Evidence for lifestyle interventions in asthma

Abstract

Asthma is a chronic inflammatory airways disease, estimated to affect 300 million people worldwide. Asthma management plans focus on optimisation of asthma pharmacotherapy. Lifestyle interventions also hold great promise for asthma sufferers as they are accessible, low cost and have minimal side-effects, thus making adherence more likely. This review explores lifestyle interventions that have been tested in asthma, including improving nutrition, increasing physical activity and introduction of relaxation therapies such as yoga and massage therapy. Available evidence suggests a protective effect of increasing fruit, vegetable and wholegrain intake and increasing physical activity levels in asthma. Weight loss is recommended for obese asthmatic patients, as just 5–10% weight loss has been found to improve quality of life and asthma control in most obese asthmatic patients. Other lifestyle interventions such as meditation, yoga and massage therapy show promise, with positive effects on asthma seen in some studies. However, the study protocols are highly variable and the results are inconsistent. Additional research is needed to further develop and refine recommendations regarding lifestyle modifications that can be implemented to improve asthma.Key pointsImproving diet quality, by increasing fruit, vegetable and wholegrain intake and reducing saturated fat intake, should be recommended in asthma, as there is evidence suggesting that this leads to improvements in airway inflammation, asthma control and exacerbation risk.Regular physical activity should be promoted for people with asthma, as it can improve quality of life and lung function, as well as general health.In obese asthmatic patients, weight loss should be recommended, as it leads to numerous health benefits, including improvements in asthma. Even small amounts of weight loss in adults (5–10% body weight) have been shown to improve asthma quality of life and asthma control in the majority of people with asthma.There is some evidence of benefit of meditation, yoga and breathing exercises for adults with asthma, while massage therapy shows promise in children with asthma. However, the evidence is inconsistent and more research is needed to make definitive recommendations.Educational aimsTo summarise current knowledge on lifestyle interventions in asthma.To improve awareness of how lifestyle modification can be used in asthma management.To identify areas for future research on lifestyle interventions in asthma.

Prevalence of modifiable factors limiting treatment efficacy of poorly controlled asthma patients: EFIMERA observational study

“…Obesity has a negative impact in asthma, and there are preliminary data showing the benefit of weight reduction on asthma control and quality of life 16 . However, recommendation of diet-induced weight loss in asthma patients is related with the plethora of general health benefits 17 , but it has insufficient evidence yet on asthma control 18 ; for that reason, authors did not include this factor into the modifiable ones.…”

Higher Omega-3 Index Is Associated with Better Asthma Control and Lower Medication Dose: A Cross-Sectional Study

“…As obesity is generally associated with increased asthma severity, poorer asthma control and more frequent exacerbations, it was important to analyse the relationship between O3I, obesity and asthma outcomes [24]. When we examined obese and nonobese asthmatics according to O3I, obese asthmatics with a higher O3I had a lower range of maintenance ICS doses compared with obese asthmatics with a lower O3I.…”

Reduced‐sodium cheeses: Implications of reducing sodium chloride on cheese quality and safety

“…Correlating low-grade metabolic acidosis and bone diseases, Morris, Schmidlin, Frassetto, and Sebastian (2006) showed that diet low in fruits and vegetables and high in sodium can result in increased bone resorption and calcium excretion due to low-grade metabolic acidosis. Further exploring the negative impacts of sodium on health, researchers have reported that diet rich in sodium may also be associated with renal disorder (Smyth et al, 2014), osteoporosis (Berry, 2019), asthma (Stoodley, Williams, Thompson, Scott, & Wood, 2019), Meniere's disease (Sajjadi & Paparella, 2008), and obesity (Ma, He, & MacGregor, 2015). Moreover, diet rich in sodium can also be linked to type-II diabetes (Hu, Jousilahti, Peltonen, Lindström, & Tuomilehto, 2005).…”