JThe relationship between respiratory health and nutrition is rarely discussed. When it comes to lung health, smoking, pollution, microbial infections, colds, and occupational exposure to dust particles are major concerns. For healthy respiratory systems, we need a diet rich in powerful nutrients. In fact, recent evidence shows that a nutritious diet has a major role to play in mitigating risk factors associated with the onset and progression of critical lung diseases such as chronic obstructive pulmonary disease, or COPD. , and asthma. Statistics from the World Health Organization show that COPD caused 3.23 million victims in 2019, making it the third leading cause of death worldwide.
Undernutrition, obesity, nutrients, active plant compounds and specific food groups affect the development and progression of respiratory disease. We discuss the role of nutrition in lung health citing and reviewing cross-sectional, epidemiological, and animal model studies.
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Malnutrition and lung disease
Undernutrition begins in the womb. A poor respiratory system in a fetus is often the result of maternal malnutrition. Patients with COPD are frequently undernourished and the clinical management of nutrition is a key component of disease management. Advanced COPD is associated with weight loss, muscle wasting, and micronutrient deficiency, which collectively increase mortality risk. In a 2013 review, nutritional supplements and high calorie intake were associated with improved muscle function in malnourished COPD patients. There is not much evidence available to establish a link between asthma and undernutrition. A Japanese observational study found that undernourished people individuals had poor asthma control compared to normal participants. Branched-chain amino acid supplementation has treated protein malnutrition in COPD and produced positive results such as growth of fat-free muscle mass.
Obesity is linked to asthma
In the United States, 250,000 new cases of asthma are caused each year by obesity. Among adults with a healthy weight, the prevalence of asthma is 7.1%, while among obese adults it is 11.1%. Even more shocking is the association between obese women and asthma: 14.6% of obese women were diagnosed with asthma, while only 7.9% of lean women had it.
There is a strong link between obesity and multiple chronic diseases, including asthma. However, the mechanism explaining this link remains to be studied. According to a 2013 study, obesity impairs the mechanical functions of the respiratory system, which may be linked to asthma. However, the extra body weight and associated complications such as gastroesophageal reflux disease, difficulty breathing during sleep, and low lung volume can worsen asthmatic conditions. A questionnaire-based cross-sectional study of 1,113 active asthma patients found that people with high body mass index (BMI) reported poor asthma-specific quality of life and poor asthma management as well as an increase in asthma-associated hospitalizations than patients with a normal BMI (< 25kg/m2). Study explains how chronic inflammation associated with obesity affects the immune system and causes diseases such as dementia, atherosclerosis, sleep apnea, type 2 diabetes, asthma, arthritis, gout, fatty liver and sepsis.
Offspring of obese mothers are more likely to develop asthma. In a study involving 1 lakh pregnant women, it was found that maternal weight gain is associated with a 15-30% increased risk of asthma in babies. Childhood and childhood obesity has also been linked to wheezing and asthma, which means there is no doubt that obesity and asthma are linked. Thus, maintaining a healthy weight at all stages of life is essential to keeping your lungs in optimal condition.
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Eating habits and respiratory health
Dietary habits have a significant impact on respiratory health. According to a 2013 study, ensuring a diet rich in antioxidants and omega-3 fatty acids during pregnancy and childhood may protect against allergic disease. Known as the most nutritious in the world, the Mediterranean diet protects against allergic respiratory diseases.
Mediterranean cuisine consists of plant foods such as fruits, colorful vegetables, roots, tubers, nuts, beans, seeds, complex carbohydrates and whole grains.
In the Mediterranean diet, olive oil is the primary cooking and dressing medium, which is loaded with healthy unsaturated fats, especially omega 3s. A moderate amount of yogurt, low-fat dairy products, fish and poultry is eaten. Wine and red meat are rare in Mediterranean culture. Nutritionally, this diet is very powerful since it is rich in phytonutrients, antioxidants, omega-3, fiber, protein, vitamins and minerals. Among 700 school-age children, a 2011 study examined the relationship between Mediterranean diet days and childhood asthma. Interestingly, these diet days were found to be inversely related to incidents of asthma. Two other studies from 2008 and 2009 produced similar results. Consuming Mediterranean foods during pregnancy is known to protect against wheezing and allergies in children aged 6.5 years.
Conversely, the “Western diet,” which is typically loaded with refined white sugar, vegetable oils, salt, processed meat, trans fats, and artificial preservatives, increases the risk of wheezing and asthma in children. An analysis of around 54,000 women found that those who ate a sugary, high-fat Western diet had more frequent asthma attacks than those who ate more fruits and vegetables. This diet has also been linked to a high risk of COPD.
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Food groups and nutrients that protect the lungs
Fruits and vegetables are still considered the best protective food group. They contain phytonutrients, vitamins, minerals and antioxidants that protect respiratory health. Evidence shows that eating cooked fruits and green vegetables can reduce incidents of wheezing in children aged 8 to 12 years. In a Prospective cohort 2000 study from the United Kingdom, adults who ate more fruits and vegetables for 3 months had a lower risk of asthma exacerbation. Consumption of antioxidants such as vitamin C, vitamin E, flavonoids and carotenoids is beneficial for the growing fetus and adults with COPD. Rachel E Foong and Graeme R. Zosky’s 2013 study explains how vitamin D deficiency is linked to respiratory disease, although the mechanism is unclear. Vitamin D is essential for optimal immune function.
The role of nutrition in protecting and promoting lung health cannot be overstated. However, there are virtually no randomized controlled trials examining the association between dietary habits, food groups, metabolic conditions, and respiratory health. Most references are epidemiological or cross-sectional. To this end, it is important to remember that a balanced diet contributes to general physical well-being, including respiratory health.
Subhasree Ray is a PhD student (ketogenic diet), certified diabetes educator, and clinical and public health nutritionist. She tweets @DrSubhasree. Views are personal.
(Editing by Zoya Bhatti)
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