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Online Library: Asthma

The following pages provide an overview of the most recent research and clinical studies about the health benefits of micronutrients in fighting asthma. This collection of scientific facts proves that anyone who privately or publicly questions the health value of micronutrients does not serve YOUR health, or the health of the people, but rather the multi-billion dollar investment 'business with disease' based on patented pharmaceutical drugs.

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Relationship Between Serum Vitamin D, Disease Severity and Airway Remodeling in Children with Asthma.

Source: American journal of respiratory and critical care medicine 2011 Sep 15. [Epub ahead of print]

Author: Gupta A, Sjoukes A, Richards D, Banya W, Hawrylowicz C, Bush A, Saglani S.

Affiliation: Royal Brompton hospital, London, United Kingdom; King's College London, London, United Kingdom.

Abstract: Rationale Little is known about vitamin D status and its effect on asthma pathophysiology in children with severe, therapy resistant asthma (STRA). Relationships between serum vitamin D, lung function, and pathology were investigated in pediatric STRA. Methods Serum 25-hydroxyvitamin D (25[OH]D3) was measured in 86 children (mean age 11.7 years), 36 STRA, 26 moderate asthmatics (MA) and 24 non-asthmatic controls. Relationships between 25[OH]D3, the asthma control test (ACT), spirometry, corticosteroid usage, and exacerbations were assessed. 22/36 children with STRA underwent fibreoptic bronchoscopy, bronchoalveolar lavage and endobronchial biopsy with assessment of airway inflammation and remodeling. Conclusions: Lower vitamin D levels in children with STRA were associated with increased airway smooth muscle (ASM) mass, worse asthma control and lung function. The link between vitamin D, airway structure and function suggests vitamin D supplementation may be useful in pediatric STRA.

Effect of supplemental folic acid in pregnancy on childhood asthma: a prospective birth cohort study.

Source: American journal of epidemiology 2009; 170(12):1486-93

Author: Whitrow MJ, Moore VM, Rumbold AR, Davies MJ.

Affiliation: Research Centre for the Early Origins of Health and Disease, Robinson Institute, The University of Adelaide, Australia.

Abstract: This study aimed to investigate the effect of the timing, dose, and source of folate during pregnancy on childhood asthma by using data from an Australian prospective birth cohort study (n = 557) from 1998 to 2005. At 3.5 years and 5.5 years, 490 and 423 mothers and children participated in the study, respectively. Maternal folate intake from diet and supplements was assessed by food frequency questionnaire in early (<16 weeks) and late (30-34 weeks) pregnancy. The primary outcome was physician-diagnosed asthma, obtained by maternal-completed questionnaire. Asthma was reported in 11.6% of children at 3.5 years (n = 57) and in 11.8% of children at 5.5 years (n = 50). Folic acid taken in supplement form in late pregnancy was associated with an increased risk of childhood asthma at 3.5 years and with persistent asthma. The effect sizes did not change with adjustment for potential confounders. The association was similar at 5.5 years but did not reach statistical significance in univariable models. These findings on childhood asthma support previous observations that supplementation with folate in pregnancy leads to an allergic asthma phenotype in mice via epigenetic mechanisms and is associated with poorer respiratory outcomes in young children.

Antioxidants play an important role in childhood asthma

Oxidative free radicals are known to trigger asthma attacks. The following study evaluated the levels of antioxidants in asthmatic children and found that antioxidant enzymes such as glutathione peroxidase and superoxide dismutase and nonenzymatic antioxidants such as glutathione, ascorbic acid, alpha-tocopherol, lycopene, and beta-carotene were significantly lower in children with asthma compared with healthy subjects. In addition, children suffering from asthma had lower levels of the majority of amino acids susceptible to oxidation.

A comprehensive evaluation of the enzymatic and nonenzymatic antioxidant systems in childhood asthma.

Source: J Allergy Clin Immunol. 2008 Jul;122(1):78-85.

Author: Sackesen C, Ercan H, Dizdar E, Soyer O, Gumus P, Tosun BN, Büyüktuncer Z, Karabulut E, Besler T, Kalayci O.

Affiliation: Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey.

Abstract: BACKGROUND: Even though there is ample evidence on the oxidative stress in asthma, there is limited information on the antioxidant defense systems. OBJECTIVES: To conduct a comprehensive evaluation of various components of both enzymatic and nonenzymatic antioxidants in a large group of children with asthma. METHODS: A total of 164 children with mild asthma and 173 healthy children were included in the study. Levels of the enzymes glutathione peroxidase and superoxide dismutase were measured by using ELISA, whereas reduced glutathione, ascorbic acid, alpha-tocopherol, lycopene, beta-carotene, amino acids participating in glutathione synthesis, and amino acids susceptible to oxidation were measured by HPLC. All comparisons were adjusted for atopy, body mass index, smoke exposure, and pet ownership. RESULTS: Levels of the enzymes glutathione peroxidase and superoxide dismutase and of the nonenzymatic components of the antioxidant system including reduced glutathione, ascorbic acid, alpha-tocopherol, lycopene, and beta-carotene were significantly lower in children with asthma compared with healthy controls (P < .001 for each). Of the amino acids contributing to glutathione synthesis, glycine and glutamine were significantly lower in children with asthma (P < .001). The majority of the amino acid susceptible to oxidative stress displayed lower levels in children with asthma (P < .05). CONCLUSION: Childhood asthma is associated with significant decreases in various components of both enzymatic and nonenzymatic antioxidant defenses.

Antioxidants reduce asthma risk in adults

Antioxidants such as vitamin C and manganese were studied in this placebo controlled clinical trial involving approximately 1000 adults; half of them had asthma and half did not. Asthmatic patients were seen to have lower fruit intake as well as lower levels of vitamin C in plasma (blood component). The authors also noted that supplementing vitamin C and manganese, significantly reduced the symptoms of asthma.

Dietary antioxidants and asthma in adults.

Source: Thorax. 2006 May;61(5):388-93.

Author: Patel BD, Welch AA, Bingham SA, Luben RN, Day NE, Khaw KT, Lomas DA, Wareham NJ.

Affiliation: Department of Public Health and Primary Care, Institute of Public Health, Cambridge, UK.

Abstract: BACKGROUND: Several antioxidant nutrients have been reported to be inversely associated with asthma. A study was undertaken to assess the independent associations of these nutrients with asthma in adults. METHODS: A nested case-control study was performed in 515 adults with physician diagnosed asthma and 515 matched controls using dietary data obtained from 7 day food diaries. The main outcome measures were physician diagnosed asthma and current symptomatic asthma (diagnosed asthma and self-reported wheeze within the previous 12 months). RESULTS: Cases were similar to controls in age, sex, social class, and daily energy intake but had a lower median intake of fruit (132.1 v 149.1 g/day, p< or =0.05). 51.5% of the population reported zero consumption of citrus fruit; relative to these individuals, people who consumed >46.3 g/day had a reduced risk of diagnosed and symptomatic asthma (OR adjusted for potential confounders 0.59 (95% CI 0.43 to 0.82) and 0.51 (95% CI 0.33 to 0.79), respectively). In nutrient analysis, dietary vitamin C and manganese were inversely and independently associated with symptomatic asthma (adjusted OR per quintile increase 0.88 (95% CI 0.77 to 1.00) for vitamin C and 0.85 (95% CI 0.74 to 0.98) for manganese), but only manganese was independently associated with diagnosed asthma (OR 0.86 (95% CI 0.77 to 0.95)). Adjusted plasma levels of vitamin C were significantly lower in symptomatic cases than in controls (54.3 v 58.2 micromol/l, p = 0.003). CONCLUSIONS: Symptomatic asthma in adults is associated with a low dietary intake of fruit, the antioxidant nutrients vitamin C and manganese, and low plasma vitamin C levels. These findings suggest that diet may be a potentially modifiable risk factor for the development of asthma.

Antioxidants supplementation reduce the response to pollutants

Asthmatic children are more prone to symptomatic attacks with increased exposure to pollutants. This study compared the responses of 117 children living in Mexico City when given supplements of vitamin C and E, versus placebo. Intake of supplements above the minimum dietary recommendations was effective in reducing the inflammatory response in children with high ozone exposure.

Antioxidant supplementation and nasal inflammatory responses among young asthmatics exposed to high levels of ozone.

Source: Clin Exp Immunol. 2004 Nov;138(2):317-22.

Author: Sienra-Monge JJ, Ramirez-Aguilar M, Moreno-Macias H, Reyes-Ruiz NI, Del Río-Navarro BE, Ruiz-Navarro MX, Hatch G, Crissman K, Slade R, Devlin RB, Romieu I.

Affiliation: Hospital Infantil de México, Federico Gómez, México.

Abstract: The inflammatory response to ozone in atopic asthma suggests that soluble mediators of inflammation are released in response to oxidant stress. Antioxidants may alleviate additional oxidative stress associated with photochemical oxidant pollution. This study investigates the impact of antioxidant supplementation on the nasal inflammatory response to ozone exposure in atopic asthmatic children. We conducted a randomized trial using a double-blinded design. Children with asthma (n = 117), residents of Mexico City, were given randomly a daily supplement of vitamins (50 mg/day of vitamin E and 250 mg/day of vitamin C) or placebo. Nasal lavages were performed three times during the 4-month follow-up and analysed for content of interleukin-6 (IL-6), IL-8, uric acid and glutathione (GSx). IL-6 levels in the nasal lavage were increased significantly in the placebo group after ozone exposure while no increase was observed in the supplement group. The difference in response to ozone exposure between the two groups was significant (P = 0.02). Results were similar for IL-8, but with no significant difference between the groups (P = 0.12). GSx decreased significantly in both groups. Uric acid decreased slightly in the placebo group. Our data suggest that vitamin C and E supplementation above the minimum dietary requirement in asthmatic children with a low intake of vitamin E might provide some protection against the nasal acute inflammatory response to ozone.

Asthmatic patients have a low intake of vitamin A, B1, E, and folic acid

Evaluation of the dietary intake of 54 asthma patients found that patients suffering from asthma had a high intake of saturated fat and low intak of important vitamins such as A, thiamine (B1), E and folic acid.

Antioxidant and fat intake in patients with polinic asthma

Source: Med Clin (Barc). 2003 Nov 15;121(17):653-4

Author: de Luis DA, Izaola O, Aller R, Armentia A, Cuéllar L.

Affiliation: Instituto de Endocrinología y Nutrición, Facultad de Medicina, Hospital Río Hortega, Universidad de Valladolid, Valladolid, España.

Abstract: BACKGROUND AND OBJECTIVE: The aim of our work was to evaluate the dietary intake of patients with asthma. PATIENTS AND METHOD: A total of 54 subjects with asthma were enrolled (average age 23.59 +/- 9.6 years). In all patients, we determined weight, height and the body mass index and a three days nutritional questionnaire was administered. RESULTS: The total calories intake was normal. Distribution of calories was: 39.7% carbohydrates, 19.4% proteins and 40.9% lipids. Low intakes of vitamin A, D, E, thiamine and folic acid were detected, and an adequate intake of vitamin K, C, niacin and B12 was observed. The mineral intake showed an increase in calcium and a decrease in magnesium, zinc, iodine and selenium. The intake of polyunsaturated omega-9 fatty acids was 34.8(12.7) g/day, that of polyunsaturated omega-6 fatty acids was 5.7(3.1) g/day, and the intake of polyunsaturated omega-3 fatty acids was 0.85(0.31) g/day. Saturated fats represented a 18.4%. The omega6/omega3 ratio was 6.63. CONCLUSIONS: Asthmatic patients have a low intake of vitamins A and E but an increase in the intake of saturated fatty acids.

Coenzyme Q10 supplements reduce the requirements of corticosteroid use in asthma

This clinical study in 41 patients taking corticosteroids shows that coenzyme Q-10 levels are lower in asthma patients and subsequent administration of Co-Q-10 helps to decrease the required doses of corticosteroids. Chronic corticosteroids administration is associated with severe and widespread side effects on multiple body systems.

Coenzyme Q10 supplementation reduces corticosteroids dosage in patients with bronchial asthma.

Source: Biofactors. 2005;25(1-4):235-40.

Author: Gvozdjáková A, Kucharská J, Bartkovjaková M, Gazdíková K, Gazdík FE.

Affiliation: Comenius University, Medical Faculty, Pharmacobiochemical Laboratory, Bratislava, Slovakia.

Abstract: Bronchial asthma is a chronic inflammatory disease of respiratory system, with disturbances in the dynamic balance of oxidant-antioxidant capacity of the lungs. Long-term administration of corticosteroids has been shown to result in mitochondrial dysfunction and oxidative damage of mitochondrial and nuclear DNAs. We previously documented decreased coenzyme Q(10) (CoQ(10)) and alpha-tocopherol concentrations in plasma and blood in corticosteroid-dependent bronchial asthma patients. In the present study we demonstrate that CoQ(10) supplementation reduces the dosage of corticosteroids in these patients. PATIENTS AND METHODS: This was an open, cross-over, randomized clinical study with 41 bronchial asthma patients (13 males, 28 females), ages 25-50 years. All patients suffered from persistent mild to moderate asthma. The patients were divided into two groups, one group receiving standard antiasthmatic therapy and clinically stabilized, and the second group receiving, in addition, antioxidants consisting of CoQ(10) as Q-Gel (120 mg) + 400 mg alpha-tocopherol + 250 mg vitamin C a day. The groups were crossed over at 16 weeks for a total duration of 32 weeks. RESULTS AND CONCLUSIONS: Data show that patients with corticosteroid-dependent bronchial asthma have low plasma CoQ(10) concentrations that may contribute to their antioxidant imbalance and oxidative stress. A reduction in the dosage of corticosteroids required by the patients following antioxidant supplementation was observed, indicating lower incidence of potential adverse effects of the drugs, decreased oxidative stress. This study also demonstrates the significant uptake of CoQ(10) by lung tissue in a rat model using hydrosoluble CoQ(10) (Q-Gel).

Deficiency of specific nutrients contributes to severe form of asthma

It is well known that asthmatic patients have significant imbalance between protective effects of antioxidants and damaging effects of free oxidative radicals. This placebo controlled clinical trial evaluated plasma concentration of specific components such as ascorbic acid, vitamin E, carotenoids, bilirubin, albumin, uric acid and total antioxidant levels in approximately 120 people with varying degrees of asthma and in healthy controls. Results indicated that vitamin C and carotenes (orange pigment present in fruits such as carrots, melons etc.) were particularly low in severe asthma patients, and increasing specific antioxidants intake would be helpful in reducing severe asthma attacks.

Dr. Rath has been the pioneer of the innovative concept of nutrient synergy, which states that combination of specific nutrients is more effective than mega doses of individual nutrients. This concept was used in Dr. Rath's research for more than a decade.

Plasma concentrations of dietary and nondietary antioxidants are low in severe asthma.

Source: Eur Respir J. 2005 Aug;26(2):257-64.

Author: Misso NL, Brooks-Wildhaber J, Ray S, Vally H, Thompson PJ.

Affiliation: Asthma & Allergy Research Institute, Ground Floor, E Block, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia.

Abstract: Low antioxidant levels and oxidative stress due to airway inflammation may be important determinants of asthma severity. The objective of the present study was to determine whether lower antioxidant intake and plasma antioxidant concentrations are associated with more severe asthma. Dietary antioxidant intakes and asthma severity were assessed using questionnaires, and plasma concentrations of ascorbic acid, vitamin E, carotenoids, bilirubin, albumin, uric acid and total antioxidant status were measured in 53 mild-to-moderate and 28 severe asthmatic patients and in 43 nonasthmatic subjects. Vitamin C and carotene intakes were lower in males than females and were particularly low in males with severe asthma. Plasma ascorbic acid was lower in severe (31.9+/-3.6 microM) compared with mild-to-moderate asthmatic (52.3+/-2.6) or control subjects (52.7+/-2.9). Low plasma ascorbic acid (odds ratio (OR) 0.93; 95% confidence interval (CI) 0.9-0.97), bilirubin (OR 0.69; 95% CI 0.51-0.93) and increased plasma cholesterol (OR 1.98; 95% CI 1.05-3.73) were independently associated with severe asthma. Albumin was positively and cholesterol negatively correlated with lung function. Low plasma concentrations of specific antioxidants are associated with more severe asthma. Increased antioxidant intake may help reduce the burden of severe asthma, particularly in males.

Effect of oral magnesium supplementation

Effect of oral magnesium supplementation on measures of airway resistance and subjective assessment of asthma control and quality of life in men and women with mild to moderate asthma: a randomized placebo controlled trial.

Source: J Asthma. 2010; 47(1):83-92

Author: Kazaks AG, Uriu-Adams JY, Albertson TE, Shenoy SF, Stern JS.

Affiliation: Department of Nutrition and Exercise Science, Bastyr University, Kenmore, Washington 98028-4966, USA.

Abstract: Epidemiological data shows low dietary magnesium(Mg) may be related to incidence and progression of asthma. In this study 55 males and females aged 21 to 55 years with mild to moderate asthma were randomly assigned to consume 340 mg(170 mg twice a day) of Mg or a placebo for 6.5 months. Conclusion of this study: Adults who received oral Mg supplements showed improvement in objective measures of bronchial reactivity to methacholine and PEFR and in subjective measures of asthma control and quality of life.

Effects of dietary supplementation with oils rich in n-3 fatty acids compared to n-6 fatty acids on bronchial asthma.

This clinical study in 14 patients with asthma conclude that supplementation for 14 weeks with with perilla seed oil (n-3 fatty acids) was beneficial in suppressing markers of bronchial asthma compared to corn oil (n-6 fatty acids)

Effects of dietary supplementation with n-3 fatty acids compared to n-6 fatty acids on bronchial asthma.

Source: Intern Med. 2000 Feb;39(2):107-11.

Author: Okamoto M, Mitsunobu F, Ashida K, Mifune T, Hosaki Y, Tsugeno H, Harada S, Tanizaki Y.

Affiliation: Department of Medicine, Misasa Medical Branch, Okayama University Medical School, Tohaku-gun, Tottori.

Abstract: OBJECTIVE: The effects of perilla seed oil (n-3 fatty acids) on bronchial asthma were compared with the effects of corn oil (n-6 fatty acids) in relation to the pulmonary function and the generation of leukotriene B4 (LTB4) and C4 (LTC4) by leucocytes. METHODS AND SUBJECTS: 14 asthmatic subjects were divided randomly into two groups: one group (7 subjects) consumed perilla seed oil-rich supplementation and the other group (7 subjects) consumed corn oil-rich supplementation for 4 weeks. Generation of LTs by leucocytes and respiratory function were compared between the two groups. RESULTS: The generation of LTB4 and LTC4 by leucocytes tended to increase in subjects (N=7) with corn oil-rich supplementation, and decrease in subjects (N=7) with perilla seed oil-rich supplementation. Significant differences between the two groups were observed in the generation of LTB4 at 2 weeks (p<0.05) and LTC4 at 2 weeks (p<0.05) after dietary supplementation. Significant increases in the value of PEF (p<0.05), FVC (p<0.01), FEV(1.0) (p<0.05) and V(25) (p<0.05) were found in subjects who received perilla seed oil supplementation for 4 weeks. And significant differences in the value of FVC (p<0.05) and FEV(1.0) (p<0.05) were observed between the two groups after 4 weeks of dietary supplementation. CONCLUSION: These results suggest that perilla seed oil-rich supplementation is useful for the treatment of asthma in terms of suppression of LTB4 and LTC4 generation by leucocytes, and improvement of pulmonary function.

Elevated oxidative stress and decreased antioxidant levels in asthmatic patients

Reactive oxygen species, constitute free radicals produced by several damaging factors, such as radiation, stress, UV rays etc. and can pose significant cell damage. Therefore these are considered to contribute to several chronic diseases. The results of this study conducted in 38 patients with asthma and 32 without asthma indicate that white blood cells of asthmatic patients have significantly higher levels of damaging free radicals and lower levels of protective antioxidant pool compared to the healthy adults.

Leukocyte oxidant and antioxidant status in asthmatic patients.

Source: Arch Med Res. 2005 Sep-Oct;36(5):502-6.

Author: Vural H, Aksoy N, Ceylan E, Gencer M, Ozguner F.

Affiliation: Department of Biochemistry, Suleyman Demirel University, Isparta, Turkey.

Abstract: BACKGROUND: Oxidative stress mediated by reactive oxygen species (ROS) is recognized to contribute significantly to the inflammatory process of bronchial asthma (BA). These species are released into the airway by activated inflammatory cells such as leukocytes. In this study, we aimed to determine whether the oxidant-antioxidant balance is changed in leukocytes of patients with BA. METHODS: Thirty eight patients (21 male, 17 female) aged 22-68 years and controls of 32 subjects (18 male, 14 female) aged 20-63 years were included in the study. A total of 10 mL venous blood was drawn, leukocytes were separated and lipid peroxidation (LPO), glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) and vitamin C levels were determined in both patients and controls. RESULTS: Leukocyte LPO and SOD activity in the patient group were higher than that of controls (p <0.001 and p <0.05, respectively). However, leukocyte GSH-Px and vitamin C levels in the patient group were lower than that of controls (p <0.01 and p <0.001, respectively). CONCLUSIONS: The results suggest that there are alterations in a wide array of oxidants and antioxidants with balance shifting toward increased oxidative stress in BA.

Fish oil may be helpful in children with asthma

The anti inflammatory properties of fish oil prove to be beneficial in children with bronchial asthma.

Dietary supplementation with fish oil rich in omega-3 polyunsaturated fatty acids in children with bronchial asthma.

Source: Eur Respir J. 2000 Nov;16(5):861-5.

Author: Nagakura T, Matsuda S, Shichijyo K, Sugimoto H, Hata K.

Affiliation: Dept of Paediatrics, Jikei University School of Medicine, Tokyo, Japan.

Abstract: Omega-3 polyunsaturated fatty acids have anti-inflammatory effects in vitro, and high dietary levels are associated with a lower incidence of inflammatory diseases. However, only limited effects have been demonstrated in asthma. The effects of dietary supplementation with fish oil for 10 months in 29 children with bronchial asthma was investigated in a randomized controlled fashion. In order to minimize the effects of environmental inhaled allergens and diet, this study was performed in a long-term treatment hospital. Subjects received fish oil capsules containing 84 mg eicosapentaenoic acid (EPA) and 36 mg docosahexaenoic acid (DHA) or control capsules containing 300 mg olive oil. The daily dosages of EPA and DHA were 17.0-26.8 and 7.3-11.5 mg x kg body weight(-1), respectively. Asthma symptom scores decreased and responsiveness to acetylcholine decreased in the fish oil group but not in the control group. In addition, plasma EPA levels increased significantly only in the fish oil group (p<0.0088). No significant side-effects were observed. The present results suggest that dietary supplementation with fish oil rich in the omega-3 polyunsaturated fatty acids eicosapentaenoic acid and docosahexaenoic acid is beneficial for children with bronchial asthma in a strictly controlled environment in terms of inhalant allergens and diet.

Fish Oil supplements reduce exercise induced asthma

In this randomized, double blind crossover study, the anti-inflammatory effects of fish oil supplements was explored and found to impart significant protection against exercise induced asthma symptoms.

Fish oil supplementation reduces severity of exercise-induced bronchoconstriction in elite athletes.

Source: Am J Respir Crit Care Med. 2003 Nov 15;168(10):1181-9.

Author: Mickleborough TD, Murray RL, Ionescu AA, Lindley MR.

Affiliation: Department of Kinesiology, Indiana University, 1025 East 7th Street, HPER 112, Bloomington, IN 47401, USA.

Abstract: In elite athletes, exercise-induced bronchoconstriction (EIB) may respond to dietary modification, thereby reducing the need for pharmacologic treatment. Ten elite athletes with EIB and 10 elite athletes without EIB (control subjects) participated in a randomized, double-blind crossover study. Subjects entered the study on their normal diet, and then received either fish oil capsules containing 3.2 g eicosapentaenoic acid and 2.2 g docohexaenoic acid (n-3 polyunsaturated fatty acid [PUFA] diet; n = 5) or placebo capsules containing olive oil (placebo diet; n = 5) taken daily for 3 weeks. Diet had no effect on preexercise pulmonary function in either group or on postexercise pulmonary function in control subjects. However, in subjects with EIB, the n-3 PUFA diet improved postexercise pulmonary function compared with the normal and placebo diets. FEV1 decreased by 3 +/- 2% on n-3 PUFA diet, 14.5 +/- 5% on placebo diet, and 17.3 +/- 6% on normal diet at 15 minutes postexercise. Leukotriene (LT)E4, 9alpha, 11beta-prostaglandin F2, LTB4, tumor necrosis factor-alpha, and interleukin-1beta, all significantly decreased on the n-3 PUFA diet compared with normal and placebo diets and after the exercise challenge. These data suggest that dietary fish oil supplementation has a markedly protective effect in suppressing EIB in elite athletes, and this may be attributed to their antiinflammatory properties.

Folic Acid may reduce allergy symptoms associated with asthma.

IgE (Immunoglobulin E) levels are used as allergy makers or hypersensitivity markers. This study evaluated IgE levels and serum levels of folic acid in 8083 children, 2 years and older, and concluded that higher the levels of folic acid is associated with lower IgE levels and other symptoms of respiratory allergy.

Higher serum folate levels are associated with a lower risk of atopy and wheeze.

Source: J Allergy Clin Immunol. 2009 Jun;123(6):1253-9.

Author: Matsui EC, Matsui W.

Affiliation: Division of Pediatric Allergy and Immunology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA.

Abstract: BACKGROUND: Folic acid is known to be associated with inflammatory diseases, but the relationship between folic acid and allergic diseases is unclear. OBJECTIVES: The purpose of the study was to examine the relationship between serum folate levels and markers of atopy, wheeze, and asthma. METHODS: Data were obtained from the 2005-2006 National Health and Nutrition Examination Survey in which serum folate and total IgE levels were measured in 8083 subjects 2 years of age and older. A high total IgE level was defined as greater than 100 kU/L. Allergen-specific IgE levels were measured for a panel of 5 common aeroallergens. Atopy was defined as at least 1 positive allergen-specific IgE level. Doctor-diagnosed asthma and wheeze in the previous 12 months were assessed by means of questionnaire. RESULTS: Serum folate levels were inversely associated with total IgE levels (P < .001). The odds of a high total IgE level, atopy, and wheeze decreased across quintiles of serum folate levels, indicating a dose-response relationship between serum folate levels and these outcomes. Each of these associations remained statistically significant after adjusting for age, sex, race/ethnicity, and poverty index ratio. Adjusted odds ratios associated with the fifth quintile of folate relative to the first quintile were as follows: high IgE level, 0.70 (95% CI, 0.53-0.92); atopy, 0.69 (95% CI, 0.57-0.85); and wheeze, 0.60 (95% CI, 0.44-0.82). Higher folate levels were also associated with a lower risk of doctor-diagnosed asthma, but this finding was not statistically significant (odds ratio for fifth quintile vs first quintile, 0.84 [95% CI, 0.70-1.02]). CONCLUSIONS: Serum folate levels are inversely associated with high total IgE levels, atopy, and wheeze.

Higher levels of vitamin D is associated with lower respiratory infections

The analysis of association between vitamin D levels and upper respiratory tract infections conducted in 18883 participants (12 years and older) of the Third National Health and Nutrition Examination Survey concluded that serum levels of vitamin D are inversely associated with lower respiratory tract infections.

Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey.

Source: Arch Intern Med. 2009 Feb 23;169(4):384-90

Author: Ginde AA, Mansbach JM, Camargo CA Jr.

Affiliation: Emergency Medicine Network, Massachusetts General Hospital, 326 Cambridge Street, Boston, MA 02114, USA.

Abstract: BACKGROUND: Recent studies suggest a role for vitamin D in innate immunity, including the prevention of respiratory tract infections (RTIs). We hypothesize that serum 25-hydroxyvitamin D (25[OH]D) levels are inversely associated with self-reported recent upper RTI (URTI). METHODS: We performed a secondary analysis of the Third National Health and Nutrition Examination Survey, a probability survey of the US population conducted between 1988 and 1994. We examined the association between 25(OH)D level and recent URTI in 18 883 participants 12 years and older. The analysis adjusted for demographics and clinical factors (season, body mass index, smoking history, asthma, and chronic obstructive pulmonary disease). RESULTS: The median serum 25(OH)D level was 29 ng/mL (to convert to nanomoles per liter, multiply by 2.496) (interquartile range, 21-37 ng/mL), and 19% (95% confidence interval [CI], 18%-20%) of participants reported a recent URTI. Recent URTI was reported by 24% of participants with 25(OH)D levels less than 10 ng/mL, by 20% with levels of 10 to less than 30 ng/mL, and by 17% with levels of 30 ng/mL or more (P < .001). Even after adjusting for demographic and clinical characteristics, lower 25(OH)D levels were independently associated with recent URTI (compared with 25[OH]D levels of > or =30 ng/mL: odds ratio [OR], 1.36; 95% CI, 1.01-1.84 for <10 ng/mL and 1.24; 1.07-1.43 for 10 to <30 ng/mL). The association between 25(OH)D level and URTI seemed to be stronger in individuals with asthma and chronic obstructive pulmonary disease (OR, 5.67 and 2.26, respectively). CONCLUSIONS: Serum 25(OH)D levels are inversely associated with recent URTI. This association may be stronger in those with respiratory tract diseases. Randomized controlled trials are warranted to explore the effects of vitamin D supplementation on RTI.

National Institute of Health (NIH) confirms association between antioxidant levels and asthma

Lower antioxidants have been associated with severity of asthma. In the following survey conducted by National Institute of Health (NIH) in approximately 4000 children aged 6-17 years, the authors found that plasma levels of antioxidants such as vitamin C and alpha-carotene were significantly lower in children with asthma.

Serum vitamin levels and the risk of asthma in children.

Source: Am J Epidemiol. 2004 Feb 15;159(4):351-7.

Author: Harik-Khan RI, Muller DC, Wise RA.

Affiliation: Clinical Research Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA.

Abstract: Dietary intake, especially of antioxidant vitamins A, C, E, and the carotenoids, has been linked with the presence and severity of asthma. From the Third National Health and Nutrition Examination Survey (NHANES III), conducted in the United States between 1988 and 1994, the authors selected 4,093 children (aged 6-17 years) for whom relevant medical, socioeconomic, and anthropometric data were complete. The children were 50.6% female, and 9.7% reported a diagnosis of asthma. Bivariate analyses showed that asthma diagnosis was associated with lower levels of serum vitamin C, alpha-carotene, beta-carotene, and beta-cryptoxanthin. However, antioxidant levels may be surrogate markers for socioeconomic variables such as race, poverty, tobacco exposure, or general nutritional status. In logistic models that included age, body mass index, socioeconomic variables, antioxidant levels, parental asthma, and household smoking, the only antioxidants significantly associated with asthma were vitamin C (odds ratio = 0.72 per mg/dl, 95% confidence interval = 0.55, 0.95) and alpha-carotene (odds ratio = 0.95 per micro g/dl, 95% confidence interval = 0.90, 0.99). The odds ratio for asthma in the highest quintile of serum vitamin C relative to the lowest was 0.65 (p < 0.05), whereas it was 0.74 for alpha-carotene (p = 0.066). The authors concluded that low vitamin C and alpha-carotene intakes are associated with asthma risk in children.

Nutrient combination significantly improved symptoms in moderate asthma

Importance and use of vitamin C as an individual nutrient in various diseases is already proven. The following study has evaluated 60 children with moderate asthma when they were given omega 3 fatty acids, vitamin C, and zinc supplements. Results indicated that these nutrients significantly improved the test results. This reiterates the importance of synergy in nutrients supplementation.

Omega-3 fatty acids, vitamin C and Zn supplementation in asthmatic children: a randomized self-controlled study.

Source: Acta Paediatr. 2009 Apr;98(4):737-42.

Author: Biltagi MA, Baset AA, Bassiouny M, Kasrawi MA, Attia M.

Affiliation: Department of Paediatric, Faculty of Medicine, Tanta University, Tanta, Egypt.

Abstract: OBJECTIVES: Bronchial asthma is a chronic inflammatory airways disease. Nutritional intervention is an important tool to decrease the severity of many chronic inflammatory diseases including asthma. The aim of this study is to evaluate the role of omega-3 fatty acids, vitamin C and Zn in children with moderately persistent asthma. PATIENTS AND METHODS: Randomly assigned, placebo-self-controlled 60 children with moderate persistent asthma completed the study, were subjected to alternating phases of supplementation with omega-3 fatty acids, vitamin C and Zn either singly or in combination separated with washout phases. Childhood asthma control test (C-ACT), pulmonary function tests and sputum inflammatory markers were evaluated at the beginning of the study and at the end of each therapeutic phase. RESULTS: There was a significant improvement of C-ACT, pulmonary function tests and sputum inflammatory markers with diet supplementation with omega-3 fatty acids, vitamin C and Zn (p < 0.001*). There was also significant improvement with the combined use of the three supplementations than single use of any one of them (p < 0.001*). CONCLUSION: Diet supplementation with omega-3 fatty acids, Zn and vitamin C significantly improved asthma control test, pulmonary function tests and pulmonary inflammatory markers in children with moderately persistent bronchial asthma either singly or in combination.

Omega 3 fatty acids could be a viable treatment in asthma

This review suggest that dietary intake of omega-3 fatty acids may be a viable treatment or adjunct therapy in airway constriction observed in patients with asthma.

Omega-3 Fatty acids and airway hyper-responsiveness in asthma.

Source: J Altern Complement Med. 2004 Dec;10(6):1067-75

Author: Mickleborough TD, Ionescu AA, Rundell KW.

Affiliation: Department of Kinesiology, Indiana University, 1025 East 7th Street, HPER 112, Bloomington, IN 47401, USA.

Abstract: Despite the progress that has been made in the treatment of asthma, the prevalence and burden of this disease has continued to increase. Exercise is a powerful trigger of asthma symptoms and reversible airflow obstruction and may result in the avoidance of physical activity by patients with asthma, resulting in detrimental consequences to their health. Approximately 90% of patients with asthma are hyperresponsive to exercise and experience exercise-induced bronchoconstriction (EIB). While pharmacologic treatment of asthma is usually highly effective, medications often have significant side-effects or exhibit tachyphylaxis. Alternative therapies for treatment (complementary medicine) that reduce the dose requirements of pharmacologic interventions would be beneficial, and could potentially reduce the public health burden of this disease. There is accumulating evidence that dietary modification has potential to influence the severity of asthma and reduce the prevalence and incidence of this condition. A possible contributing factor to the increased incidence of asthma in Western societies may be the consumption of a proinflammatory diet. In the typical Western diet, 20- to 25-fold more omega- 6 polyunsaturated fatty acids (PUFA) than omega-3 PUFA are consumed, which causes the release of proinflammatory arachidonic acid metabolites (leukotrienes and prostanoids). This review analyzes the existing literature on omega-3 PUFA supplementation as a potential modifier of airway hyperresponsiveness in asthma and includes studies concerning the efficacy of omega-3 PUFA supplementation in EIB. While clinical data evaluating the effect of omega-3 PUFA supplementation in asthma has been equivocal, it has recently been shown that pharmaceutical-grade fish oil (omega-3 PUFA) supplementation reduces airway hyperresponsiveness after exercise, medication use, and proinflammatory mediator generation in nonatopic elite athletes with EIB. These findings are provocative and suggest that dietary omega-3 PUFA supplementation may be a viable treatment modality and/or adjunct therapy in airway hyperresponsiveness. Further studies are needed to confirm these results and understand their mechanism of action.

Reduced levels of vitamin C associated with asthma

This study once again indicates the importance vitamin C and that its dietary deficiency associated with bronchial asthma. Plasma vitamin C was deficient in 38% of asthma patients vs 0% healthy patients. White blood cells were deficient in vitamin C in 92% asthma patients and only in 8% of healthy controls. Vitamin C plasma level was also associated with the duration of asthma.

Comparison of plasma and leukocyte vitamin C status between asthmatic and healthy subjects.

Source: East Mediterr Health J. 2005 Jan-Mar;11(1-2):87-95.

Author: Shidfar F, Baghai N, Keshavarz A, Ameri A, Shidfar S.

Affiliation: Department of Nutrition, School of Health, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran.

Abstract: In a case-control study the vitamin C status of 50 adults with chronic controlled asthma was compared with that of 50 randomly selected healthy controls. Vitamin C intake was assessed by 3-day dietary recall, and plasma and leukocyte vitamin C concentrations were measured colorimetrically. A positive significant correlation was found between plasma vitamin C and dietary vitamin C intake. Plasma and leukocyte vitamin C levels were significantly lower in the asthma group. Plasma vitamin C was deficient (< 0.4 mg/dL) in significantly more patients than controls (38.0% versus 0%) and leukocyte vitamin C (< 20 microg/10(8) leukocytes) was deficient in 92.0% of asthmatics versus 8.0% of controls. A significant association was observed between duration of asthma and plasma vitamin C level.

Vitamin C and E intake during pregnancy affects the risk of developing asthma in infants

In the following clinical trials 2000 women were asked for their diet during pregnancy and their infants were assessed for wheezing and allergy symptoms up to two years of age. Results indicated that pregnancy diet involving vitamin C and E were most significantly associated with reduced risk of development of asthma and allergy symptoms in infants.

Antioxidant intake in pregnancy in relation to wheeze and eczema in the first two years of life.

Source: Am J Respir Crit Care Med. 2005 Jan 15;171(2):121-8.

Author: Martindale S, McNeill G, Devereux G, Campbell D, Russell G, Seaton A.

Affiliation: Department of Environmental and Occupational Medicine, University of Aberdeen, Aberdeen, Scotland, United Kingdom.

Abstract: Two thousand women were recruited for a prospective investigation of the influence of maternal antioxidant intake in pregnancy on the development of asthma and eczema in children. A food frequency questionnaire was used to characterize diet during pregnancy and blood antioxidant levels were measured. Postal questionnaires were used to follow up the 1,924 singleton children born to the cohort at 6, 12, and 24 months of age. There were no associations between maternal antioxidant intake and wheezing symptoms and eczema in the children's first year. In the children's second year, maternal vitamin E intake during pregnancy was negatively associated with wheeze in the absence of a "cold" (p for trend 0.010) and, in children whose mothers were atopic, there was a negative association between maternal vitamin E intake and childhood eczema (p for trend 0.024). Maternal vitamin C intake during pregnancy was positively associated with "ever wheeze" and eczema during the children's second year. This study suggests that maternal dietary antioxidant intakes during pregnancy may modify the risks of developing wheeze and eczema during early childhood. Further follow up of the cohort will determine whether maternal diet during pregnancy is associated with asthma and atopic disease in later childhood.

Vitamin C prevents exercise induced asthma attacks

Asthma patients should familiarize themselves with the importance of dietary micronutrient intake. This double blind clinical trial in asthmatic people documented that intake of vitamin C supplements prior to the exercise routine, decreases inflammatory markers and airway narrowing , thereby decreasing symptoms of asthma.

Ascorbic acid supplementation attenuates exercise-induced bronchoconstriction in patients with asthma.

Source: Respir Med. 2007 Aug;101(8):1770-8.

Author: Tecklenburg SL, Mickleborough TD, Fly AD, Bai Y, Stager JM.

Affiliation: Human Performance and Exercise Biochemistry Laboratory, Department of Kinesiology, Indiana University, 1025 E. 7th St, HPER 112, Bloomington, IN 47401, USA.

Abstract: BACKGROUND: Previous research has shown that diet can modify the bronchoconstrictor response to exercise in asthmatic subjects. OBJECTIVE: Determine the effect of ascorbic acid supplementation on pulmonary function and several urinary markers of airway inflammation in asthmatic subjects with exercise-induced bronchoconstriction (EIB). METHODS: Eight asthmatic subjects with documented EIB participated in a randomized, placebo controlled double-blind crossover trial. Subjects entered the study on their usual diet and were placed on either 2 weeks of ascorbic acid supplementation (1500 mg/day) or placebo, followed by a 1-week washout period, before crossing over to the alternative diet. Pre- and post-exercise pulmonary function, asthma symptom scores, fraction of exhaled nitric oxide (FENO), and urinary leukotriene (LT) C4-E4 and 9alpha, 11beta-prostagladin (PG) F2] were assessed at the beginning of the trial (usual diet) and at the end of each treatment period. Results: The ascorbic acid diet significantly reduced (p < 0.05) the maximum fall in post-exercise FEV1 (-6.4 +/- 2.4%) compared to usual (-14.3 +/- 1.6%) and placebo diet (-12.9 +/- 2.4%). Asthma symptoms scores significantly improved (p<0.05) on the ascorbic acid diet compared to the placebo and usual diet. Post-exercise FENO, LTC4-E4 and 9alpha, 11beta-PGF2 concentrations were significantly lower (p<0.05) on the ascorbic acid diet compared to the placebo and usual diet. CONCLUSION: Ascorbic acid supplementation provides a protective effect against exercise-induced airway narrowing in asthmatic subjects.

Vitamin C reduces the requirements of corticosteroid use in asthma patients

Corticosteroids are often given to asthma patients to combat inflammatory response and to prevent and treat asthma flare-ups. However taken chronically, these medications have serious side effects and suppress immune system. Vitamin C administration along with corticosteroids, not only helps reduce asthma symptoms but it also reduces some of the dangers associated with corticosteroid use.

Corticosteroid sparing effects of vitamin C and magnesium in asthma: a randomised trial.

Source: Respir Med. 2006 Jan;100(1):174-9.

Author: Fogarty A, Lewis SA, Scrivener SL, Antoniak M, Pacey S, Pringle M, Britton J.

Affiliation: Division of Respiratory Medicine, University of Nottingham, Nottingham City Hospital, Hucknall Rd, Nottingham NG5 1PB, UK.

Abstract: AIM: The study aims to assess the a priori hypothesis that regular supplementation with vitamin C or magnesium will permit a reduction in the corticosteroid dose required to maintain asthma control in adults. METHODS: We invited all participants recruited from primary care centres who completed a parallel-group, randomised, placebo-controlled, 16-week supplementation trial of 1g/day vitamin C or 450 mg/day magnesium to continue and participate in a structured corticosteroid reduction protocol over 10 weeks. RESULTS: A total of 92 participants (29 vitamin C, 31 magnesium and 32 placebo) entered the study. Assuming no reduction in corticosteroid dose in the 10 who subsequently withdrew, the geometric mean reductions in inhaled corticosteroid dose achieved with vitamin C, magnesium and placebo were 49, 13 and 11 microg, respectively. Relative to placebo, the unadjusted effect of vitamin C was significant, and remained at borderline significance after adjustment for baseline corticosteroid dose (relative reduction ratio=4.03, 95% CI 0.95 to 17.1, P=0.06). CONCLUSIONS: We conclude that while vitamin C supplements may have modest corticosteroid sparing effects and hence the potential to reduce exposure to their side effects, magnesium supplements have no effect on the inhaled corticosteroid dose required to maintain asthma control.