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Jackson MK, Choi Y, Eisenberg E, Hanson C, Wang A, Wang JG, Washko GR, Ash S, Estepar RSJ, Liu G, Shikany JM, Steffen LM, Wharton R, Kalhan R, Jacobs DR, Bose S. A Plant-Centered Diet is Inversely Associated With Radiographic Emphysema: Findings from the CARDIA Lung Study. CHRONIC OBSTRUCTIVE PULMONARY DISEASES (MIAMI, FLA.) 2024; 11:164-173. [PMID: 37931598 DOI: 10.15326/jcopdf.2023.0437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
Background Chronic obstructive pulmonary disease (COPD) is a significant public health concern and intercepting the development of emphysema is vital for COPD prevention. Smokers are a high-risk population for emphysema with limited prevention strategies. We aimed to determine if adherence to a nutritionally rich, plant-centered diet among young ever-smokers is associated with reduced risk of future radiographic emphysema. Methods We studied participants from the Coronary Artery Risk Development in Young Adults (CARDIA) Lung Prospective Cohort Study who were 18-30 years old at enrollment and followed for 30 years. We analyzed 1706 adults who reported current or former smoking by year 20. Repeated measures of diet history were used to calculate A Priori Diet Quality Scores (APDQSs), and categorized into quintiles, with higher quintiles representing higher nutritionally rich plant-centered food intake. Emphysema was assessed at year 25 (n=1351) by computed tomography (CT). Critical covariates were selected, acknowledging potential residual confounding. Results Emphysema was observed in 13.0% of the cohort, with a mean age of 50.4 ± 3.5 years. The prevalence of emphysema was 4.5% in the highest APDQS quintile (nutritionally rich), compared with 25.4% in the lowest quintile. After adjustment for multiple covariates, including smoking, greater adherence to a plant-centered diet was inversely associated with emphysema (highest versus lowest quintile odds ratio: 0.44, 95% CI 0.19-0.99, ptrend=0.008). Conclusion Longitudinal adherence to a nutritionally rich, plant-centered diet was associated with a decreased risk of emphysema development in middle adulthood, warranting further examination of diet as a strategy for emphysema prevention in a high-risk smoking population.
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Affiliation(s)
- Mariah K Jackson
- Division of Medical Nutrition Education, University of Nebraska Medical Center, Omaha, Nebraska, United States
| | - Yuni Choi
- Division of Epidemiology and Community Health, University of Minnesota Twin Cities, Minneapolis, Minnesota, United States
| | - Elliot Eisenberg
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Corrine Hanson
- Division of Medical Nutrition Education, University of Nebraska Medical Center, Omaha, Nebraska, United States
| | - Ann Wang
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Jing Gennie Wang
- Division of Pulmonary Critical Care and Sleep Medicine, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - George R Washko
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States
| | - Samuel Ash
- Critical Care, South Shore Hospital, Weymouth, Massachusetts, United States
| | - Raul San Jose Estepar
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, United States
| | - Gabrielle Liu
- Division of Pulmonary and Critical Care Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States
| | - James M Shikany
- Division of Preventive Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Lyn M Steffen
- Division of Epidemiology and Community Health, University of Minnesota Twin Cities, Minneapolis, Minnesota, United States
| | - Robert Wharton
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Ravi Kalhan
- Division of Pulmonary and Critical Care Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States
| | - David R Jacobs
- Division of Epidemiology and Community Health, University of Minnesota Twin Cities, Minneapolis, Minnesota, United States
| | - Sonali Bose
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, United States
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Wharton RC, Wang JG, Choi Y, Eisenberg E, Jackson MK, Hanson C, Liu B, Washko GR, Kalhan R, Jacobs DR, Bose S. Associations of a plant-centered diet and lung function across early to mid-adulthood: The CARDIA Lung Study. Respir Res 2024; 25:122. [PMID: 38468283 PMCID: PMC10926674 DOI: 10.1186/s12931-023-02632-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 12/07/2023] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Lung function throughout adulthood predicts morbidity and mortality even among adults without chronic respiratory disease. Diet quality may represent a modifiable risk factor for lung function impairment later in life. We investigated associations between nutritionally-rich plant-centered diet and lung function across early and middle adulthood from the Coronary Artery Risk Development in Young Adults (CARDIA) Study. METHODS Diet was assessed at baseline and years 7 and 20 of follow-up using the validated CARDIA diet history questionnaire. Plant-centered diet quality was scored using the validated A Priori Diet Quality Score (APDQS), which weights food groups to measure adherence to a nutritionally-rich plant-centered diet for 20 beneficially rated foods and 13 adversely rated foods. Scores were cumulatively averaged over follow-up and categorized into quintiles. The primary outcome was lung function decline, including forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC), measured at years 0, 2, 5, 10, 20, and 30. We estimated the association of APDQS with annual pulmonary function changes and cross-sectional differences in a repeated measures regression model, adjusting for clinically relevant covariates. RESULTS The study included 3,787 Black and White men and women aged 18-30 in 1985-86 and followed for 30 years. In multivariable repeated measures regression models, individuals in the lowest APDQS quintile (poorest diet) had declines in FEV1 that were 1.6 ml/year greater than individuals in the highest quintile (35.0 vs. 33.4 ml/year, ß ± SE per 1 SD change APDQS 0.94 ± 0.36, p = 0.009). Additionally, declines in FVC were 2.4 ml/year greater in the lowest APDQS quintile than those in the highest quintile (37.0 vs 34.6 ml/year, ß ± SE per 1 SD change APDQS 1.71 ± 0.46, p < 0.001). The association was not different between never and ever smokers (pint = 0.07 for FVC and 0.32 for FEV1). In sensitivity analyses where current asthma diagnosis and cardiorespiratory fitness were further adjusted, results remained similar. Cross-sectional analysis at each exam year also showed significant differences in lung function according to diet after covariate adjustment. CONCLUSIONS In this 30-year longitudinal cohort study, long-term adherence to a nutritionally-rich plant-centered diet was associated with cross-sectional differences in lung function as well as slower decline in lung function, highlighting diet quality as a potential treatable trait supporting long-term lung health.
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Affiliation(s)
- Robert C Wharton
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York City, USA
| | - Jing Gennie Wang
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Yuni Choi
- Division of Epidemiology and Community Health, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Elliot Eisenberg
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Mariah K Jackson
- Division of Medical Nutrition Education, University of Nebraska Medical Center, Omaha, NE, USA
| | - Corrine Hanson
- Division of Medical Nutrition Education, University of Nebraska Medical Center, Omaha, NE, USA
| | - Bian Liu
- Department of Population Health Science and Policy, Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - George R Washko
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Ravi Kalhan
- Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - David R Jacobs
- Division of Medical Nutrition Education, University of Nebraska Medical Center, Omaha, NE, USA
| | - Sonali Bose
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
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Huang X, Li J, Cao W, Lyu J, Guo Y, Pei P, Xia Q, Du H, Chen Y, Ling Y, Kerosi R, Stevens R, Yang X, Chen J, Yu C, Chen Z, Li L. Association between fresh fruit consumption and the risk of chronic obstructive pulmonary disease-related hospitalization and death in Chinese adults: A prospective cohort study. Chin Med J (Engl) 2023; 136:2316-2323. [PMID: 37537725 PMCID: PMC10538915 DOI: 10.1097/cm9.0000000000002591] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Existing evidence suggests that fruit consumption is a significant influencing factor for chronic obstructive pulmonary disease (COPD), but this is unclear in the Chinese population. We examined the association of fresh fruit consumption with the risk of COPD-related hospitalization and death in a nationwide, population-based prospective cohort from China. METHODS Between 2004 and 2008, the China Kadoorie Biobank recruited >0.5 million adults aged 30 to 79 years from ten diverse regions across China. After excluding individuals diagnosed with major chronic diseases and prevalent COPD, the prospective analysis included 421,428 participants. Cox regression was used to calculate the hazard ratios (HRs) for the association between fresh fruit consumption and risk of COPD-related hospitalization and death, with adjustment for established and potential confounders. RESULTS During a mean follow-up of 10.9 years, 11,292 COPD hospitalization events and deaths were documented, with an overall incidence rate of 2.47/1000 person-years. Participants who consumed fresh fruit daily had a 22% lower risk of COPD-related hospitalization and death compared with non-consumers (HR = 0.78, 95% confidence interval [CI]: 0.71-0.87). The inverse association between fresh fruit consumption and COPD-related hospitalization and death was stronger among non-current smokers and participants with normal body mass index (BMI) (18.5 kg/m 2 ≤ BMI < 24.0 kg/m 2 ); the corresponding HRs for daily fresh fruit consumption were 0.78 (95% CI: 0.68-0.89) and 0.69 (95% CI: 0.59-0.79) compared with their counterparts, respectively. CONCLUSIONS High-frequency fruit consumption was associated with a lower risk of COPD in Chinese adults. Increasing fruit consumption, together with cigarette cessation and weight control, should be considered in the prevention and management of COPD.
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Affiliation(s)
- Xin Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Jiachen Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Weihua Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Jun Lyu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing 100191, China
- Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing 100191, China
| | - Yu Guo
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases, Beijing 100037, China
| | - Pei Pei
- National Coordinate Center, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Qingmei Xia
- National Coordinate Center, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Huaidong Du
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford OX3 7LF, UK
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford OX3 7LF, UK
| | - Yiping Chen
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford OX3 7LF, UK
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford OX3 7LF, UK
| | - Yang Ling
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford OX3 7LF, UK
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford OX3 7LF, UK
| | - Rene Kerosi
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford OX3 7LF, UK
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford OX3 7LF, UK
| | - Rebecca Stevens
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford OX3 7LF, UK
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford OX3 7LF, UK
| | - Xujun Yang
- Maiji Center for Disease Control and Prevention, Tianshui, Gansu 741020, China
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing 100022, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing 100191, China
| | - Zhengming Chen
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford OX3 7LF, UK
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing 100191, China
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4
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Wharton R, Wang JG, Choi Y, Eisenberg E, Jackson MK, Hanson C, Liu B, Washko GR, Kalhan R, Jacobs DR, Bose S. Associations of a Plant-centered Diet and Lung Function Decline across Early to Mid-Adulthood: The CARDIA Lung Study. RESEARCH SQUARE 2023:rs.3.rs-2845326. [PMID: 37163005 PMCID: PMC10168442 DOI: 10.21203/rs.3.rs-2845326/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Background Lung function throughout adulthood predicts morbidity and mortality even among adults without chronic respiratory disease. Diet quality may represent a modifiable risk factor for lung function impairment later in life. We investigated associations between nutritionally-rich plant-centered diet and lung function decline across early and middle adulthood from the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Methods Diet was assessed at baseline and years 7 and 20 of follow-up using the validated CARDIA diet history questionnaire. Plant-centered diet quality was scored using the validated A Priori Diet Quality Score (APDQS), which weights food groups to measure adherence to a nutritionally-rich plant-centered diet 1 to 5 points for 20 beneficially rated foods and 5 to 1 points for 13 adversely rated foods. Scores were cumulatively averaged over follow-up and categorized into quintiles. The primary outcome was lung function decline, including forced expiratory volume in 1 second (FEV1) and functional vital capacity (FVC), measured at years 0, 2, 5, 10, 20, and 30. We estimated the association of APDQS with annual pulmonary function changes in a repeated measures regression model, adjusting for clinically relevant covariates. Results The study included 3,787 Black and White men and women aged 18-30 in 1985-86 and followed for 30 years. In multivariable repeated measures regression models, individuals in the lowest APDQS quintile (poorest diet) had declines in FEV1 that were 1.6 ml/year greater than individuals in the highest quintile (35.0 vs. 33.4 ml/year, ß±SE per 1 SD change APDQS 0.94 ± 0.36, p = 0.009). Additionally, declines in FVC were 2.4 ml/year greater in the lowest APDQS quintile than those in the highest quintile (37.0 vs 34.6 ml/year, ß±SE per 1 SD change APDQS 1.71 ± 0.46, p < 0.001). The association was not different between never and ever smokers (pint = 0.07 for FVC and 0.32 for FEV1). In sensitivity analyses where current asthma diagnosis and cardiorespiratory fitness were further adjusted, results remained similar. Conclusions In this 30-year longitudinal cohort study, long-term adherence to a nutritionally-rich plant-centered diet was associated with slower decline in lung function, highlighting diet quality as a potential treatable trait supporting long-term lung health.
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Affiliation(s)
| | | | | | | | | | | | - Bian Liu
- Icahn School of Medicine at Mount Sinai
| | | | - Ravi Kalhan
- Northwestern University Feinberg School of Medicine
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Liu Z, Su Y, Chen Q, Xiao L, Zhao X, Wang F, Peng Z, Zhang H. Association of Dietary intake of vitamin E with chronic obstructive pulmonary disease events in US adults: A cross-sectional study of NHANES 2013-2018. Front Nutr 2023; 10:1124648. [PMID: 37125038 PMCID: PMC10130507 DOI: 10.3389/fnut.2023.1124648] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/24/2023] [Indexed: 05/02/2023] Open
Abstract
Introduction Several studies have demonstrated that vitamin E intake is negatively associated with the development of several diseases, but the relationship between vitamin E intake and COPD in different groups of people is not clear. The aim was to investigate the relationship between vitamin E intake and COPD in different groups of people. Methods This study used data from NHANES (National Health and Nutrition Examination Survey) from 2013-2018. A final total of 4,706 participants were included, univariate versus multivariate logistic regression and restricted cubic spline models adjusted for confounders were used to explore the relationship between vitamin E intake and COPD, and subgroup analyses were conducted to assess whether there are differences in the relationship between vitamin E intake and COPD in different populations or conditions. Results After adjusting for potential confounders, higher vitamin E intake showed a significant negative association with COPD [Model 1(unadjusted covariates, OR = 0.48;95% CI:0.33-0.70; p < 0.001), Model 2(adjusted for age, sex, and race, OR = 0.48;95% CI:0.31-0.73; p < 0.01), and Model 3(adjusted for all covariates, OR = 0.57;95% CI:0.36-0.91; p = 0.02)]. And a restricted cubic spline curve showed a significant negative correlation between vitamin E intake and COPD (p for nonlinear = 0.2036). In the subgroup analysis, we found a negative association between vitamin E intake and COPD in all subgroups as well. Conclusion After analyzing data based on the NHANES database from 2013-2018, the results showed that vitamin E intake among U.S. adults was well below the recommended levels and that higher vitamin E intake was negatively associated with COPD incidence.
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Affiliation(s)
- Ziyi Liu
- Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yingjie Su
- Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qing Chen
- Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Lihua Xiao
- Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xue Zhao
- College of Medicine, Hunan Normal University, Changsha, China
| | - Feichi Wang
- Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhenyu Peng
- Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Hongliang Zhang
- Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- *Correspondence: Hongliang Zhang,
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Lajiness JD, Amarsaikhan N, Tat K, Tsoggerel A, Cook-Mills JM. β-Glucosylceramides and Tocopherols Regulate Development and Function of Dendritic Cells. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2022; 209:1837-1850. [PMID: 36426950 PMCID: PMC9643659 DOI: 10.4049/jimmunol.2101188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 09/07/2022] [Indexed: 12/30/2022]
Abstract
In humans and mice, offspring of allergic mothers are predisposed to development of allergy. In mice, allergic mothers have elevated β-glucosylceramides (βGlcCers) that are transported to the fetus via the placenta and to offspring via milk. The elevated βGlcCers increase the number of fetal liver CD11c+CD11b+ dendritic cells (DCs) and offspring allergen-induced lung eosinophilia. These effects are modifiable by maternal dietary supplementation with the plant-derived lipids α-tocopherol and γ-tocopherol. It is not known whether βGlcCers and tocopherols directly regulate development of DCs. In this study, we demonstrated that βGlcCers increased development of GM-CSF-stimulated mouse bone marrow-derived DCs (BMDCs) in vitro without altering expression of costimulatory molecules. This increase in BMDC numbers was blocked by α-tocopherol and potentiated by γ-tocopherol. Furthermore, βGlcCers increased protein kinase Cα (PKCα) and PKCδ activation in BMDCs that was blocked by α-tocopherol. In contrast, γ-tocopherol increased BMDC PKCα and PKCδ activation and enhanced the βGlcCer-induced increase in PKCδ activation in a DC subset. Ag processing per DC was minimally enhanced in βGlcCer-treated BMDCs and not altered ex vivo in lung DCs from pups of allergic mothers. Pups of allergic mothers had an increased proportion of CD11b+CD11c+ subsets of DCs, contributing to enhanced stimulation of T cell proliferation ex vivo. Thus, βGlcCer, which is both necessary and sufficient for development of allergic predisposition in offspring of allergic mothers, directly increased development and PKC activation in BMDCs. Furthermore, this was modifiable by dietary tocopherols. This may inform design of future studies for the prevention or intervention in asthma and allergic disease.
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Affiliation(s)
- Jacquelyn D Lajiness
- Herman B Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN; and
| | - Nansalmaa Amarsaikhan
- Herman B Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN; and
| | - Kiet Tat
- Herman B Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN; and
| | - Angar Tsoggerel
- Herman B Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN; and
| | - Joan M Cook-Mills
- Herman B Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN; and
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN
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7
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Khazdair MR, Boskabady MH. Possible Treatment Approaches of Sulfur Mustard-Induced Lung Disorders, Experimental and Clinical Evidence, an Updated Review. Front Med (Lausanne) 2022; 9:791914. [PMID: 35572987 PMCID: PMC9106304 DOI: 10.3389/fmed.2022.791914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 04/12/2022] [Indexed: 12/04/2022] Open
Abstract
Sulfur mustard (SM) is one of the major potent chemical warfare that caused the death of victims in World War I and the Iraq-Iran conflict (1980-1988). The respiratory system is the main target of SM exposure and there are no definitive therapeutic modalities for SM-induced lung injury. The effects of the new pharmaceutical drugs on lung injury induced by SM exposure were summarized in this review. Literature review on PubMed, ScienceDirect, and Google Scholar databases was performed to find papers that reported new treatment approach on SM-exposure-induced injury in the respiratory system until October 2019. The search was restricted to sulfur mustard AND induced injury (in vitro studies, animal experiments, and clinical trials) AND respiratory system OR lung, AND treatment in all fields. Two hundred and eighty-three relevant articles were identified that 97 retrieved articles were eligible and were included in the review. Some new pharmaceutical drugs have shown therapeutic potential in controlling various characteristics of lung injury due to SM exposure. Recent studies showed therapeutic effects of mucolytic drugs, non-steroidal drugs, and antibiotics on reducing lung inflammation, oxidative stress responses, and modulating of the immune system as well as improving of respiratory symptoms and pulmonary function tests. Studies on the therapeutic effects of new agents with amelioration or treatment of SM-induced lung injury were reviewed and discussed.
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Affiliation(s)
- Mohammad Reza Khazdair
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Mohammad Hossein Boskabady
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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8
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Xu J, Guertin KA, Gaddis NC, Agler AH, Parker RS, Feldman JM, Kristal AR, Arnold KB, Goodman PJ, Tangen CM, Hancock DB, Cassano PA. Change in plasma α-tocopherol associations with attenuated pulmonary function decline and with CYP4F2 missense variation. Am J Clin Nutr 2022; 115:1205-1216. [PMID: 35040869 PMCID: PMC8970985 DOI: 10.1093/ajcn/nqac013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 01/14/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Vitamin E (vitE) is hypothesized to attenuate age-related decline in pulmonary function. OBJECTIVES We investigated the association between change in plasma vitE (∆vitE) and pulmonary function decline [forced expiratory volume in the first second (FEV1)] and examined genetic and nongenetic factors associated with ∆vitE. METHODS We studied 1144 men randomly assigned to vitE in SELECT (Selenium and Vitamin E Cancer Prevention Trial). ∆vitE was the difference between baseline and year 3 vitE concentrations measured with GC-MS. FEV1 was measured longitudinally by spirometry. We genotyped 555 men (vitE-only arm) using the Illumina Expanded Multi-Ethnic Genotyping Array (MEGAex). We used mixed-effects linear regression modeling to examine the ∆vitE-FEV1 association. RESULTS Higher ∆vitE was associated with lower baseline α-tocopherol (α-TOH), higher baseline γ-tocopherol, higher baseline free cholesterol, European ancestry (as opposed to African) (all P < 0.05), and the minor allele of a missense variant in cytochrome P450 family 4 subfamily F member 2 (CYP4F2) (rs2108622-T; 2.4 µmol/L higher ∆vitE, SE: 0.8 µmol/L; P = 0.0032). Higher ∆vitE was associated with attenuated FEV1 decline, with stronger effects in adherent participants (≥80% of supplements consumed): a statistically significant ∆vitE × time interaction (P = 0.014) indicated that a 1-unit increase in ∆vitE was associated with a 2.2-mL/y attenuation in FEV1 decline (SE: 0.9 mL/y). The effect size for 1 SD higher ∆vitE (+4 µmol/mmol free-cholesterol-adjusted α-TOH) was roughly one-quarter of the effect of 1 y of aging, but in the opposite direction. The ∆vitE-FEV1 association was similar in never smokers (2.4-mL/y attenuated FEV1 decline, SE: 1.0 mL/y; P = 0.017, n = 364), and current smokers (2.8-mL/y, SE: 1.6 mL/y; P = 0.079, n = 214), but there was little to no effect in former smokers (-0.64-mL/y, SE: 0.9 mL/y; P = 0.45, n = 564). CONCLUSIONS Greater response to vitE supplementation was associated with attenuated FEV1 decline. The response to supplementation differed by rs2108622 such that individuals with the C allele, compared with the T allele, may need a higher dietary intake to reach the same plasma vitE concentration.
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Affiliation(s)
- Jiayi Xu
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
- Pamela Sklar Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kristin A Guertin
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Nathan C Gaddis
- GenOmics, Bioinformatics, and Translational Research Center, Biostatistics and Epidemiology Division, RTI International, Research Triangle Park, NC, USA
| | - Anne H Agler
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
- Abbott, Columbus, OH, USA
| | - Robert S Parker
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Jared M Feldman
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Alan R Kristal
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | | | | | | | - Dana B Hancock
- GenOmics, Bioinformatics, and Translational Research Center, Biostatistics and Epidemiology Division, RTI International, Research Triangle Park, NC, USA
| | - Patricia A Cassano
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
- Division of Epidemiology, Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA
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9
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Cook-Mills JM, Averill SH, Lajiness JD. Asthma, allergy and vitamin E: Current and future perspectives. Free Radic Biol Med 2022; 179:388-402. [PMID: 34785320 PMCID: PMC9109636 DOI: 10.1016/j.freeradbiomed.2021.10.037] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 10/12/2021] [Accepted: 10/21/2021] [Indexed: 02/03/2023]
Abstract
Asthma and allergic disease result from interactions of environmental exposures and genetics. Vitamin E is one environmental factor that can modify development of allergy early in life and modify responses to allergen after allergen sensitization. Seemingly varied outcomes from vitamin E are consistent with the differential functions of the isoforms of vitamin E. Mechanistic studies demonstrate that the vitamin E isoforms α-tocopherol and γ-tocopherol have opposite functions in regulation of allergic inflammation and development of allergic disease, with α-tocopherol having anti-inflammatory functions and γ-tocopherol having pro-inflammatory functions in allergy and asthma. Moreover, global differences in prevalence of asthma by country may be a result, at least in part, of differences in consumption of these two isoforms of tocopherols. It is critical in clinical and animal studies that measurements of the isoforms of tocopherols be determined in vehicles for the treatments, and in the plasma and/or tissues before and after intervention. As allergic inflammation is modifiable by tocopherol isoforms, differential regulation by tocopherol isoforms provide a foundation for development of interventions to improve lung function in disease and raise the possibility of early life dietary interventions to limit the development of lung disease.
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Affiliation(s)
- Joan M Cook-Mills
- Herman B Wells Center for Pediatric Research, Departments of Pediatrics and Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.
| | - Samantha H Averill
- Herman B Wells Center for Pediatric Research, Departments of Pediatrics and Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Jacquelyn D Lajiness
- Herman B Wells Center for Pediatric Research, Departments of Pediatrics and Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
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10
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Birru RL, Bein K, Bondarchuk N, Wells H, Lin Q, Di YP, Leikauf GD. Antimicrobial and Anti-Inflammatory Activity of Apple Polyphenol Phloretin on Respiratory Pathogens Associated With Chronic Obstructive Pulmonary Disease. Front Cell Infect Microbiol 2021; 11:652944. [PMID: 34881190 PMCID: PMC8645934 DOI: 10.3389/fcimb.2021.652944] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 10/11/2021] [Indexed: 11/13/2022] Open
Abstract
Bacterial infections contribute to accelerated progression and severity of chronic obstructive pulmonary disease (COPD). Apples have been associated with reduced symptoms of COPD and disease development due to their polyphenolic content. We examined if phloretin, an apple polyphenol, could inhibit bacterial growth and inflammation induced by the main pathogens associated with COPD. Phloretin displayed bacteriostatic and anti-biofilm activity against nontypeable Haemophilus influenzae (NTHi), Moraxella catarrhalis, Streptococcus pneumoniae, and to a lesser extent, Pseudomonas aeruginosa. In vitro, phloretin inhibited NTHi adherence to NCI-H292 cells, a respiratory epithelial cell line. Phloretin also exhibited anti-inflammatory activity in COPD pathogen-induced RAW 264.7 macrophages and human bronchial epithelial cells derived from normal and COPD diseased lungs. In mice, NTHi bacterial load and chemokine (C-X-C motif) ligand 1 (CXCL1), a neutrophil chemoattractant, was attenuated by a diet supplemented with phloretin. Our data suggests that phloretin is a promising antimicrobial and anti-inflammatory nutraceutical for reducing bacterial-induced injury in COPD.
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Affiliation(s)
- Rahel L Birru
- Department of Environmental and Occupational Health, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kiflai Bein
- Department of Environmental and Occupational Health, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Natalya Bondarchuk
- Department of Environmental and Occupational Health, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Heather Wells
- Department of Environmental and Occupational Health, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Qiao Lin
- Department of Environmental and Occupational Health, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Y Peter Di
- Department of Environmental and Occupational Health, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - George D Leikauf
- Department of Environmental and Occupational Health, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
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11
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Marín-Hinojosa C, Eraso CC, Sanchez-Lopez V, Hernández LC, Otero-Candelera R, Lopez-Campos JL. Nutriepigenomics and chronic obstructive pulmonary disease: potential role of dietary and epigenetics factors in disease development and management. Am J Clin Nutr 2021; 114:1894-1906. [PMID: 34477827 DOI: 10.1093/ajcn/nqab267] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 07/22/2021] [Indexed: 12/15/2022] Open
Abstract
Over recent decades, a number of studies have revealed the possible role of different types of diets, as well as the nutritional elements they are made up of, in the pathogenesis of chronic obstructive pulmonary disease (COPD). To date, dietary factors have been identified to play a role in the prevention of COPD, with evidence from antioxidant nutrients, vitamins, and fiber intake. Additionally, certain dietary patterns such as the Mediterranean diet, together with other Western diets, provide evidence of the influence on COPD development, promoting lung health through nutritional approaches, and giving us an opportunity for intervention. The effect of diet on COPD is conveyed by 3 mechanisms: regulation of inflammation, oxidative stress, and carbon dioxide produced/oxygen intake. Current advances have begun to highlight the possible role of diet in modifying gene expression in certain individuals that predisposes them to COPD through epigenetic modifications. The relation between dietary intake and epigenetic factors has therefore outlined nutriepigenomics as a possible missing link in the relation between environmental exposure to smoke and the appearance of a subsequent chronic bronchial obstruction. This review summarizes the evidence regarding the influence of dietary patterns and nutrients and epigenetic regulatory mechanisms on COPD development and prevention with the aim of encouraging clinical research on the impact of dietary modifications on COPD-related clinical outcomes. This review highlights the importance of proposing and carrying out future studies focused on the modulating effects of certain nutrients on epigenetic changes in patients with specific COPD phenotypes (bronchiectasis, emphysema, asthma/COPD, chronic bronchitis), and their individual responses to cigarette smoking, environmental pollution, or other noxious particles. The objectives of these future studies must be directed to the development of novel therapeutic approaches and personalized management of COPD.
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Affiliation(s)
- Carmen Marín-Hinojosa
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Candelaria Caballero Eraso
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Veronica Sanchez-Lopez
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Laura Carrasco Hernández
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Remedios Otero-Candelera
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Jose Luis Lopez-Campos
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
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12
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Banks J, Kesternich I, Smith JP. International differences in interspousal health correlations. HEALTH ECONOMICS 2021; 30:1152-1177. [PMID: 33705589 DOI: 10.1002/hec.4253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 06/12/2023]
Abstract
Using objective measures of lung function, we document strong positive associations in health within couples in all European countries but large and significant differences in this correlation within broad European regions, with Southern Europe having by far stronger correlations than elsewhere. We analyze potential explanations for such differences, investigating the role of measures capturing current and past health behaviors, early life circumstances of each spouse, and measures capturing assortative mating in multiple dimensions. We show that marital sorting patterns by dimensions of early life health and socioeconomic position, as well as by geographical subregion within countries, are key to understanding the empirical patterns observed.
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Affiliation(s)
- James Banks
- Department of Economics, University of Manchester and Institute for Fiscal Studies, London, UK
| | | | - James P Smith
- Labor and Population, RAND Corporation, and Center for Scientific Research, Rose Li and Associates, Los Angeles, USA
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13
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Hogenkamp A, Ehlers A, Garssen J, Willemsen LEM. Allergy Modulation by N-3 Long Chain Polyunsaturated Fatty Acids and Fat Soluble Nutrients of the Mediterranean Diet. Front Pharmacol 2020; 11:1244. [PMID: 32973501 PMCID: PMC7472571 DOI: 10.3389/fphar.2020.01244] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 07/29/2020] [Indexed: 12/12/2022] Open
Abstract
The Mediterranean diet, containing valuable nutrients such as n-3 long chain poly-unsaturated fatty acids (LCPUFAs) and other fat-soluble micronutrients, is known for its health promoting and anti-inflammatory effects. Its valuable elements might help in the battle against the rising prevalence of non-communicable diseases (NCD), including the development of allergic diseases and other (chronic) inflammatory diseases. The fat fraction of the Mediterranean diet contains bioactive fatty acids but can also serve as a matrix to dissolve and increase the uptake of fat-soluble vitamins and phytochemicals, such as luteolin, quercetin, resveratrol and lycopene with known immunomodulatory and anti-inflammatory capacities. Especially n-3 LCPUFAs such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) derived from marine oils can target specific receptors or signaling cascades, act as eicosanoid precursors and/or alter membrane fluidity and lipid raft formation, hereby exhibiting anti-inflammatory properties. Beyond n-3 LCPUFAs, fat-soluble vitamins A, D, E, and K1/2 have the potential to affect pro-inflammatory signaling cascades by interacting with receptors or activating/inhibiting signaling proteins or phosphorylation in immune cells (DCs, T-cells, mast cells) involved in allergic sensitization or the elicitation/effector phase of allergic reactions. Moreover, fat-soluble plant-derived phytochemicals can manipulate signaling cascades, mostly by interacting with other receptors or signaling proteins compared to those modified by fat-soluble vitamins, suggesting potential additive or synergistic actions by applying a combination of these nutrients which are all part of the regular Mediterranean diet. Research concerning the effects of phytochemicals such as polyphenols has been hampered due to their poor bio-availability. However, their solubility and uptake are improved by applying them within the dietary fat matrix. Alternatively, they can be prepared for targeted delivery by means of pharmaceutical approaches such as encapsulation within liposomes or even unique nanoparticles. This review illuminates the molecular mechanisms of action and possible immunomodulatory effects of n-3 LCPUFAs and fat-soluble micronutrients from the Mediterranean diet in allergic disease development and allergic inflammation. This will enable us to further appreciate how to make use of the beneficial effects of n-3 LCPUFAs, fat-soluble vitamins and a selection of phytochemicals as active biological components in allergy prevention and/or symptom reduction.
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Affiliation(s)
- Astrid Hogenkamp
- Division of Pharmacology, Department of Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, Netherlands
| | - Anna Ehlers
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.,Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Johan Garssen
- Division of Pharmacology, Department of Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, Netherlands.,Global Centre of Excellence Immunology, Danone Nutricia Research B.V., Utrecht, Netherlands
| | - Linette E M Willemsen
- Division of Pharmacology, Department of Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, Netherlands
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14
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Papassotiriou I, Shariful Islam SM. Adherence to Mediterranean Diet Is Associated With Lung Function in Older Adults: Data From the Health and Retirement Study. J Am Coll Nutr 2020; 40:119-124. [PMID: 32202968 DOI: 10.1080/07315724.2020.1740114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Objective: The aim of this work was to examine the association between adherence to a Mediterranean diet (MD) and lung function in older adults.Design: This was an observational and cross-sectional study.Setting: This research was conducted among community-dwelling older adults from the 2014 Health and Retirement Study (HRS).Subjects: Subjects were 2108 adults aged 50 years or older, 1234 (58.5%) of whom were female.Measures: Dietary intakes from respondents of the Health and Retirement Study (HRS) were used for the current analysis. Adherence to MD was evaluated using the MedDietScore, while lung function was evaluated through peak expiratory flow rate (PEF; l/min). Multiple linear regression and logistic regression were performed, adjusted for potential confounders, to examine the relation between adherence to MD and lung function.Results: Mean MedDietScore was 28.0 (± 5.0), indicating a moderate adherence to MD. Multiple linear regression showed a significant association between the MedDietScore and lung function (β = 0.072, 95% confidence interval [CI]: 0.039-0.104) after adjusting for age, gender, body mass index, race, comorbidities, education, height, grip strength, smoking history, physical activity, and daily caloric intake. Specific food groups such as grains, dairy products, and fish consumption were also associated with PEF rate (p < 0.05). Logistic regression confirmed these findings, and high adherence to MD was associated with reduced risk of having PEF rate < 80% of its peak predictive value (odds ratio: 0.65, 95% CI: 0.48-0.89).Conclusions: The results of this study indicate that adherence to MD is an independent predictor of lung function in older adults, and dietary interventions could be a possible preventive measure in adults with a high risk of developing lung function decline.
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Affiliation(s)
- Ionas Papassotiriou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
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15
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Role of Diet in Chronic Obstructive Pulmonary Disease Prevention and Treatment. Nutrients 2019; 11:nu11061357. [PMID: 31208151 PMCID: PMC6627281 DOI: 10.3390/nu11061357] [Citation(s) in RCA: 103] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 06/11/2019] [Accepted: 06/14/2019] [Indexed: 12/15/2022] Open
Abstract
Chronic obstructive pulmonary disease is one of the leading causes of morbidity and mortality worldwide and a growing healthcare problem. Identification of modifiable risk factors for prevention and treatment of COPD is urgent, and the scientific community has begun to pay close attention to diet as an integral part of COPD management, from prevention to treatment. This review summarizes the evidence from observational and clinical studies regarding the impact of nutrients and dietary patterns on lung function and COPD development, progression, and outcomes, with highlights on potential mechanisms of action. Several dietary options can be considered in terms of COPD prevention and/or progression. Although definitive data are lacking, the available scientific evidence indicates that some foods and nutrients, especially those nutraceuticals endowed with antioxidant and anti-inflammatory properties and when consumed in combinations in the form of balanced dietary patterns, are associated with better pulmonary function, less lung function decline, and reduced risk of COPD. Knowledge of dietary influences on COPD may provide health professionals with an evidence-based lifestyle approach to better counsel patients toward improved pulmonary health.
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16
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Kaluza J, Harris HR, Linden A, Wolk A. Long-term consumption of fruits and vegetables and risk of chronic obstructive pulmonary disease: a prospective cohort study of women. Int J Epidemiol 2019; 47:1897-1909. [PMID: 30239739 DOI: 10.1093/ije/dyy178] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2018] [Indexed: 01/22/2023] Open
Abstract
Background Fruits and vegetables, due to high antioxidant capacity, may protect the lung from oxidative damage caused by tobacco smoke and potentially prevent chronic obstructive pulmonary disease (COPD). Only one study based on baseline diet has examined fruit and vegetable consumption in relation to risk of COPD, and no previous studies have examined long-term diet. Methods We investigated whether long-term fruit and vegetable consumption was associated with COPD incidence among 34 739 women (age 48-83 years) in the population-based prospective Swedish Mammography Cohort. Fruit and vegetable consumption was assessed twice (1987, 1997) with a self-administered questionnaire. Cases of COPD were identified by linkage to the Swedish health register. Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results During follow-up from 2002 to 2014, 1512 women were diagnosed with COPD. Long-term fruit was associated with lower risk of COPD; women in the highest vs lowest quintile of consumption (≥2.5 vs <0.8 servings/day) had a 37% lower risk of COPD (95% CI: 25-48%; P-trend < 0.0001). No association was observed with long-term vegetable intake. Current and ex-smokers with low long-term consumption of fruits (<1 serving/day) in comparison to never smokers with high consumption (≥3 servings/day) had a 38-fold (HR: 38.1; 95% CI: 20.2-71.7) and 13-fold (HR: 12.5, 95% CI: 6.5-24.1) higher risk of COPD, respectively. However, no significant interaction between smoking status and fruit intake in relation to COPD incidence was observed (P-interaction = 0.95). Conclusions In this prospective cohort of middle-age and older women, long-term consumption of fruits but not vegetables was inversely associated with COPD incidence.
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Affiliation(s)
- Joanna Kaluza
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, SE 171-77 Stockholm, Sweden.,Nutrition Research Laboratory, Department of Human Nutrition, Warsaw University of Life Sciences-SGGW, Warsaw, Poland
| | - Holly R Harris
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Anders Linden
- Unit for Lung and Airway Research, Institute of Environmental Medicine, Karolinska Institutet, SE 171-77 Stockholm, Sweden.,Lung Allergy Clinic, Karolinska University Hospital, Stockholm, Sweden
| | - Alicja Wolk
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, SE 171-77 Stockholm, Sweden.,Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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17
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Seyedrezazadeh E, Moghaddam MP, Ansarin K, Asghari Jafarabadi M, Sharifi A, Sharma S, Kolahdooz F. Dietary Factors and Risk of Chronic Obstructive Pulmonary Disease: a Systemic Review and Meta-Analysis. TANAFFOS 2019; 18:294-309. [PMID: 32607110 PMCID: PMC7309892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND The relationship between dietary pattern and the risk of chronic obstructive pulmonary disease (COPD) has been described; however, the exclusive role of dietary factors remains controversial. Hence, we conducted this systematic meta-analysis to clarify the role of some nutrients and antioxidant vitamins in the risk of COPD. MATERIALS AND METHODS PubMed, Embase, and Scopus databases were searched for studies evaluating the associations between COPD outcome measures, symptoms, and mortality, and intake of fruits and vegetables, fiber, fish, n-3 or n-6 fatty acids, and antioxidant vitamins in adults. The random-effect model meta-analyses were used to pool the results. RESULTS Ten cohort, six case-control, and 20 cross-sectional studies were identified. The pooled relative risks (RRs) of the COPD and confidence intervals (CIs) for the highest intake group compared with the lowest intake group were 0.74 (95% CI: 0.65-0.85) for fruit, 0.65 (95% CI: 0.55-0.78) for dietary fiber, 0.71 (95% CI: 0.58-0.85) for fish, and 0.89 (95% CI: 0.76-0.99) for vitamin C. No association was observed between the risk of COPD and the intake of vegetables, n-3 fatty acids, vitamin E, and β-carotene; however, it was associated with n-6 fatty acids 1.06 (95% CI: 0.87-1.30). CONCLUSION The results suggested that a higher intake of fruits, probably dietary fiber, and fish reduce the risk of COPD.
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Affiliation(s)
- Ensiyeh Seyedrezazadeh
- Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Khalil Ansarin
- Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari Jafarabadi
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Akbar Sharifi
- Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sangita Sharma
- Indigenous & Global Health Research Group, Department of Medicine, University of Alberta, Edmonton, Canada
| | - Fariba Kolahdooz
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.,Correspondence to: Kolahdooz F, Address: Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Unit 5-10 University Terrace, 8303 - 112 Street, Edmonton, Alberta T6G 2T4, Email address:
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18
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Polak M, Szafraniec K, Kozela M, Wolfshaut-Wolak R, Bobak M, Pająk A. Socioeconomic status and pulmonary function, transition from childhood to adulthood: cross-sectional results from the polish part of the HAPIEE study. BMJ Open 2019; 9:e022638. [PMID: 30782683 PMCID: PMC6340009 DOI: 10.1136/bmjopen-2018-022638] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE Previous studies have reported inverse associations between socioeconomic status (SES) and lung function, but less is known about whether pulmonary function is affected by SES changes. We aimed to describe the relationship of changes of SES between childhood and adulthood with pulmonary function. DESIGN Cross-sectional study. PARTICIPANTS The study sample included 4104 men and women, aged 45-69 years, residents of Krakow, participating in the Polish part of the Health, Alcohol and Psychosocial Factors in Eastern Europe Project. MAIN OUTCOME Forced expiratory volume (FEV1) and forced vital capacity (FVC) were assessed by the standardised spirometry procedure. Participants were classified into three categories of SES (low, moderate or high) based on information on parent's education, housing standard during childhood, own education, employment status, household amenities and financial status. RESULTS The adjusted difference in mean FVC between persons with low and high adulthood SES was 100 mL (p=0.005) in men and 100 mL (p<0.001) in women; the differences in mean FEV1 were 103 mL (p<0.001) and 80 mL (p<0.001), respectively. Upward social mobility and moderate or high SES at both childhood and adulthood were related to significantly higher FEV1 and FVC compared with low SES at both childhood and adulthood or downward social mobility. CONCLUSIONS Low SES over a life course was associated with the lowest lung function. Downward social mobility was associated with a poorer pulmonary function, while upward mobility or life course and moderate or high SES were associated with a better pulmonary function.
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Affiliation(s)
- Maciej Polak
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - Krystyna Szafraniec
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - Magdalena Kozela
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - Renata Wolfshaut-Wolak
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Andrzej Pająk
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
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19
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Kaluza J, Larsson SC, Orsini N, Linden A, Wolk A. Fruit and vegetable consumption and risk of COPD: a prospective cohort study of men. Thorax 2017; 72:500-509. [DOI: 10.1136/thoraxjnl-2015-207851] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 11/07/2016] [Accepted: 11/08/2016] [Indexed: 11/04/2022]
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20
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de Boer A, van de Worp WRPH, Hageman GJ, Bast A. The effect of dietary components on inflammatory lung diseases - a literature review. Int J Food Sci Nutr 2017; 68:771-787. [PMID: 28276906 DOI: 10.1080/09637486.2017.1288199] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Anti-inflammatory treatment in chronic inflammatory lung diseases usually involves glucocorticosteroids. With patients suffering from serious side effects or becoming resistant, specific nutrients, that are suggested to positively influence disease progression, can be considered as new treatment options. The dietary inflammatory index is used to calculate effects of dietary components on inflammation and lung function to identify most potent dietary components, based on 162 articles. The positive effects of n-3 PUFAs and vitamin E on lung function can at least partially be explained by their anti-inflammatory effect. Many other dietary components showed only small or no effects on inflammation and/or lung function, although the number of weighted studies was often too small for a reliable assessment. Optimal beneficial dietary elements might reduce the required amounts of anti-inflammatory treatments, thereby decreasing both side effects and development of resistance as to improve quality of life of patients suffering from chronic inflammatory lung diseases.
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Affiliation(s)
- Alie de Boer
- a Faculty of Humanities and Sciences , Food Claims Centre Venlo, Maastricht University Campus Venlo, Maastricht University , Venlo , The Netherlands
| | - Wouter R P H van de Worp
- b Department of Pharmacology and Toxicology, Faculty of Health Medicine and Life Sciences , Maastricht University , Maastricht , The Netherlands
| | - Geja J Hageman
- b Department of Pharmacology and Toxicology, Faculty of Health Medicine and Life Sciences , Maastricht University , Maastricht , The Netherlands
| | - Aalt Bast
- b Department of Pharmacology and Toxicology, Faculty of Health Medicine and Life Sciences , Maastricht University , Maastricht , The Netherlands.,c Faculty of Humanities and Sciences , Maastricht University Campus Venlo, Maastricht University , Venlo , The Netherlands
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21
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The Relationship between Dietary Fiber Intake and Lung Function in the National Health and Nutrition Examination Surveys. Ann Am Thorac Soc 2016; 13:643-50. [DOI: 10.1513/annalsats.201509-609oc] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Gaffney AW, Hang JQ, Lee MS, Su L, Zhang FY, Christiani DC. Socioeconomic status is associated with reduced lung function in China: an analysis from a large cross-sectional study in Shanghai. BMC Public Health 2016; 16:96. [PMID: 26832923 PMCID: PMC4736183 DOI: 10.1186/s12889-016-2752-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 01/19/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND An inverse association between socioeconomic status and pulmonary function has emerged in many studies. However, the mediating factors in this relationship are poorly understood, and might be expected to differ between countries. We sought to investigate the relationship between socioeconomic status and lung function in China, a rapidly industrializing nation with unique environmental challenges, and to identify potentially-modifiable environmental mediators. METHODS We used data from the Shanghai Putuo Study, a cross-sectional study performed in Shanghai, China. Participants completed a questionnaire and spirometry. The primary exposure was socioeconomic status, determined by education level. The primary outcomes were FEV1 and FVC percent predicted. Multiple linear regressions were used to test this association, and the percent explained by behavioral, environmental, occupational, and dietary variables was determined by adding these variables to a base model. RESULTS The study population consisted of a total of 22,878 study subjects that were 53.3 % female and had a mean age of 48. In the final multivariate analysis, the effect estimates for FEV1 and FVC percent predicted for low socioeconomic status (compared to high) were statistically significant at a p-value of <0.01. Smoking, biomass exposure, mode of transportation to work, a diet low in fruits or vegetables, and occupational category partially attenuated the relationship between SES and lung function. In a fully-adjusted age-stratified analysis, the socioeconomic disparity in lung function widened with increasing age. CONCLUSIONS We found cross-sectional evidence of socioeconomic disparities in pulmonary function in Shanghai. These differences increased with age and were partially explained by potentially modifiable exposures.
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Affiliation(s)
- Adam W Gaffney
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
| | - Jing-qing Hang
- Shanghai Putuo District People's Hospital, Shanghai, China.
| | - Mi-Sun Lee
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.
| | - Li Su
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.
| | | | - David C Christiani
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.
- Harvard Medical School, Boston, MA, USA.
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Abdala-Valencia H, Soveg F, Cook-Mills JM. γ-Tocopherol supplementation of allergic female mice augments development of CD11c+CD11b+ dendritic cells in utero and allergic inflammation in neonates. Am J Physiol Lung Cell Mol Physiol 2016; 310:L759-71. [PMID: 26801566 DOI: 10.1152/ajplung.00301.2015] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 01/20/2016] [Indexed: 11/22/2022] Open
Abstract
γ-Tocopherol increases responses to allergen challenge in allergic adult mice, but it is not known whether γ-tocopherol regulates the development of allergic disease. Development of allergic disease often occurs early in life. In clinical studies and animal models, offspring of allergic mothers have increased responsiveness to allergen challenge. Therefore, we determined whether γ-tocopherol augments development of allergic responses in offspring of allergic female mice. Allergic female mice were supplemented with γ-tocopherol starting at mating. The pups from allergic mothers developed allergic lung responses, whereas pups from saline-treated mothers did not respond to allergen challenge. The γ-tocopherol supplementation of allergic female mice increased the numbers of eosinophils twofold in the pup bronchoalveolar lavage and lungs after allergen challenge. There was also about a twofold increase in pup lung CD11b(+) subsets of CD11c(+) dendritic cells and in numbers of these dendritic cells expressing the transcription factor IRF4. There was no change in several CD11b(-) dendritic cell subsets. Furthermore, maternal supplementation with γ-tocopherol increased the number of fetal liver CD11b(+)CD11c(+) dendritic cells twofold in utero. In the pups, γ-tocopherol increased lung expression of the inflammatory mediators CCL11, amphiregulin, activin A, and IL-5. In conclusion, maternal supplementation with γ-tocopherol increased fetal development of subsets of dendritic cells that are critical for allergic responses and increased development of allergic responses in pups from allergic mothers. These results have implications for supplementation of allergic mothers with γ-tocopherol in prenatal vitamins.
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Affiliation(s)
- Hiam Abdala-Valencia
- Allergy-Immunology Division, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Frank Soveg
- Allergy-Immunology Division, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Joan M Cook-Mills
- Allergy-Immunology Division, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Joshi P, Kim WJ, Lee SA. The effect of dietary antioxidant on the COPD risk: the community-based KoGES (Ansan-Anseong) cohort. Int J Chron Obstruct Pulmon Dis 2015; 10:2159-68. [PMID: 26504380 PMCID: PMC4603710 DOI: 10.2147/copd.s91877] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Dietary antioxidants have been suggested to have protective role against chronic obstructive pulmonary disease (COPD), but few prospective studies examined this relationship. The prospective study was conducted to evaluate the effect of dietary antioxidants on COPD risk and lung function in the Korean population. Methods The data were collected from the community-based Korean Genome Epidemiology Study (KoGES) cohort. To diagnose COPD, forced expiratory volume (FEV1) and forced vital capacity (FVC) were measured by spirometry. The dietary intake of antioxidant vitamins was estimated from validated Food-Frequency Questionnaire. For the analysis, 325 COPD patients and 6,781 at risk subjects were selected from the cohort of 10,038 subjects. Multiple logistic regression models were used to examine the odds ratio (OR) after adjusting for age, sex, marital status, income, history of asthma, history of tuberculosis, and smoking. Results The risk of COPD was positively associated with aging, low education, low household income, lower body mass index, and cigarette smoking. The risk of COPD decreased with increase in the dietary vitamin C (ORQ1 vs Q5=0.66, Ptrend=0.03) and vitamin E (ORQ1 vs Q5=0.56, Ptrend=0.05) intake, predominantly, in men (Ptrend=0.01 and 0.05 for vitamins C and E, respectively). In addition, the lung function was significantly improved with increase in vitamins C (FEV1, P=0.04; FVC, P=0.03) and E (FEV1, P=0.03; FVC, P=0.04) intake. No statistically significant interactions were observed between smoking and vitamin C or E intake in relation to COPD risk among men. Conclusion Our results suggest the independent beneficial effect of antioxidants, particularly vitamins C and E, on COPD risk and lung function in men.
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Affiliation(s)
- Pankaj Joshi
- Department of Preventive Medicine, Kangwon National University School of Medicine, Chuncheon-si, Gangwon-do, South Korea ; BIT Medical Convergence Graduate Program, Kangwon National University School of Medicine, Chuncheon-si, Gangwon-do, South Korea
| | - Woo Jin Kim
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon-si, Gangwon-do, South Korea ; Environmental Health Center, Kangwon National University School of Medicine, Chuncheon-si, Gangwon-do, South Korea
| | - Sang-Ah Lee
- Department of Preventive Medicine, Kangwon National University School of Medicine, Chuncheon-si, Gangwon-do, South Korea ; BIT Medical Convergence Graduate Program, Kangwon National University School of Medicine, Chuncheon-si, Gangwon-do, South Korea ; Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon-si, Gangwon-do, South Korea
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25
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Saadeh D, Salameh P, Caillaud D, Charpin D, De Blay F, Kopferschmitt C, Lavaud F, Annesi-Maesano I, Baldi I, Raherison C. Prevalence and association of asthma and allergic sensitization with dietary factors in schoolchildren: data from the french six cities study. BMC Public Health 2015; 15:993. [PMID: 26423141 PMCID: PMC4589972 DOI: 10.1186/s12889-015-2320-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 09/22/2015] [Indexed: 11/10/2022] Open
Abstract
Background The prevalence of asthma and allergy has recently risen among children. This increase in prevalence might be related to various factors, particularly diet. The aim of this study is to assess the prevalence and association of asthma and allergic sensitization with dietary factors in the French Six Cities Study. Methods Cross-sectional studies were performed among 7432 schoolchildren aged 9–11 years in Bordeaux, Clermont-Ferrand, Créteil, Marseille, Reims, and Strasbourg. Parental questionnaires, based on the International Study on Asthma and Allergies in Childhood (ISAAC), were used to collect information on allergic diseases and potential exposure factors including a food frequency questionnaire to evaluate dietary habits. Skin prick testing to common allergens for allergic sensitization and bronchial hyper-responsiveness (BHR) testing to exercise were performed. Confounders control was performed with multiple logistic regressions. Results Asthma symptoms, asthma and allergic sensitization were more prevalent in boys than in girls and were more prevalent in the South than in the North of France. After adjustment for confounders, fruit juice intake was associated with a low prevalence of lifetime asthma (ORa [95 % CI]; 0.73 [0.56–0.97]), butter intake was positively associated with atopic wheeze (1.48 [1.07–2.05]) and having lunch at the canteen 1–2 times/week compared to never or occasionally was associated with a lower prevalence of past year wheeze (0.71 [0.52–0.96]), lifetime asthma (0.76 [0.60–0.96]) and allergic sensitization (0.80 [0.67–0.95]). Meat intake was inversely related to past year wheeze among atopic children (0.68 [0.50–0.98]) while fast food consumption and butter intake were associated with an increase prevalence of asthma (2.39 [1.47–3.93] and 1.51 [1.17–2.00] respectively). Fish intake was associated with a lower prevalence of asthma among non-atopic children (0.61 [0.43–0.87]. None of the dietary factors was associated with BHR. Conclusions Diet is associated with wheeze, asthma and allergic sensitization but not with BHR in children. These results provide further evidence that adherence to a healthy diet including fruits, meat and fish seems to have a protective effect on asthma and allergy in childhood. However, prospective and experimental studies are needed to provide causal evidence concerning the effect of diet on asthma and atopy.
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Affiliation(s)
- Danielle Saadeh
- Clinical and Epidemiological Research Laboratory, Lebanese University, Hadath, Lebanon. .,INSERM U897, Institut de Santé Publique d'Epidémiologie et de Développement, Laboratoire Santé Travail Environnement, Université de Bordeaux, Bordeaux, France.
| | - Pascale Salameh
- Clinical and Epidemiological Research Laboratory, Lebanese University, Hadath, Lebanon.
| | | | | | | | | | | | - Isabella Annesi-Maesano
- EPAR, UMR-S 1136, Institute Pierre Louis of Epidemiology and Public Health, INSERM and UPMC Sorbonne Universities, Paris, France.
| | - Isabelle Baldi
- INSERM U897, Institut de Santé Publique d'Epidémiologie et de Développement, Laboratoire Santé Travail Environnement, Université de Bordeaux, Bordeaux, France.
| | - Chantal Raherison
- INSERM U897, Institut de Santé Publique d'Epidémiologie et de Développement, Laboratoire Santé Travail Environnement, Université de Bordeaux, Bordeaux, France. .,Service des Maladies Respiratoires, Hôpital du Haut-Lévèque, Avenue de Magellan, Pessac, France.
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26
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Vestbo J, Lange P. Natural history of COPD: Focusing on change in FEV1. Respirology 2015; 21:34-43. [PMID: 26176980 DOI: 10.1111/resp.12589] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 05/03/2015] [Accepted: 05/06/2015] [Indexed: 11/28/2022]
Abstract
The natural history of chronic obstructive pulmonary disease (COPD) is usually described with a focus on change in forced expiratory volume in 1 s (FEV1 ) over time as this allows for exploration of risk factors for an accelerated decline-and thus of developing COPD. From epidemiological studies we have recognized important risk factors such as smoking, exposure to biomass and occupational exposures, but we have also learnt about features such as chronic bronchitis, airway hyper-responsiveness and asthma that seem to accelerate decline in FEV1 independent of exposures. In addition we are gradually beginning to better link early life events to subsequent risk of disease in adulthood. Although more complicated, our current understanding of COPD has come a long way from being a simple image of smoking leading to poor lungs.
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Affiliation(s)
- Jørgen Vestbo
- Centre for Respiratory Medicine and Allergy, Manchester Academic Health Science Centre, University Hospital South Manchester, NHS Foundation Trust, Manchester, UK
| | - Peter Lange
- Department of Social Medicine, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark.,Department of Respiratory Medicine, Hvidovre University Hospital, Copenhagen, Denmark
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27
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Abstract
Asthma occurs as a result of complex interactions of environmental and genetic factors. Clinical studies and animal models of asthma indicate offspring of allergic mothers have increased risk of development of allergies. Environmental factors including stress-induced corticosterone and vitamin E isoforms during pregnancy regulate the risk for offspring development of allergy. In this review, we discuss mechanisms for the development of allergic disease early in life, environmental factors that may impact the development of risk for allergic disease early in life, and how the variation in global prevalence of asthma may be explained, at least in part, by some environmental components.
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28
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Ventilatory function in young adults and dietary antioxidant intake. Nutrients 2015; 7:2879-96. [PMID: 25884660 PMCID: PMC4425179 DOI: 10.3390/nu7042879] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 03/18/2015] [Accepted: 03/26/2015] [Indexed: 11/17/2022] Open
Abstract
Dietary antioxidants may protect against poor ventilatory function. We assessed the relation between ventilatory function and antioxidant components of diet in young Chileans. Forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and the ratio FEV1/FVC were measured in 1232 adults aged 22–28 years, using a Vitalograph device. Dietary intake was ascertained with a food frequency questionnaire (FFQ) designed for this study, from which nutrient and flavonoid intakes were estimated. Dietary patterns were derived with Principal Component Analysis (PCA). After controlling for potential confounders, dietary intake of total catechins was positively associated with FVC (Regression coefficient (RC) of highest vs. lowest quintile of intake 0.07; 95% CI 0.01 to 0.15; p per trend 0.006). Total fruit intake was related to FVC (RC of highest vs. lowest quintile 0.08; 95% CI 0.003 to 0.15; p per trend 0.02). Intake of omega 3 fatty acids was associated with a higher FEV1 (RC for highest vs. lowest quintile 0.08; 95% CI 0.01 to 0.15 L; p per trend 0.02) and with FVC 0.08 (RC in highest vs. lowest quintile of intake 0.08, 95% CI 0.001 to 0.16; p per trend 0.04). Our results show that fresh fruits, flavonoids, and omega 3 fatty acids may contribute to maintain ventilatory function.
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29
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Berthon BS, Wood LG. Nutrition and respiratory health--feature review. Nutrients 2015; 7:1618-43. [PMID: 25751820 PMCID: PMC4377870 DOI: 10.3390/nu7031618] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 02/15/2015] [Accepted: 02/15/2015] [Indexed: 01/08/2023] Open
Abstract
Diet and nutrition may be important modifiable risk factors for the development, progression and management of obstructive lung diseases such as asthma and chronic obstructive pulmonary disease (COPD). This review examines the relationship between dietary patterns, nutrient intake and weight status in obstructive lung diseases, at different life stages, from in-utero influences through childhood and into adulthood. In vitro and animal studies suggest important roles for various nutrients, some of which are supported by epidemiological studies. However, few well-designed human intervention trials are available to definitively assess the efficacy of different approaches to nutritional management of respiratory diseases. Evidence for the impact of higher intakes of fruit and vegetables is amongst the strongest, yet other dietary nutrients and dietary patterns require evidence from human clinical studies before conclusions can be made about their effectiveness.
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Affiliation(s)
- Bronwyn S Berthon
- Centre for Asthma and Respiratory Diseases, Level 2, Hunter Medical Research Institute, University of Newcastle, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia.
| | - Lisa G Wood
- Centre for Asthma and Respiratory Diseases, Level 2, Hunter Medical Research Institute, University of Newcastle, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia.
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30
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Menotti A, Puddu PE. How the Seven Countries Study contributed to the definition and development of the Mediterranean diet concept: a 50-year journey. Nutr Metab Cardiovasc Dis 2015; 25:245-252. [PMID: 25650160 DOI: 10.1016/j.numecd.2014.12.001] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 11/06/2014] [Accepted: 12/01/2014] [Indexed: 12/14/2022]
Abstract
The Seven Countries Study of Cardiovascular Diseases was started at the end of the 1950s and it continues to be run after >50 years. It enrolled, at entry, 16 population cohorts in eight nations of seven countries for a total of 12,763 middle-aged men. It was the prototype of epidemiological studies seeking cultural contrasts and the first to compare cardiovascular disease (CVD) rates related to diet differences. The study has shown that populations suffer widely different incidence and mortality rates from coronary heart disease (CHD) as well as from other CVDs and overall mortality. Higher rates were found in North America and northern Europe, and lower rates in southern Europe - Mediterranean countries - and Japan. These differences in CHD rates were strongly associated with different levels of saturated fat consumption and average serum cholesterol levels, with lowest rates in Greece and Japan where the total fat intake was very different. The cohorts were also different in dietary patterns defined by the ratio of calories derived from plant foods and fish on the one hand and calories derived from animal foods and sugar on the other. These findings pointed to the so-called Mediterranean diet, which is characterized by large values of that plant/animal ratio, a pattern associated with lower incidence and mortality from CHD and also with the lowest death rates and the greatest survival rates. More recent studies have refined these concepts and documented on a larger scale the virtues of these eating habits.
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Affiliation(s)
- A Menotti
- Association for Cardiac Research, Rome, Italy.
| | - P E Puddu
- Department of Cardiovascular, Respiratory Nephrological, Anesthesiological and Geriatric Sciences, Sapienza University of Rome, Italy.
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31
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Hanson C, Lyden E, Furtado J, Campos H, Sparrow D, Vokonas P, Litonjua AA. Serum tocopherol levels and vitamin E intake are associated with lung function in the normative aging study. Clin Nutr 2015; 35:169-174. [PMID: 25715694 DOI: 10.1016/j.clnu.2015.01.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 01/23/2015] [Accepted: 01/25/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS The results of studies assessing relationships between vitamin E intake and status and lung function are conflicting. This study aimed to evaluate the effect of vitamin E intake and serum levels of tocopherol isoforms on lung function in a cross-sectional sample of 580 men from the Normative Aging Study, a longitudinal aging study. METHODS Regression models were used to look at associations of serum tocopherol isoform levels and vitamin E intake with lung function parameters after adjustment for confounders. Vitamin E intake was measured using a food frequency questionnaire and serum levels of γ, α, and δ-tocopherol levels were measured using high-performance liquid chromatography. RESULTS After adjustment for potential confounders, serum γ-tocopherol had a significant inverse association with forced vital capacity (β = -0.10, p = 0.05). Alpha and δ-tocopherol were not associated with any lung function parameter. After classifying COPD status according to Global Initiative for Obstructive Lung Disease (GOLD) stage criteria, serum levels of δ-tocopherol were lower in participants with more severe COPD (p = 0.01). Serum levels of δ-tocopherol were also lower in participants with greater levels of smoking (p = 0.02). Both vitamin E intake (β = 0.03, p = 0.02; β = 0.03, p = 0.01) and use of vitamin E supplements (β = 0.05, p = 0.03; β = 0.06. p = 0.02) were positively associated with FEV1 and FVC, after adjusting for confounders. Subjects who took vitamin E supplements had significantly higher α-tocopherol levels (p < 0.0001) and lower γ-tocopherol levels (p < 0.0001) than non-users. CONCLUSION In this study, there is a positive association between dietary vitamin E intake and lung function, and evidence of an inverse relationship between serum levels of γ-tocopherol and lung function.
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Affiliation(s)
- Corrine Hanson
- University of Nebraska Medical Center, School of Allied Health Professions, Medical Nutrition Education, 984045 Nebraska Medical Center, Omaha, NE 68198-4045, USA.
| | - Elizabeth Lyden
- University of Nebraska Medical Center, College of Public Health, 984375 Nebraska Medical Center, Omaha, NE 68198-4375, USA
| | - Jeremy Furtado
- Department of Nutrition, Harvard School of Public Health, 655 Huntington Avenue, Boston, MA 02215, USA
| | - Hannia Campos
- Department of Nutrition, Harvard School of Public Health, 655 Huntington Avenue, Boston, MA 02215, USA
| | - David Sparrow
- Veterans Affairs Boston Healthcare System and Department of Medicine, Boston University School of Medicine, Boston, MA 02130, USA
| | - Pantel Vokonas
- Veterans Affairs Boston Healthcare System and Department of Medicine, Boston University School of Medicine, Boston, MA 02130, USA
| | - Augusto A Litonjua
- Channing Laboratory and Pulmonary and Critical Care Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, USA
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Varraso R, Barr RG, Willett WC, Speizer FE, Camargo CA. Fish intake and risk of chronic obstructive pulmonary disease in 2 large US cohorts. Am J Clin Nutr 2015; 101:354-61. [PMID: 25646333 PMCID: PMC4307205 DOI: 10.3945/ajcn.114.094516] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Despite mechanistic data that linked fish and omega-3 (n-3) PUFAs with lower risk of chronic obstructive pulmonary disease (COPD), epidemiologic data remain scarce. Fish and n-3 PUFAs are an important component of the prudent dietary pattern that is thought to be protective in the onset of COPD. OBJECTIVE We examined the role of fish and PUFA intakes on risk of developing COPD while taking into account the overall dietary pattern. DESIGN We investigated the objective in 120,175 women and men from the Nurses' Health Study and Health Professionals Follow-Up Study. Over the study period (1984-2000), there were 889 cases of newly diagnosed COPD. Cumulative average intakes of fish, eicosapentaenoic acid, docosahexaenoic acid, n-3 PUFAs, n-6 PUFAs, and the n-3:n-6 ratio were calculated from repeated food-frequency questionnaires. Because fish is a food group included in the prudent pattern, we derived a new prudent pattern without the contribution from fish, and we termed this pattern the "modified prudent" pattern. We performed multivariable Cox proportional hazards models. RESULTS Before the dietary pattern was taken into account, and with 14 factors controlled for, we showed that more-frequent fish intake (≥4 servings/wk) was inversely associated with risk of COPD [adjusted pooled HR for the highest intake compared with the lowest intake (<1 serving/wk): 0.71; 95% CI: 0.54, 0.94]. After additional adjustment for the dietary pattern (modified prudent and Western patterns), the association was NS (0.84; 95% CI: 0.63, 1.13). No significant associations were shown between PUFA intakes and risk of COPD. CONCLUSION Although COPD-prevention efforts should continue to focus on smoking cessation, these prospective findings support the importance of promoting a healthy diet in multi-interventional programs to prevent COPD instead of focusing on changes in an isolated food or nutrient.
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Affiliation(s)
- Raphaëlle Varraso
- From the Centre for Research in Epidemiology and Population Health, U1018, Respiratory and Environmental Epidemiology team, Villejuif, France (RV); the Université Paris-Sud 11, UMRS 1018, Villejuif, France (RV); the Division of General Medicine, Departments of Medicine and of Epidemiology, Columbia University Medical Center, New York, NY (RGB); the Departments of Nutrition (WCW) and Epidemiology (WCW and CAC), Harvard School of Public Health, Boston, MA; the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (WCW, FES, and CAC); and the Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA (CAC)
| | - R Graham Barr
- From the Centre for Research in Epidemiology and Population Health, U1018, Respiratory and Environmental Epidemiology team, Villejuif, France (RV); the Université Paris-Sud 11, UMRS 1018, Villejuif, France (RV); the Division of General Medicine, Departments of Medicine and of Epidemiology, Columbia University Medical Center, New York, NY (RGB); the Departments of Nutrition (WCW) and Epidemiology (WCW and CAC), Harvard School of Public Health, Boston, MA; the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (WCW, FES, and CAC); and the Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA (CAC)
| | - Walter C Willett
- From the Centre for Research in Epidemiology and Population Health, U1018, Respiratory and Environmental Epidemiology team, Villejuif, France (RV); the Université Paris-Sud 11, UMRS 1018, Villejuif, France (RV); the Division of General Medicine, Departments of Medicine and of Epidemiology, Columbia University Medical Center, New York, NY (RGB); the Departments of Nutrition (WCW) and Epidemiology (WCW and CAC), Harvard School of Public Health, Boston, MA; the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (WCW, FES, and CAC); and the Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA (CAC)
| | - Frank E Speizer
- From the Centre for Research in Epidemiology and Population Health, U1018, Respiratory and Environmental Epidemiology team, Villejuif, France (RV); the Université Paris-Sud 11, UMRS 1018, Villejuif, France (RV); the Division of General Medicine, Departments of Medicine and of Epidemiology, Columbia University Medical Center, New York, NY (RGB); the Departments of Nutrition (WCW) and Epidemiology (WCW and CAC), Harvard School of Public Health, Boston, MA; the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (WCW, FES, and CAC); and the Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA (CAC)
| | - Carlos A Camargo
- From the Centre for Research in Epidemiology and Population Health, U1018, Respiratory and Environmental Epidemiology team, Villejuif, France (RV); the Université Paris-Sud 11, UMRS 1018, Villejuif, France (RV); the Division of General Medicine, Departments of Medicine and of Epidemiology, Columbia University Medical Center, New York, NY (RGB); the Departments of Nutrition (WCW) and Epidemiology (WCW and CAC), Harvard School of Public Health, Boston, MA; the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (WCW, FES, and CAC); and the Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA (CAC)
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Ford ES, Li C, Cunningham TJ, Croft JB. Associations between antioxidants and all-cause mortality among US adults with obstructive lung function. Br J Nutr 2014; 112:1662-73. [PMID: 25315508 PMCID: PMC4560207 DOI: 10.1017/s0007114514002669] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Chronic obstructive pulmonary disease is characterised by oxidative stress, but little is known about the associations between antioxidant status and all-cause mortality in adults with this disease. The objective of the present study was to examine the prospective associations between concentrations of α- and β-carotene, β-cryptoxanthin, lutein/zeaxanthin, lycopene, Se, vitamin C and α-tocopherol and all-cause mortality among US adults with obstructive lung function. Data collected from 1492 adults aged 20-79 years with obstructive lung function in the National Health and Nutrition Examination Survey III (1988-94) were used. Through 2006, 629 deaths were identified during a median follow-up period of 14 years. After adjustment for demographic variables, the concentrations of the following antioxidants modelled as continuous variables were found to be inversely associated with all-cause mortality among adults with obstructive lung function: α-carotene (P= 0·037); β-carotene (P= 0·022); cryptoxanthin (P= 0·022); lutein/zeaxanthin (P= 0·004); total carotenoids (P= 0·001); vitamin C (P< 0·001). In maximally adjusted models, only the concentrations of lycopene (P= 0·013) and vitamin C (P= 0·046) were found to be significantly and inversely associated with all-cause mortality. No effect modification by sex was detected, but the association between lutein/zeaxanthin concentrations and all-cause mortality varied by smoking status (P interaction= 0·048). The concentrations of lycopene and vitamin C were inversely associated with all-cause mortality in this cohort of adults with obstructive lung function.
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Affiliation(s)
- Earl S. Ford
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F78, Atlanta, GA 30341, USA
| | - Chaoyang Li
- Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Timothy J. Cunningham
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F78, Atlanta, GA 30341, USA
| | - Janet B. Croft
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F78, Atlanta, GA 30341, USA
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Ng TP, Niti M, Yap KB, Tan WC. Dietary and supplemental antioxidant and anti-inflammatory nutrient intakes and pulmonary function. Public Health Nutr 2014; 17:2081-6. [PMID: 24074036 PMCID: PMC11108714 DOI: 10.1017/s1368980013002590] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Revised: 08/16/2013] [Accepted: 08/20/2013] [Indexed: 11/06/2022]
Abstract
OBJECTIVE A limited but growing body of evidence supports a significant role of antioxidant and anti-inflammatory micronutrients in pulmonary health. We investigated the associations of dietary and supplemental intakes of vitamins A, C, E and D, Se and n-3 PUFA with pulmonary function in a population-based study. DESIGN Population-based, cross-sectional study and data analysis of fruits and vegetables, dairy products and fish, vitamins A, C, E and D, Se and n-3 PUFA supplemental intakes, pulmonary risk factors and spirometry. SUBJECTS Chinese older adults (n 2478) aged 55 years and above in the Singapore Longitudinal Ageing Studies. RESULTS In multiple regression models that controlled simultaneously for gender, age, height, smoking, occupational exposure and history of asthma/chronic obstructive pulmonary disease, BMI, physical activity, and in the presence of other nutrient variables, daily supplementary vitamins A/C/E (b = 0·044, SE = 0·022, P = 0·04), dietary fish intake at least thrice weekly (b = 0·058, SE = 0·016, P < 0·0001) and daily supplementary n-3 PUFA (b = 0·068, SE = 0·032, P = 0·034) were individually associated with forced expiratory volume in the first second. Supplemental n-3 PUFA was also positively associated with forced vital capacity (b = 0·091, SE = 0·045, P = 0·045). No significant association with daily dairy product intake, vitamin D or Se supplements was observed. CONCLUSIONS The findings support the roles of antioxidant vitamins and n-3 PUFA in the pulmonary health of older persons.
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Affiliation(s)
- Tze Pin Ng
- Gerontological Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Psychological Medicine, National University Hospital, Yong Loo Lin School of Medicine, National University of Singapore, 5 Lower Kent Ridge Road, Singapore 119074
| | - Mathew Niti
- Gerontological Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Health Service Research and Evaluation, Ministry of Health, Singapore
| | - Keng Bee Yap
- Gerontological Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Alexandra Hospital, Singapore
| | - Wan Cheng Tan
- Gerontological Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Respiratory Medicine Division, University of British Columbia, Vancouver, British Columbia, Canada
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Cook-Mills JM, Avila PC. Vitamin E and D regulation of allergic asthma immunopathogenesis. Int Immunopharmacol 2014; 23:364-72. [PMID: 25175918 DOI: 10.1016/j.intimp.2014.08.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 08/06/2014] [Accepted: 08/07/2014] [Indexed: 01/08/2023]
Abstract
Asthma occurs as complex interactions of the environmental and genetics. Clinical studies and animal models of asthma indicate dietary factors such as vitamin E and vitamin D as protective for asthma risk. In this review, we discuss opposing regulatory functions of tocopherol isoforms of vitamin E and regulatory functions of vitamin D in asthma and how the variation in global prevalence of asthma may be explained, at least in part, by these dietary components.
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Affiliation(s)
- Joan M Cook-Mills
- Allergy-Immunology Division, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
| | - Pedro C Avila
- Allergy-Immunology Division, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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Hanson C, Rutten EP, Wouters EFM, Rennard S. Influence of diet and obesity on COPD development and outcomes. Int J Chron Obstruct Pulmon Dis 2014; 9:723-33. [PMID: 25125974 PMCID: PMC4130708 DOI: 10.2147/copd.s50111] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The global increase in the prevalence and incidence of obesity has called serious attention to this issue as a major public health concern. Obesity is associated with many chronic diseases, including cardiovascular disease and diabetes, and recently the role of overweight and obesity in lung disease has received new interest. Independently of obesity, diet also plays a role as a risk factor for many chronic diseases, and evidence is accumulating to support a role for diet in the prevention and management of several lung diseases. Chronic obstructive lung disease is the third-leading cause of death globally, and both obesity and diet appear to play roles in its pathophysiology. Obesity has been associated with decreased lung-function measures in population-based studies, with increased prevalence of several lung diseases and with compromised pulmonary function. In contrast, obesity has a protective effect against mortality in severe chronic obstructive pulmonary disease (COPD). Nutrient intake and dietary patterns have also been associated with lung-function measures and the development and progression of COPD. Taken together, this suggests that a focus on obesity and diet should be part of public health campaigns to reduce the burden of lung disease, and could have important implications for clinicians in the management of their patients. Future research should also focus on elucidating these relationships in diverse populations and age-groups, and on understanding the complex interaction between behavior, environment, and genetics in the development and progression of COPD. The goal of this article is to review current evidence regarding the role that obesity and diet play in the development of COPD, and in COPD-related outcomes.
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Affiliation(s)
- Corrine Hanson
- Division of Medical Nutrition Education, School of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, USA
| | - Erica P Rutten
- Research and Education, Centre of Expertise for Chronic Organ Failure, Horn, The Netherlands
| | - Emiel F M Wouters
- Research and Education, Centre of Expertise for Chronic Organ Failure, Horn, The Netherlands ; Department of Pulmonary Diseases, University of Maastricht, Maastricht, The Netherlands
| | - Stephen Rennard
- Division of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
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Hanson C, Sayles H, Rutten EEPA, Wouters EFM, MacNee W, Calverley P, Meza JL, Rennard S. The Association Between Dietary Intake and Phenotypical Characteristics of COPD in the ECLIPSE Cohort. CHRONIC OBSTRUCTIVE PULMONARY DISEASES-JOURNAL OF THE COPD FOUNDATION 2014; 1:115-124. [PMID: 28848815 DOI: 10.15326/jcopdf.1.1.2014.0113] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background: Diet is a potentially modifiable risk factor in the development and progression of many diseases, and there is evidence that diet plays a role in COPD. Objective: Evaluate the relationship between dietary intake and clinical characteristics of COPD in a large and well-characterized population of COPD patients and controls who were part of the ECLIPSE study. Methods: Limited diet records were available from 2,167 participants at 8 time points over a 3-year period. Participants reported the amount they had consumed over the last 24 hours for 8 food categories. Intake of each food group was handled as a dichotomous variable (Yes/last 24 hours at any of the 8 follow-up points vs. No at all 8 points). These 2 groups were then compared using clinical outcome measures at the last available follow-up that included lung function, emphysema, 6-minute walk, St. George's Respiratory Questionaire (SGRQ) scores, the change in these scores over a 3-year period, and inflammatory biomarkers. Multivariate models for each food group and each outcome measure were run to adjust for confounding factors of age, sex, body mass index (BMI), and smoking. Results: Participants who demonstrated recent consumption of foods associated with a healthful diet, including fish, fruit, tea, and dairy products, had greater lung function measures and less decline over time, less emphysema and emphysema progression, greater 6-minute walk and SGRQ scores, and lower levels of certain inflammatory markers. Increasing the number of diet record time points that were included in the analysis improved ability to detect significant associations. Conclusion: Diet as a possible modifiable risk factor in COPD continues to warrant investigation.
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Affiliation(s)
- Corrine Hanson
- University of Nebraska Medical Center, School of Allied Health Professions, Medical Nutrition Education, Omaha
| | - Harlan Sayles
- University of Nebraska Medical Center, College of Public Health, Omaha
| | - Erica E P A Rutten
- Program Development Centre, Centre of Expertise for Chronic Organ Failure,The Horn, Netherlands
| | - E F M Wouters
- Department of Pulmonary Diseases, University of Maastricht, Maastrict, Netherlands
| | | | - Peter Calverley
- Department of Medicine, Clinical Sciences Centre, University of Liverpool, UK
| | - Jane L Meza
- University of Nebraska Medical Center, College of Public Health, Omaha
| | - Stephen Rennard
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha
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Camargo CA, Budinger GRS, Escobar GJ, Hansel NN, Hanson CK, Huffnagle GB, Buist AS. Promotion of lung health: NHLBI Workshop on the Primary Prevention of Chronic Lung Diseases. Ann Am Thorac Soc 2014; 11 Suppl 3:S125-38. [PMID: 24754821 PMCID: PMC4112505 DOI: 10.1513/annalsats.201312-451ld] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Accepted: 03/04/2014] [Indexed: 12/17/2022] Open
Abstract
Lung-related research primarily focuses on the etiology and management of diseases. In recent years, interest in primary prevention has grown. However, primary prevention also includes "health promotion" (actions in a population that keep an individual healthy). We encourage more research on population-based (public health) strategies that could not only maximize lung health but also mitigate "normal" age-related declines-not only for spirometry but across multiple measures of lung health. In developing a successful strategy, a "life course" approach is important. Unfortunately, we are unable to achieve the full benefit of this approach until we have better measures of lung health and an improved understanding of the normal trajectory, both over an individual's life span and possibly across generations. We discuss key questions in lung health promotion, with an emphasis on the upper (healthier) end of the distribution of lung functioning and resiliency and briefly summarize the few interventions that have been studied to date. We conclude with suggestions regarding the most promising future research for this important, but largely neglected, area of lung research.
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Affiliation(s)
- Carlos A. Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - G. R. Scott Budinger
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Northwestern University, Chicago, Illinois
| | | | - Nadia N. Hansel
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins Medical Center, Baltimore, Maryland
| | - Corrine K. Hanson
- School of Allied Health Professions, University of Nebraska Medical Center, Omaha, Nebraska
| | - Gary B. Huffnagle
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan; and
| | - A. Sonia Buist
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Oregon Health and Science University, Portland, Oregon
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Hirayama F, Lee AH, Binns CW. Dietary factors for chronic obstructive pulmonary disease: epidemiological evidence. Expert Rev Respir Med 2014; 2:645-53. [DOI: 10.1586/17476348.2.5.645] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abdala-Valencia H, Berdnikovs S, Cook-Mills JM. Vitamin E isoforms as modulators of lung inflammation. Nutrients 2013; 5:4347-63. [PMID: 24184873 PMCID: PMC3847734 DOI: 10.3390/nu5114347] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 10/12/2013] [Accepted: 10/18/2013] [Indexed: 01/19/2023] Open
Abstract
Asthma and allergic diseases are complex conditions caused by a combination of genetic and environmental factors. Clinical studies suggest a number of protective dietary factors for asthma, including vitamin E. However, studies of vitamin E in allergy commonly result in seemingly conflicting outcomes. Recent work indicates that allergic inflammation is inhibited by supplementation with the purified natural vitamin E isoform α-tocopherol but elevated by the isoform γ-tocopherol when administered at physiological tissue concentrations. In this review, we discuss opposing regulatory effects of α-tocopherol and γ-tocopherol on allergic lung inflammation in clinical trials and in animal studies. A better understanding of the differential regulation of inflammation by isoforms of vitamin E provides a basis towards the design of clinical studies and diets that would effectively modulate inflammatory pathways in lung disease.
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Affiliation(s)
- Hiam Abdala-Valencia
- Allergy-Immunology Division, Feinberg School of Medicine, Northwestern University, McGaw-M304, 240 E. Huron, Chicago, IL 60611, USA.
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Cook-Mills JM, Abdala-Valencia H, Hartert T. Two faces of vitamin E in the lung. Am J Respir Crit Care Med 2013; 188:279-84. [PMID: 23905522 DOI: 10.1164/rccm.201303-0503ed] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Asthma and allergic lung disease occur as complex environmental and genetic interactions. Clinical studies of asthma indicate a number of protective dietary factors, such as vitamin E, on asthma risk. However, these studies have had seemingly conflicting outcomes. In this perspective, we discuss opposing regulatory effects of tocopherol isoforms of vitamin E, mechanisms for tocopherol isoform regulation of allergic lung inflammation, association of vitamin E isoforms with outcomes in clinical studies, and how the variation in global prevalence of asthma may be explained, at least in part, by vitamin E isoforms.
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Affiliation(s)
- Joan M Cook-Mills
- Allergy-Immunology Division, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
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42
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Hanson C, Rutten EPA, Wouters EFM, Rennard S. Diet and vitamin D as risk factors for lung impairment and COPD. Transl Res 2013; 162:219-36. [PMID: 23685188 DOI: 10.1016/j.trsl.2013.04.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 04/23/2013] [Accepted: 04/24/2013] [Indexed: 02/03/2023]
Abstract
Epidemiologic and observational studies have shown an association between increased intakes of certain micronutrients and higher levels of lung function and health. The National Health and Nutrition Examination Surveys of the U.S. population have demonstrated repeatedly that increased intakes or serum levels of some micronutrients, including the vitamins E, D, C, and A, and carotenes are associated positively with forced expiratory volume in 1 second (FEV1). These findings are complemented by other observational studies, including the MORGEN study as well as the Seven Countries Study, both of which found micronutrient status had positive correlations with pulmonary function. In addition, epidemiologic studies have demonstrated that dietary intake patterns with increased intakes of fruit, vegetables, fish, vitamin E, and whole grains have been associated with a decreased development of chronic obstructive pulmonary disease (COPD) in smokers and nonsmokers, higher levels of FEV1, and decreased long-term COPD mortality. Diets high in refined food have been associated with accelerated longitudinal decline in FEV1 over 5 years. Taken together, these results suggest that micronutrient status may impact lung function, and that nutrition interventions could be a useful tool in a public health campaign aimed at the prevention of lung disease. Future research should focus on the effect of nutrition interventions on the natural history of lung disease.
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Affiliation(s)
- Corrine Hanson
- Division of Medical Nutrition Education, School of Allied Health Professions, University of Nebraska Medical Center, Omaha, Neb.
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Improving asthma during pregnancy with dietary antioxidants: the current evidence. Nutrients 2013; 5:3212-34. [PMID: 23948757 PMCID: PMC3775250 DOI: 10.3390/nu5083212] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Revised: 08/06/2013] [Accepted: 08/07/2013] [Indexed: 12/16/2022] Open
Abstract
The complication of asthma during pregnancy is associated with a number of poor outcomes for the mother and fetus. This may be partially driven by increased oxidative stress induced by the combination of asthma and pregnancy. Asthma is a chronic inflammatory disease of the airways associated with systemic inflammation and oxidative stress, which contributes to worsening asthma symptoms. Pregnancy alone also intensifies oxidative stress through the systemic generation of excess reactive oxidative species (ROS). Antioxidants combat the damaging effects of ROS; yet antioxidant defenses are reduced in asthma. Diet and nutrition have been postulated as potential factors to combat the damaging effects of asthma. In particular, dietary antioxidants may play a role in alleviating the heightened oxidative stress in asthma. Although there are some observational and interventional studies that have shown protective effects of antioxidants in asthma, assessment of antioxidants in pregnancy are limited and there are no antioxidant intervention studies in asthmatic pregnancies on asthma outcomes. The aims of this paper are to (i) review the relationships between oxidative stress and dietary antioxidants in adults with asthma and asthma during pregnancy, and (ii) provide the rationale for which dietary management strategies, specifically increased dietary antioxidants, might positively impact maternal asthma outcomes. Improving asthma control through a holistic antioxidant dietary approach might be valuable in reducing asthma exacerbations and improving asthma management during pregnancy, subsequently impacting perinatal health.
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Itoh M, Tsuji T, Nemoto K, Nakamura H, Aoshiba K. Undernutrition in patients with COPD and its treatment. Nutrients 2013; 5:1316-35. [PMID: 23598440 PMCID: PMC3705350 DOI: 10.3390/nu5041316] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 03/25/2013] [Accepted: 04/08/2013] [Indexed: 12/31/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disorder of the lung and whole body caused mainly by tobacco smoking. Patients with advanced COPD are in a state of undernutrition, referred to as pulmonary cachexia; the exercise performance and quality of life (QOL) of these patients are deteriorated, the vital prognosis is unfavorable, and the medico-economic burden posed by poorly nourished COPD patients is high. The mainstays of COPD treatment are pharmacotherapy, mainly with bronchodilators, and non-pharmacotherapeutic approaches such as respiratory rehabilitation and nutrition counseling. Nutritional supplement therapy, consisting primarily of high calorie intake, has been demonstrated to be effective for maintaining and improving the muscle strength and exercise tolerance in poorly nourished COPD patients. The efficacy of intake of various nutrients, besides a high calorie intake, for amelioration of the disease state of COPD has also been reported. The roles of adipokines in the pathophysiology of COPD have begun to receive attention recently, and not only their regulatory effects on appetite and nutritional status, but also their influence on systemic inflammation have been increasingly clarified. We review the papers on COPD and nutrition and discuss the role of nutritional supplement therapy in the treatment of COPD.
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Affiliation(s)
| | | | | | | | - Kazutetsu Aoshiba
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +81-29-887-1161; Fax: +81-29-888-3463
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Cook-Mills JM. Isoforms of Vitamin E Differentially Regulate PKC α and Inflammation: A Review. ACTA ACUST UNITED AC 2013; 4. [PMID: 23977443 DOI: 10.4172/2155-9899.1000137] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Vitamin E regulation of disease has been extensively studied but most studies focus on the α-tocopherol isoform of vitamin E. These reports indicate contradictory outcomes for anti-inflammatory functions of the α-tocopherol isoform of vitamin E with regards to animal and clinical studies. These seemingly disparate results are consistent with our recent studies demonstrating that purified natural forms of vitamin E have opposing regulatory functions during inflammation. In this review, we discuss that α-tocopherol inhibits whereas γ-tocopherol elevates allergic inflammation, airway hyperresponsiveness, leukocyte transendothelial migration, and endothelial cell adhesion molecule signaling through protein kinase Cα. Moreover, we have demonstrated that α-tocopherol is an antagonist and γ-tocopherol is an agonist of PKCα through direct binding to a regulatory domain of PKCα. In summary, we have determined mechanisms for opposing regulatory functions of α-tocopherol and γ-tocopherol on inflammation. Information from our studies will have significant impact on the design of clinical studies and on vitamin E consumption.
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Affiliation(s)
- Joan M Cook-Mills
- Allergy-Immunology Division, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Ng TP, Niti M, Yap KB, Tan WC. Curcumins-rich curry diet and pulmonary function in Asian older adults. PLoS One 2012; 7:e51753. [PMID: 23300564 PMCID: PMC3530490 DOI: 10.1371/journal.pone.0051753] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Accepted: 11/05/2012] [Indexed: 11/18/2022] Open
Abstract
Background Research on the effects of dietary nutrients on respiratory health in human populations have not investigated curcumin, a potent anti-oxidant and anti-inflammatory compound present principally in turmeric used in large amounts in Asian curry meals. Objectives To examine the association of curry intake with pulmonary function among smokers and non-smokers. Design The frequency of curry intake, respiratory risk factors and spirometry were measured in a population-based study of 2,478 Chinese older adults aged 55 and above in the Singapore Longitudinal Ageing Studies. Results Curry intake (at least once monthly) was significantly associated with better FEV1 (b = 0.045±0.018, p = 0.011) and FEV1/FVC (b = 1.14±0.52, p = 0.029) in multivariate analyses that controlled simultaneously for gender, age, height, height-squared, smoking, occupational exposure and asthma/COPD history and other dietary or supplementary intakes. Increasing levels of curry intake (‘never or rarely’, ‘occasional’, ‘often’, ‘very often’) were associated with higher mean adjusted FEV1 (p for linear trend = 0.001) and FEV1/FVC% (p for linear trend = 0.048). Significant effect modifications were observed for FEV1 (curry* smoking interaction, p = 0.028) and FEV1/FVC% (curry*smoking interaction, p = 0.05). There were significantly larger differences in FEV1 and FEV1/FVC% between curry intake and non-curry intake especially among current and past smokers. The mean adjusted FEV1 associated with curry intake was 9.2% higher among current smokers, 10.3% higher among past smokers, and 1.5% higher among non-smokers. Conclusion The possible role of curcumins in protecting the pulmonary function of smokers should be investigated in further clinical studies.
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Affiliation(s)
- Tze Pin Ng
- Gerontological Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
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Seo JH, Kwon SO, Lee SY, Kim HY, Kwon JW, Kim BJ, Yu J, Kim HB, Kim WK, Jang GC, Song DJ, Shim JY, Oh SY, Hong SJ. Association of antioxidants with allergic rhinitis in children from seoul. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2012; 5:81-7. [PMID: 23450181 PMCID: PMC3579096 DOI: 10.4168/aair.2013.5.2.81] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Revised: 05/11/2012] [Accepted: 06/26/2012] [Indexed: 01/25/2023]
Abstract
Purpose The prevalence of allergic diseases has risen over the last few decades. Many factors, including environmental factors such as those related to diet, have been considered. Among dietary factors, intake of antioxidant-related nutrients has been associated with the risk of allergic disease. We investigated the association of antioxidant nutritional status with allergic rhinitis (AR) in Korean schoolchildren aged 6-12 years. Methods Subjects were 4,554 children in Seoul, Korea. The risk of allergic disease was measured using the Korean version of the International Study of Asthma and Allergies in Childhood, and dietary intake was measured by a semi-quantitative food frequency questionnaire. Intake of vitamins A (including retinol and β-carotene), C, and E was used in the analysis. Results Vitamin C intake was negatively associated with an increased risk of current symptoms (adjusted odds ratio, 0.886; 95% confidence interval, 0.806-0.973). There was no association between AR and intake of vitamin A, retinol, β-carotene, or vitamin E. Total serum IgE level and sensitization to allergen did not differ according to nutrient intake. Conclusions The group of children with increased vitamin C consumption had fewer AR symptoms, despite the lack of a difference in total serum IgE level or allergen sensitization. These findings suggest that nutrient intake, especially that of vitamin C, influences AR symptoms.
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Affiliation(s)
- Ju-Hee Seo
- Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea
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Boeing H, Bechthold A, Bub A, Ellinger S, Haller D, Kroke A, Leschik-Bonnet E, Müller MJ, Oberritter H, Schulze M, Stehle P, Watzl B. Critical review: vegetables and fruit in the prevention of chronic diseases. Eur J Nutr 2012; 51:637-63. [PMID: 22684631 PMCID: PMC3419346 DOI: 10.1007/s00394-012-0380-y] [Citation(s) in RCA: 876] [Impact Index Per Article: 73.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Accepted: 05/09/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND Vegetables and fruit provide a significant part of human nutrition, as they are important sources of nutrients, dietary fibre, and phytochemicals. However, it is uncertain whether the risk of certain chronic diseases can be reduced by increased consumption of vegetables or fruit by the general public, and what strength of evidence has to be allocated to such an association. METHODS Therefore, a comprehensive analysis of the studies available in the literature and the respective study results has been performed and evaluated regarding obesity, type 2 diabetes mellitus, hypertension, coronary heart disease (CHD), stroke, cancer, chronic inflammatory bowel disease (IBD), rheumatoid arthritis (RA), chronic obstructive pulmonary disease (COPD), asthma, osteoporosis, eye diseases, and dementia. For judgement, the strength of evidence for a risk association, the level of evidence, and the number of studies were considered, the quality of the studies and their estimated relevance based on study design and size. RESULTS For hypertension, CHD, and stroke, there is convincing evidence that increasing the consumption of vegetables and fruit reduces the risk of disease. There is probable evidence that the risk of cancer in general is inversely associated with the consumption of vegetables and fruit. In addition, there is possible evidence that an increased consumption of vegetables and fruit may prevent body weight gain. As overweight is the most important risk factor for type 2 diabetes mellitus, an increased consumption of vegetables and fruit therefore might indirectly reduces the incidence of type 2 diabetes mellitus. Independent of overweight, there is probable evidence that there is no influence of increased consumption on the risk of type 2 diabetes mellitus. There is possible evidence that increasing the consumption of vegetables and fruit lowers the risk of certain eye diseases, dementia and the risk of osteoporosis. Likewise, current data on asthma, COPD, and RA indicate that an increase in vegetable and fruit consumption may contribute to the prevention of these diseases. For IBD, glaucoma, and diabetic retinopathy, there was insufficient evidence regarding an association with the consumption of vegetables and fruit. CONCLUSIONS This critical review on the associations between the intake of vegetables and fruit and the risk of several chronic diseases shows that a high daily intake of these foods promotes health. Therefore, from a scientific point of view, national campaigns to increase vegetable and fruit consumption are justified. The promotion of vegetable and fruit consumption by nutrition and health policies is a preferable strategy to decrease the burden of several chronic diseases in Western societies.
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Affiliation(s)
- Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany
| | | | - Achim Bub
- Department of Physiology and Biochemistry of Nutrition, Max Rubner-Institut, Karlsruhe, Germany
| | - Sabine Ellinger
- Department of Nutrition and Food Science, University of Bonn, Bonn, Germany
| | - Dirk Haller
- Nutrition and Food Research Centre, Chair for the Biofunctionality of Food, Technical University of Munich, Freising-Weihenstephan, Germany
| | - Anja Kroke
- Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, Fulda, Germany
| | | | - Manfred J. Müller
- Institute of Human Nutrition and Food Science, Christian-Albrechts-University Kiel, Kiel, Germany
| | | | - Matthias Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany
| | - Peter Stehle
- Department of Nutrition and Food Science, University of Bonn, Bonn, Germany
| | - Bernhard Watzl
- Department of Physiology and Biochemistry of Nutrition, Max Rubner-Institut, Karlsruhe, Germany
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Specific micronutrient concentrations are associated with inflammatory cytokines in a rural population of Mexican women with a high prevalence of obesity. Br J Nutr 2012; 109:686-94. [PMID: 22640991 DOI: 10.1017/s0007114512001912] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
It has been recognised recently that obese individuals have lower concentrations of micronutrients and this may affect the concentrations of inflammatory cytokines. A cross-sectional study was carried out to evaluate the association of specific micronutrients' status with chronic inflammation caused by obesity in 280 women (36·1 (SD 7·5) years) from seven rural communities in Mexico. Measurements of weight, height and waist circumference were made on all women and body composition was determined by dual-energy X-ray absorptiometry. Concentrations of the cytokines IL-1, TNF-α, IL-6, IL-10 and IL-12, lipid profile, and the micronutrients Zn and vitamins A, C and E were determined in fasting blood samples. Ordered logistic regression models were used to determine associations between categorised cytokine levels and micronutrients. It was found that 80% of women were overweight or obese, and had significantly higher concentrations of C-reactive protein than normal-weight women (P= 0·05). The risk of higher levels of TNF-α, IL-6, IL-10 and IL-12 was reduced significantly among women with higher Zn concentrations (OR 0·63, 95% CI 0·42, 0·96, P= 0·03; OR 0·57, 95% CI 0·39, 0·86, P= 0·025; OR 0·63, 95% CI 0·41, 0·96, P= 0·04; OR 0·62, 95% CI 0·41, 0·95, P= 0·03, respectively). Higher concentrations of vitamin A were slightly associated with reduced risks of higher levels of IL-1 and IL-12 (OR 0·97, 95% CI 0·95, 0·99, P= 0·03; OR 0·97, 95% CI 0·94, 0·99, P= 0·03, respectively); when adjusting for BMI, this association was lost. No associations were found between vitamin C or vitamin E:lipids concentrations and inflammatory cytokines. In conclusion, higher Zn concentrations are associated with reduced risks of higher concentration of inflammation markers in a population of women with a high prevalence of obesity.
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Cook-Mills JM, Marchese ME, Abdala-Valencia H. Vascular cell adhesion molecule-1 expression and signaling during disease: regulation by reactive oxygen species and antioxidants. Antioxid Redox Signal 2011; 15:1607-38. [PMID: 21050132 PMCID: PMC3151426 DOI: 10.1089/ars.2010.3522] [Citation(s) in RCA: 356] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The endothelium is immunoregulatory in that inhibiting the function of vascular adhesion molecules blocks leukocyte recruitment and thus tissue inflammation. The function of endothelial cells during leukocyte recruitment is regulated by reactive oxygen species (ROS) and antioxidants. In inflammatory sites and lymph nodes, the endothelium is stimulated to express adhesion molecules that mediate leukocyte binding. Upon leukocyte binding, these adhesion molecules activate endothelial cell signal transduction that then alters endothelial cell shape for the opening of passageways through which leukocytes can migrate. If the stimulation of this opening is blocked, inflammation is blocked. In this review, we focus on the endothelial cell adhesion molecule, vascular cell adhesion molecule-1 (VCAM-1). Expression of VCAM-1 is induced on endothelial cells during inflammatory diseases by several mediators, including ROS. Then, VCAM-1 on the endothelium functions as both a scaffold for leukocyte migration and a trigger of endothelial signaling through NADPH oxidase-generated ROS. These ROS induce signals for the opening of intercellular passageways through which leukocytes migrate. In several inflammatory diseases, inflammation is blocked by inhibition of leukocyte binding to VCAM-1 or by inhibition of VCAM-1 signal transduction. VCAM-1 signal transduction and VCAM-1-dependent inflammation are blocked by antioxidants. Thus, VCAM-1 signaling is a target for intervention by pharmacological agents and by antioxidants during inflammatory diseases. This review discusses ROS and antioxidant functions during activation of VCAM-1 expression and VCAM-1 signaling in inflammatory diseases.
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Affiliation(s)
- Joan M Cook-Mills
- Allergy-Immunology Division, Northwestern University Feinberg School of Medicine, 240 E Huron, Chicago, IL 60611, USA.
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