Pneumology - Original Articles

Association between dietary live microbe intake and emphysema prevalence:evidence from the National Health and Nutrition Examination Survey 2009-2018

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Published: 19 February 2026
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Utilizing the National Health and Nutrition Examination Survey data from 2009 to 2018, this study examines the association between dietary live microbe consumption and emphysema prevalence in 24,174 participants. Dietary live microbe intake was classified into three categories: low, medium, and high. Adjusted logistic regression models demonstrated a significant inverse relationship between dietary live microbe intake and emphysema prevalence. Participants in the medium and high intake groups showed approximately 40% [odds ratio (OR)=0.595] and 60% (OR=0.378) reduced risk, respectively (p<0.00001). Subgroup analysis revealed a stronger protective effect in males, potentially linked to their higher oxidative stress and metabolic rates. These findings suggest that dietary live microbes may reduce emphysema risk by modulating immune responses and inflammation through the gut-lung axis. However, as this is a cross-sectional study, causality cannot be established, and further longitudinal research is required to validate these findings.

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Ethics Approval

This study was conducted using publicly available and anonymized data from the National Health and Nutrition Examination Survey (NHANES). The NHANES protocols were approved by the National Center for Health Statistics (NCHS) Research Ethics Review Board under Protocol #2005-06 and Protocol #2011-17.

How to Cite



“Association Between Dietary Live Microbe Intake and Emphysema prevalence:Evidence from the National Health and Nutrition Examination Survey 2009-2018”. 2026. Monaldi Archives for Chest Disease, February. https://doi.org/10.4081/monaldi.2026.3631.