Association of healthy dietary patterns and cardiorespiratory fitness in the community.

To evaluate the associations of dietary indices and quantitative cardiorespiratory fitness (CRF) measures in a large, community-based sample harnessing metabolomic profiling to interrogate shared biology. Framingham Heart Study (FHS) participants underwent maximum effort cardiopulmonary exercise tests for CRF quantification (via peak VO2) and completed semi-quantitative food frequency questionnaires. Dietary quality was assessed by the Alternative Healthy Eating Index (AHEI) and Mediterranean-style Diet Score (MDS), and fasting blood concentrations of 201 metabolites were quantified. In 2380 FHS participants (54 ± 9 years, 54% female, body mass index 28 ± 5 kg/m2), 1 SD higher AHEI and MDS were associated with 5.2% (1.2 mL/kg/min, 95% CI 4.3-6.0%, P < 0.0001) and 4.5% (1.0 mL/kg/min, 95% CI 3.6-5.3%, P < 0.0001) greater peak VO2 in linear models adjusted for age, sex, total daily energy intake, cardiovascular risk factors, and physical activity. In participants with metabolite profiling (N = 1154), 24 metabolites were concordantly associated with both dietary indices and peak VO2 in multivariable-adjusted linear models (FDR < 5%). Metabolites that were associated with lower CRF and poorer dietary quality included C6 and C7 carnitines, C16:0 ceramide, and dimethylguanidino valeric acid, and metabolites that were positively associated with higher CRF and favourable dietary quality included C38:7 phosphatidylcholine plasmalogen and C38:7 and C40:7 phosphatidylethanolamine plasmalogens. Higher diet quality is associated with greater CRF cross-sectionally in a middle-aged community-dwelling sample, and metabolites highlight potential shared favourable effects on cardiometabolic health. This study seeks to address whether healthy dietary patterns relate to gold-standard measures of physical fitness in community-dwelling adults and how circulating metabolites can demonstrate biological relationships between diet and fitness. Healthy diet is associated with greater physical fitness in middle-aged adults. The beneficial relationship between diet and fitness may be partly explained by favourable metabolic health.

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Déclaration de conflit d'intérêts

Conflict of interest: V.L.M. owns stock in Amgen, General Electric, and Cardinal Health. He has received speaking honoraria from, serves as a scientific advisor for, and owns stock options in Ionetix. He has received research funding and speaking honoraria from Siemens Medical Imaging. He has served as a scientific advisor for Curium and has received expert witness fees from Jubilant Draximage. He has received a speaking honorarium from 2Quart Medical. He has received non-financial research support from INVIA Medical Imaging Solutions. In the past 12 months, R.V.S. has served as a consultant for Myokardia, Best Doctors, Amgen, and Cytokinetics. R.V.S. is a co-inventor on a patent for ex-RNAs signatures of cardiac remodelling. The spouse of R.V.S. works for UpToDate (Wolters Kluwer). G.D.L. has research funding from Amgen, Cytokinetics, Applied Therapeutics, AstraZeneca, and Sonivie in relation to projects and clinical trials investigating exercise capacity that are distinct from this work. He has served as a scientific advisor for Pfizer, Merck, Boehringer-Ingelheim, Novartis, American Regent, Relypsa, Cyclerion, Cytokinetics, and Amgen and receives royalties from UpToDate for scientific content authorship related to exercise physiology. M.N. has received speaking honoraria from Cytokinetics.