Healthy plant-based diets reduce risk for obstructive sleep apnea

Key takeaways:

• Greater adherence to a plant-based diet overall reduced OSA risk by 19%.
• Those who adhered to an unhealthy plant-based diet had 22% greater odds of OSA.

Adherence to plant-based diets decreased the risk for obstructive sleep apnea, or OSA, although the reduction in risk differed between men and women, a study published in the European Respiratory Journal showed.

According to Yohannes Adama Melaku, PhD, a senior research fellow from Flinders University in Australia, and colleagues, “dietary patterns based on plant-based diets may have a potential effect on OSA risk via different mechanisms, including reduced inflammation and adiposity.”

“Thus, considering overall adherence to a plant-based diet and investigating its association with OSA risk is crucial to design appropriate control and prevention strategies,” they wrote.

In the study, the researchers analyzed data from 14,210 participants enrolled in the National Health and Nutrition Examination Survey who had provided 24-hour dietary recall data. About half of the participants (49.4%) were men.

Melaku and colleagues calculated four dietary indices, which included a:

• plant-based dietary index (PDI);
• healthy PDI (hPDI);
• unhealthy PDI (uPDI); and a
• pro-vegetarian diet index (PVDI).

Meanwhile, OSA risk was measured using STOP-BANG scores.

The researchers found that higher adherence to PDI, hPDI and PVDI was associated with 19% (OR = 0.81; 95% CI, 0.66-1), 17% (OR = 0.83; 95% CI, 0.69-1.01) and 16% (OR = 0.84; 95% CI, 0.68-1.05) reduced risks for OSA, respectively, whereas higher consumption of an unhealthy plant-based diet was associated with an increased risk for OSA (OR = 1.22; 95% CI, 1-1.49).

The risk reduction associated with PVDI in particular “supports the potential protective role of certain vegetarian-leaning dietary patterns,” the researchers wrote.

Also, the researchers found differences in the risk for OSA associated with diet based on sex, specifically pertaining to three of the four indices:

• PDI (OR = 0.71; 95% CI, 0.56-0.9 in men vs. OR = 0.93; 95% CI, 0.68-1.28 in women);
• hPDI (OR = 0.9; 95% CI, 0.68-1.18 in men vs. OR = 0.77; 95% CI, 0.54-1.09 in women); and
• uPDI (OR = 1.13; 95% CI, 0.89-1.44 in men vs. OR = 1.42; 95% CI, 1.03-1.97 in women).

“This suggests potential sex-specific mechanisms or susceptibilities that warrant further exploration,” Melaku and colleagues wrote.

The researchers explained that because of the cross-sectional design of the study, they could not infer causality between the dietary indices and OSA risk, whereas the 24-hour recall method used “may not be indicative of typical consumption patterns and might introduce recall biases.”

Still, “such findings prompt consideration for re-evaluation of dietary recommendations to a shift toward emphasizing healthy plant-based diets that are rich in anti-inflammatory components and antioxidant nutrients and low in harmful dietary factors,” Melaku and colleagues concluded. “These diets not only influence OSA risk but also have the potential to modulate other pathophysiological mechanisms, possibly affecting various other health conditions, from obesity to CVD.”