Investigating Ultra-Processed Foods as a Modifiable Risk Factor for Respiratory Exacerbations

About This Grant

Variability in food processing across and within food groups classified as ultraprocessed foods (UPFs) makes quantifying processing levels challenging, and existing classification systems lack the needed granularity. Given the contribution of UPFs to dietary intake and the likely impact of respiratory health, understanding the precise inflammatory effects and pulmonary consequences of UPFs is critical. Our preliminary work demonstrates that Artificial Intelligence (AI) offers solutions for more precise quantification of UPF composition profiles and consumption, enabling the proposed study on the variable effects of UPF subgroups on pulmonary outcomes. Exacerbations of respiratory symptoms lead to significant medical expenditures, lost productivity, higher overall morbidity, and accelerated lung function decline. However, questions about the effects of food processing on pulmonary outcomes remain under-addressed, and dietary guidelines to date have focused on nutrients to limit, with little guidance on UPFs specifically. Diets high in UPFs have been linked to increased inflammatory markers, suggesting that inflammation may mediate the association between UPF consumption and adverse health outcomes. This relationship has not been rigorously explored in relation to pulmonary symptoms and may represent diet as a point of intervention. We hypothesize that UPF subgroups are variably associated with respiratory exacerbation frequency and severity, and that UPF impacts on the lung are mediated by chronic systemic inflammation. By combining novel AI methodologies to assess food processing with the deep clinical and molecular phenotypes of the COPDGene longitudinal cohort study, we are uniquely positioned to robustly investigate this hypothesis in the following specific aims: Aim 1. Quantify the association of AI-scored UPF consumption with respiratory exacerbations, lung function, and COPD in people at high risk of lung disease; Aim 2. Evaluate the mediating effect of inflammatory proteins in the associations between UPF consumption and respiratory exacerbations, lung function, and COPD. Through this research, we will elucidate the contributions of UPF consumption to systemic inflammation, COPD, and respiratory outcomes in a high-risk population, leveraging AI approaches to improve precision across UPF subgroups and generate insights into biomarkers for UPFs. Our long-term goal is to inform “food as medicine” interventions to reduce the severity and progression of chronic lung diseases, a high-priority area in need of precise methods and solutions.