Diet supplementation with omega-3 fatty acids, Zn and vitamin C significantly improved asthma control test, pulmonary function tests and pulmonary inflammatory markers in children with moderately persistent bronchial asthma either singly or in combination.

BackgroundWe previously found a significant benefit of vitamin C supplementation in asthmatic children.PurposeTo test whether the effect of vitamin C on asthma is heterogeneous over the participant population.MethodsEgyptian asthmatic children between 7 and 10 years of age (n = 60) were included in the cross-over trial. They were administered 0.2 grams per day of vitamin C and placebo for separate 6-week periods. The variation in the vitamin C effect on two clinically relevant outcomes was analyzed: the childhood asthma control test (C-ACT), which measures the severity of asthma symptoms (the scale ranges from 0 to 27 points, < 20 points indicating unsatisfactory asthma control), and FEV1. We used linear modeling to examine the variation of the vitamin C effect in the subgroups.ResultsThe effect of vitamin C on the C-ACT was significantly modified by age and baseline C-ACT levels. In the children aged 7.0-8.2 years with a baseline C-ACT of 18 to 19 points, vitamin C increased the C-ACT score by 4.2 points (95% CI: 3.3-5.3); whereas in the children aged 8.3-10 years who had a baseline C-ACT of 14 to 15 points, vitamin C increased the C-ACT score by only 1.3 points (95% CI: 0.1-2.5). The effect of vitamin C on the FEV1 levels was significantly modified by age and exposure to dampness. In the children aged 7.0-8.2 years with no exposure to dampness, vitamin C increased the FEV1 level by 37% (95% CI: 34-40%), whereas in the children aged 8.3-10 years with exposure to dampness or mold in their bedroom more than one year prior to the study, vitamin C increased the FEV1 level by only 21% (95% CI: 18-25%).ConclusionsWe found strong evidence that the effect of vitamin C on asthmatic children is heterogeneous. Further research is needed to confirm our findings and identify the groups of children who would receive the greatest benefit from vitamin C supplementation.

The aim was to evaluate the serum leptin level in children with protein-energy malnutrition (PEM) with and without pneumonia. The study included 60 children; 20 were controls, 20 had PEM without infection and 20 had PEM and pneumonia. They were subjected to nutritional assessments; serum leptin level, haemoglobin concentration, white-blood cell (WBC) count, CD4%, serum albumin, blood glucose, blood urea-nitrogen, and serum ferritin, and chest x-ray. Serum leptin levels were independently associated with pneumonia on multivariate analysis. In addition, serum leptin level and CD4% were significantly lower in the groups with PEM and pneumonia than in the group with PEM without pneumonia (p < 0.001). Low serum leptin levels were associated with pneumonia in children with protein energy malnutrition.

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