Resting Energy Expenditure Is Elevated in Asthma

Abstract

Background: Asthma physiology affects respiratory function and inflammation, factors that may contribute to elevated resting energy expenditure (REE) and altered body composition. Objective: We hypothesized that asthma would present with elevated REE compared to weight-matched healthy controls. Methods: Adults with asthma (n = 41) and healthy controls (n = 20) underwent indirect calorimetry to measure REE, dual-energy X-ray absorptiometry (DEXA) to measure body composition, and 3-day diet records. Clinical assessments included spirometry, fractional exhaled nitric oxide (FENO), and a complete blood count. Results: Asthmatics had greater REE than controls amounting to an increase of ~100 kcals/day, even though body mass index (BMI) and body composition were similar between groups. Inclusion of asthma status and FENO in validated REE prediction equations led to improved estimates. Further, asthmatics had higher white blood cell (control vs. asthma (mean ± SD): 4.7 ± 1.1 vs. 5.9 ± 1.6, p < 0.01) and neutrophil (2.8 ± 0.9 vs. 3.6 ± 1.4, p = 0.02) counts that correlated with REE (both p < 0.01). Interestingly, despite higher REE, asthmatics reported consuming fewer calories (25.1 ± 7.5 vs. 20.3 ± 6.0 kcals/kg/day, p < 0.01) and carbohydrates than controls. Conclusion: REE is elevated in adults with mild asthma, suggesting there is an association between REE and the pathophysiology of asthma.

Mitochondrial DNA Copy Number Variation in Asthma Risk, Severity, and Exacerbations

“…Prior work has shown changes in mitochondrial function in platelets and airway epithelial cells from asthmatics (41). Interestingly, although asthma is associated with obesity (42), resting energy expenditure is elevated in asthmatics as compared to non-asthmatics (43), supporting the concept of changes in mitochondrial function.…”

The Role of Nutrition in Mitigating the Effects of COVID-19 from Infection through PASC

“…Recently asthma, which is a pulmonary disease that has many symptoms in common with COVID-19 and is also a comorbid condition related to elevated risk of COVID-19 and PASC severity, has been shown to have a metabolic underpinning [ 77 ]. The unique metabolic underpinning in asthma has yet to be fully elucidated but may involve a shift in fuel preference (i.e., nutrient utilization), away from carbohydrates towards lipids or ketones [ 78 , 79 ]. In agreement with the shift away from carbohydrate metabolism, ketosis shows a therapeutic benefit in murine asthma models by reducing bronchoconstriction in the airway smooth muscle; bronchoconstriction being the primary airway symptoms leading to wheezing and difficulty breathing [ 80 ].…”