Diet and Asthma: A Narrative Review

Rodrigues, Mónica; Mendes, Francisca de Castro; Delgado, Luís; Padrão, Patrícia; Paciência, Inês; Barros, Renata; Rufo, João Cavaleiro; Silva, Diana; Moreira, André; Moreira, Pedro

doi:10.3390/app13116398

Cited by 4 publications

(1 citation statement)

References 119 publications

(297 reference statements)

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“…The Mediterranean diet is acknowledged for its overall anti-inflammatory effects [ 41 ]. Nonetheless, a more adequate dietary pattern for asthma prevention is not fully established, and other components are not present in this score, including trans-saturated fatty acids, the n -6: n -3 ratio, and dietary diversity, that may be essential when considering asthma prevention [ 58 ].…”

Section: Discussionmentioning

confidence: 99%

Mediterranean Diet and Airway Inflammation in School-Aged Children

Rodrigues,

de Castro Mendes,

Padrão

et al. 2023

Children

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There seems to exist an intricate relationship between airway inflammation, body mass index (BMI), and diet. The intake of specific foods or food groups has been suggested to suppress the oxidative stress and inflammatory processes that characterize airway inflammation, but little is known about dietary patterns and their complex interplay with BMI and airway inflammation. Therefore, this cross-sectional study aimed to explore the association between adherence to the Mediterranean diet (MD), a characteristic European diet, and levels of airway inflammation in school-aged children, taking into account their BMI. This cross-sectional analysis comprised 660 children: 49.1% females, 7–12 years old. Adherence to the MD was assessed through the alternate Mediterranean score (aMED). Higher scores represent a healthier diet (0–8). Airway inflammation was assessed measuring exhaled fractional nitric oxide (eNO). Two categories of BMI were considered: non-overweight/non-obese (p < 85th) and overweight/obese (p ≥ 85th). The associations between diet and airway inflammation were estimated using logistic regression models. Higher scores of the aMED were associated with decreased odds of having eNO ≥ 35 ppb, but only in non-overweight/non-obese children (OR = 0.77; 95% CI, 0.61–0.97). For overweight/obese children, the previous association was not significant (OR = 1.57, 95% CI, 0.88–2.79). Our findings suggest that adherence to the MD is associated with lower levels of airway inflammation among non-overweight/non-obese children.

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Section: Discussionmentioning

confidence: 99%

Mediterranean Diet and Airway Inflammation in School-Aged Children

Rodrigues,

de Castro Mendes,

Padrão

et al. 2023

Children

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Obesity and Asthma: Implementing a Treatable Trait Care Model

Mendes,

Garcia‐Larsen,

Moreira

2024

Clin Experimental Allergy

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Recognition of obesity as a treatable trait of asthma, impacting its development, clinical presentation and management, is gaining widespread acceptance. Obesity is a significant risk factor and disease modifier for asthma, complicating treatment. Epidemiological evidence highlights that obese asthma correlates with poorer disease control, increased severity and persistence, compromised lung function and reduced quality of life. Various mechanisms contribute to the physiological and clinical complexities observed in individuals with obesity and asthma. These encompass different immune responses, including Type IVb, where T helper 2 cells are pivotal and driven by cytokines like interleukins 4, 5, 9 and 13, and Type IVc, characterised by T helper 17 cells and Type 3 innate lymphoid cells producing interleukin 17, which recruits neutrophils. Additionally, Type V involves immune response dysregulation with significant activation of T helper 1, 2 and 17 responses. Finally, Type VI is recognised as metabolic‐induced immune dysregulation associated with obesity. Body mass index (BMI) stands out as a biomarker of a treatable trait in asthma, readily identifiable and targetable, with significant implications for disease management. There exists a notable gap in treatment options for individuals with obese asthma, where asthma management guidelines lack specificity. For example, there is currently no evidence supporting the use of incretin mimetics to improve asthma outcomes in asthmatic individuals without Type 2 diabetes mellitus (T2DM). In this review, we advocate for integrating BMI into asthma care models by establishing clear target BMI goals, promoting sustainable weight loss via healthy dietary choices and physical activity and implementing regular reassessment and referral as necessary.

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Association between Serum Lipids and Asthma in Adults—A Systematic Review

Maștaleru,

Popescu,

Abdulan

et al. 2024

Nutrients

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(1) Background: Asthma is a syndrome found in both adults and children, characterized by airflow obstruction caused by the inflammation of the airways. In recent years, an increasing number of studies have found that lipid metabolism influences both the development and symptomatology of asthma. Lipid metabolism plays an important role both in the occurrence of exacerbations and in the reduction of lung inflammation. Our study aimed to identify any type of association between patients diagnosed with asthma and their serum lipids, including HDL-cholesterol, LDL-cholesterol, total cholesterol, and triglycerides in adults. (2) Methods: To find articles for our review, we searched two platforms: PubMed and Google Scholar. A total of 309 articles from two platforms were analyzed. Finally, 12 papers were selected from the initial pool of identified articles. (3) Results: The positive correlation between triglycerides, total cholesterol, low-density lipoprotein-cholesterol (LDL-cholesterol), and asthma has been demonstrated in several studies. Moreover, it appears that there is an association between biomarkers of type 2 inflammation and HDL and serum triglycerides in people with atopic status. Regarding the nutrition of asthmatic patients, the greatest impact on the development of the disease seems to be the consumption of fruit and vegetables. Several studies show that a predominantly vegan diet is associated with better control of the disease and a decrease in the number of pro-inflammatory cytokines. (4) Conclusions: Studies show a positive correlation between total cholesterol, triglyceride, and LDL-cholesterol levels and asthma and a negative correlation between HDL-cholesterol and asthma. Increased cholesterol values would lead to the stimulation of pro-inflammatory processes and the secretion of cytokines involved in these processes. The most successful diets for asthma patients seem to be those in which the consumption of fruit, vegetables, and high-fiber foods is increased because all of these food groups are rich in vitamins, antioxidants, and minerals.

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Diet and Asthma: A Narrative Review

Cited by 4 publications

References 119 publications

Mediterranean Diet and Airway Inflammation in School-Aged Children

Mediterranean Diet and Airway Inflammation in School-Aged Children

Obesity and Asthma: Implementing a Treatable Trait Care Model

Association between Serum Lipids and Asthma in Adults—A Systematic Review

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