Consumption of antioxidant-rich foods attenuates respiratory and cardiovascular health effects in a population highly exposed to air pollution

Background: Diet and nutrition have shown promise in attenuating air pollution health effects. However, to date, no study has been conducted in an occupationally exposed population who experience high levels of very complex air pollution mixtures on a daily basis. Objectives: We therefore evaluated the effectiveness of regular consumption of antioxidant-rich foods in attenuating respiratory and cardiovascular health effects among street vendors in Accra, Ghana. Methods: We used a quasi-experimental design of 12-month duration, assigning 307 street vendors to either an intervention group (n = 155) to receive a weekly supply of antioxidant-rich foods or a control group (n = 152) who maintained their usual dietary pattern. Participants regularly consuming antioxidant-rich foods were assigned to the intervention group, with those consuming less of these foods assigned to the control group. Results: In the multivariable ordinal multinomial logistic regression model controlling for age, gender, educational level, and body mass index, the intervention participants were found to have reduced odds of cough (adjusted odds ratio [AOR] = 0.45; 95% CI: 0.33, 0.63), difficulty breathing (AOR = 0.40; 95% CI: 0.25, 0.65), irregular heartbeat (AOR = 0.08; 95% CI: 0.05, 0.13), and hospital visits (AOR = 0.34; 95% CI: 0.16, 0.72) compared with the control participants. Surprisingly, we observed a decline in lung function among the intervention participants compared with the control participants. Conclusions: We found regular consumption of antioxidant-rich foods to attenuate adverse air pollution health effects among this vulnerable population. Risk communication among this group and other outdoor workers should emphasize this nutrition intervention.