulate matter (PM2.5) exposure and all-cause, respiratory, and circulatory mortality remains unclear.

Methods

A total of 3,937 older adults (≥ 65 years) living in the community were enrolled in a prospective cohort study from 2001 to 2003 in Hong Kong. Assessment of the Diet Quality Index-International (DQI-I), Dietary Inflammatory Index (DII), the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet was carried out utilizing a 280-item food frequency questionnaire. Annual PM2.5 concentrations were estimated via land use regression models. Mortality outcomes were sourced from official death registry. Time-varying Cox proportional hazards models were applied to estimate hazard ratios (HRs) and their 95% confidence intervals (CIs).

Results

During a median of 16.8 years follow-up, 1,856 deaths were recorded. PM2.5 exposure significantly increased the risks of all-cause mortality, respiratory and circulatory mortality. The MIND diet interacted with PM2.5 exposure on all-cause (p-interaction = 0.008) and respiratory mortality (p-interaction = 0.022). Higher MIND diet scores (≥ median) attenuated the adverse PM2.5 exposure-mortality association, showing lower risks for all-cause (HR: 1.18, 95% CI: 1.06–1.32) and respiratory mortality (HR: 1.14, 95% CI: 0.91–1.41). In contrast, those with lower MIND scores (< median) had elevated mortality risks, with HRs of 1.45 (95% CI: 1.27–1.65) for all-cause mortality and 1.60 (95% CI: 1.24–2.06) for respiratory mortality. No significant interaction was observed for circulatory mortality. Besides, no interaction was found between PM2.5 exposure with DQI-I or DII in relation to mortality.

Conclusions

Adherence to MIND diet may mitigate the detrimental effects of long-term exposure to PM2.5 on all-cause and respiratory mortality in older adults, whereas overall diet quality or an anti-inflammatory diet showed no protective effects.