New Opportunities to Mitigate the Burden of Disease Caused by Traffic Related Air Pollution: Antioxidant-Rich Diets and Supplements

Abstract

Air pollution is associated with premature mortality and a wide spectrum of diseases. Traffic-related air pollution (TRAP) is one of the most concerning sources of air pollution for human exposure and health. Until TRAP levels can be significantly reduced on a global scale, there is a need for effective shorter-term strategies to prevent the adverse health effects of TRAP. A growing number of studies suggest that increasing antioxidant intake, through diet or supplementation, may reduce this burden of disease. In this paper, we conducted a non-systematic literature review to assess the available evidence on antioxidant-rich diets and antioxidant supplements as a strategy to mitigate adverse health effects of TRAP in human subjects. We identified 11 studies that fit our inclusion criteria; 3 of which investigated antioxidant-rich diets and 8 of which investigated antioxidant supplements. Overall, we found consistent evidence that dietary intake of antioxidants from adherence to the Mediterranean diet and increased fruit and vegetable consumption is effective in mitigating adverse health effects associated with TRAP. In contrast, antioxidant supplements, including fish oil, olive oil, and vitamin C and E supplements, presented conflicting evidence. Further research is needed to determine why antioxidant supplementation has limited efficacy and whether this relates to effective dose, supplement formulation, timing of administration, or population being studied. There is also a need to better ascertain if susceptible populations, such as children, the elderly, asthmatics and occupational workers consistently exposed to TRAP, should be recommended to increase their antioxidant intake to reduce their burden of disease. Policymakers should consider increasing populations’ antioxidant intake, through antioxidant-rich diets, as a relatively cheap and easy preventive measure to lower the burden of disease associated with TRAP.

Air pollution and neurological development in children

“…Other studies suggest that dietary supplementations (e.g. antioxidants, folate) may mitigate some negative effects of air pollution, although the direct effects on developmental outcomes are unclear and should be investigated 65–67 . Such understanding may shed light on novel cost‐effective interventions that can help mitigate the negative effects of air pollution.…”

The cardiovascular effects of air pollution: Prevention and reversal by pharmacological agents

“…A number of epidemiological studies have adjusted for patient medication as confounders in their analysis, although this has not been investigated as a primary aim in large scale studies or meta-analyses. Given the prominent role of oxidative stress, pharmacological approaches to prevent or reverse the effects of air pollution have centred on compounds with antioxidant properties ( Barthelemy, Sanchez, Miller, & Khreis, 2020 ; Peter et al, 2015 ; Romieu, Castro-Giner, Kunzli, & Sunyer, 2008 ). A recent review discussed the use of antioxidants to protect against the pulmonary effects of air pollution ( Whyand, Hurst, Beckles, & Caplin, 2018 ).…”

“…While a detailed discussion of large cohort epidemiological studies looking at the effects of air pollution are beyond the scope of this review, it is worth mentioning selected studies that have explored the effect of antioxidant-rich diets or supplements on gross cardiovascular endpoints such as mortality rates, or morbidity via hospital admissions and acute cardiovascular events (see also Barthelemy et al, 2020 ).…”

Interactions between environmental pollutants and dietary nutrients: current evidence and implications in epidemiological research

“…The role of nutrition to prevent the effects of xenobiotics may bring some hope to develop preventive strategies against the deleterious effects of pervasive, historical or banned chemicals. 2 3 61 However, it should not represent a reasoning to relax the protective policies for new chemicals or chemicals under regulatory evaluations. From a point of view of chemical regulation and risk assessment, the negative confounding bias should not be neglected due to the direct impacts on epidemiological risk analysis, attenuating or nullifying the effect estimates of toxic chemicals.…”