Dietary factors in the pathogenesis of asthma and chronic obstructive pulmonary disease

Abstract

This review focuses on the role of dietary factors in the pathogenesis of asthma and chronic obstructive pulmonary disease. Reduced pulmonary function and indicators of airway obstruction have been shown to be strong indicators of mortality; therefore, a link with diet in the pathogenesis of these diseases would have important public health implications. The results of the studies identified in the review suggest that people who have a diet rich in fruit and vegetables have a lower risk of poor respiratory health, and that this may be due to the antioxidant nutrients these foods contain. On the basis of the evidence, it seems justified to promote a healthy diet, high in fruits, vegetables, and whole grain foods and low in alcohol and fatty foods, as set out in existing guidelines for prevention of cardiovascular disease and cancer, to protect respiratory health in both children and adults.

Obesity, Nutrition, and Asthma in Children

“…Asthmatics have increased airway and circulating markers of oxidative stress. 60 The antioxidant system, which is equipped to protect the lung from damaging oxidants, is impaired in asthma. 61 Some antioxidants that neutralize reactive species can only be obtained in the diet (including carotenoids, vitamin E, and vitamin C).…”

Antioxidant Diet Protects Against Emphysema, but Increases Mortality in Cigarette Smoke-Exposed Mice

“…In humans, there is substantial evidence that a “healthy diet,” particularly one rich in fruits [10] and possibly vegetables [11-12] is protective against CS-induced emphysema and chronic obstructive pulmonary disease. However, the specific components responsible for these effects have not been defined.…”

Dietary polyunsaturated fatty acids in asthma- and exercise-induced bronchoconstriction

“…For example, daily use of long-acting b 2 -agonists in the management of exercise-induced asthma in children has recently been questioned (Bisgaard, 2000), and reversal of an asthma attack, such as exercise-induced asthma, may be ineffective in a large portion of asthmatics when short-acting b 2 -agonists are used daily (Hancox et al, 2002). Therefore, alternative treatment approaches in asthma that focus on manipulation of dietary factors are of real interest since they could potentially reduce the dose requirements of pharmacological medications (Hackman et al, 1996;Smit et al, 1999;Baker & Ayres, 2000;Fogarty & Britton, 2000a;Devereux & Seaton, 2001;Picado et al, 2001;Romieu & Trenga, 2001;Smit, 2001;Denny et al, 2003;Mickleborough & Gotshall, 2003), and reduce the public health burden of this disease. The effect of diet on asthma is complex, and likely involves involvement from a variety of nutrients, including flavanoids, vitamins, minerals, and fatty acids (Fogarty & Britton, 2000b;.…”