Diet and Asthma: A Narrative Review

Rodrigues, Mónica; Mendes, Francisca de Castro; Delgado, Luís; Padrão, Patrícia; Paciência, Inês; Barros, Renata; Rufo, João Cavaleiro; Silva, Diana; Moreira, André; Moreira, Pedro

doi:10.3390/app13116398

Cited by 5 publications

(1 citation statement)

References 119 publications

(297 reference statements)

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“…The Mediterranean diet is acknowledged for its overall anti-inflammatory effects [ 41 ]. Nonetheless, a more adequate dietary pattern for asthma prevention is not fully established, and other components are not present in this score, including trans-saturated fatty acids, the n -6: n -3 ratio, and dietary diversity, that may be essential when considering asthma prevention [ 58 ].…”

Section: Discussionmentioning

confidence: 99%

Mediterranean Diet and Airway Inflammation in School-Aged Children

Rodrigues,

de Castro Mendes,

Padrão

et al. 2023

Children

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There seems to exist an intricate relationship between airway inflammation, body mass index (BMI), and diet. The intake of specific foods or food groups has been suggested to suppress the oxidative stress and inflammatory processes that characterize airway inflammation, but little is known about dietary patterns and their complex interplay with BMI and airway inflammation. Therefore, this cross-sectional study aimed to explore the association between adherence to the Mediterranean diet (MD), a characteristic European diet, and levels of airway inflammation in school-aged children, taking into account their BMI. This cross-sectional analysis comprised 660 children: 49.1% females, 7–12 years old. Adherence to the MD was assessed through the alternate Mediterranean score (aMED). Higher scores represent a healthier diet (0–8). Airway inflammation was assessed measuring exhaled fractional nitric oxide (eNO). Two categories of BMI were considered: non-overweight/non-obese (p < 85th) and overweight/obese (p ≥ 85th). The associations between diet and airway inflammation were estimated using logistic regression models. Higher scores of the aMED were associated with decreased odds of having eNO ≥ 35 ppb, but only in non-overweight/non-obese children (OR = 0.77; 95% CI, 0.61–0.97). For overweight/obese children, the previous association was not significant (OR = 1.57, 95% CI, 0.88–2.79). Our findings suggest that adherence to the MD is associated with lower levels of airway inflammation among non-overweight/non-obese children.

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Section: Discussionmentioning

confidence: 99%

Mediterranean Diet and Airway Inflammation in School-Aged Children

Rodrigues,

de Castro Mendes,

Padrão

et al. 2023

Children

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Dried fruit, acetate, and asthma: a mediation Mendelian randomization analysis

Yang,

Wang,

Yang

2024

Journal of Asthma

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Obesity and Asthma: Implementing a Treatable Trait Care Model

Mendes,

Garcia‐Larsen,

Moreira

2024

Clin Experimental Allergy

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Recognition of obesity as a treatable trait of asthma, impacting its development, clinical presentation and management, is gaining widespread acceptance. Obesity is a significant risk factor and disease modifier for asthma, complicating treatment. Epidemiological evidence highlights that obese asthma correlates with poorer disease control, increased severity and persistence, compromised lung function and reduced quality of life. Various mechanisms contribute to the physiological and clinical complexities observed in individuals with obesity and asthma. These encompass different immune responses, including Type IVb, where T helper 2 cells are pivotal and driven by cytokines like interleukins 4, 5, 9 and 13, and Type IVc, characterised by T helper 17 cells and Type 3 innate lymphoid cells producing interleukin 17, which recruits neutrophils. Additionally, Type V involves immune response dysregulation with significant activation of T helper 1, 2 and 17 responses. Finally, Type VI is recognised as metabolic‐induced immune dysregulation associated with obesity. Body mass index (BMI) stands out as a biomarker of a treatable trait in asthma, readily identifiable and targetable, with significant implications for disease management. There exists a notable gap in treatment options for individuals with obese asthma, where asthma management guidelines lack specificity. For example, there is currently no evidence supporting the use of incretin mimetics to improve asthma outcomes in asthmatic individuals without Type 2 diabetes mellitus (T2DM). In this review, we advocate for integrating BMI into asthma care models by establishing clear target BMI goals, promoting sustainable weight loss via healthy dietary choices and physical activity and implementing regular reassessment and referral as necessary.

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Diet and Asthma: A Narrative Review

Cited by 5 publications

References 119 publications

Mediterranean Diet and Airway Inflammation in School-Aged Children

Mediterranean Diet and Airway Inflammation in School-Aged Children

Dried fruit, acetate, and asthma: a mediation Mendelian randomization analysis

Obesity and Asthma: Implementing a Treatable Trait Care Model

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