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Increased dietary beta-carotene intake associated with better asthma quality of life
Abstract
Asthma prevalence and morbidity have steadily increased in last decades in face of our improved knowledge of the disease. Changing patterns and interactions among asthma risk factors may contribute to these trends, in which diet is a recognized risk factor for asthma occurrence. Although a possible protective role of dietary antioxidants in asthma has been proposed, little is known about possible relationship between dietary intake and asthma severity, if any. Our objective was to investigate whether asthma severity is associated with antioxidants consumption. We found that better asthma quality of life was associated, in females, with increased consumption of beta-carotene, even after adjustment for energy intake and potential confounders (p=0.023) and in males, with lesser consumption of dietary iron (13.9±2.1 vs. 17.8±2.1 mg, p=0.026; after adjustment for energy intake and confounders, p=0.012). Our study shows promising results that need further investigation relating these two nutrients involved in several antioxidant mechanisms
... The β-carotene content of D. salina was shown to confer protection against acetic acid-induced small bowel inflammation in rats (Lavy et al., 2003), while the ethanolic extract inhibited inflammatory cytokines in different animal models (Cha et al., 2010;El-Baz et al., 2016). Human studies suggest that β-carotene can provide better quality of life for asthmatic females (Moreira et al., 2004), normalize the enhanced LDL oxidation in patients with diabetes (Levy et al., 2000) and lowered LDL lipid peroxides in male hyperlipidemic smokers (Chao et al., 2002). The antioxidant and immune-modulatory effect of carotenoids has led to investigating their potential application for the prevention of human cancer (Chidambara Murthy et al., 2005). ...
Dunaliella salina (D. salina) is one of the most common microalgae that is used as human food. It is isolated from the salty lakes in El-Fayoum and Lake of Bardawil-Sinai in Egypt and can withstand very high concentrations of salt: The potentiality of D. salina, a unicellular biflagellate green alga to protect against intestinal injury induced after radiation exposure was studied. D. salina was given orally in doses of 100 and 200 mg/kg to male Wistar rats for 5 days before exposure to 6 Gray (Gy) gamma radiation and continued for a further two days. Rats were sacrificed 24 h later and intestinal segments were dissected out. One segment was examined histologically and another was used to prepare homogenates to assess relevant biochemical parameters reflecting intestinal injury. Radiation exposure led to a rise in the histological damage score, an increase in tissue tumor necrosis factor (TNF-α), interleukin (IL-1β) and thiobarbituric acid reactive substances (TBARS) but a reduction in tissue reduced glutathione (GSH) and in serum citrulline. Pretreatment with either dose of D. salina effectively reduced the severity of intestinal mucositis induced by gamma radiation. Keyword: Biochemistry
... It could be helpful in preventing asthma. The high levels of antioxidants in Dunaliella help quench free radicals and reduce their effects on allergies 55 . Human studies suggest that D. salina extracts can protect against exercise-induced asthma 56 . ...
Dunaliella is a halophilic alga, which secretes some special metabolites (i.e. β-carotene, glycerol) to survive in such hypersaline environment, these metabolites can play a multitude of potential applications in various fields of pharmacology. Importance of Dunaliella derived β-carotene pigments includes its application as a yellow colorant in different food products such as noodles, confectionery, beverages and cosmetic industry. Present review is an attempt to summarize the pharmacological application of alga Dunaliella in various diseases. There have been various reports regarding use of alga or its extracts and metabolites as antioxidant, anti-allergy, antimicrobial, cytotoxic, cardioactive, anticough, antidiabetic, anti-inflammatory, hepatoprotection. Current status and the potential application of Dunaliella in the field of pharmaceuticals, nutraceuticals and various industrial products have been discussed. [
... However, our strategy-supplementation at a dose known to carry no risk of adverse events and over a short period of time-is more prone to increase compliance in real life. We restricted inclusion to women based on previous observations that the relationship between asthma measures and diet or obesity is sex dependent [21,22]. Almost all of the subjects were within the normal range for baseline FeNO, with values probably representing optimum FeNO levels, due to the current use of inhaled corticosteroids. ...
The anti-inflammatory effects of n-3 polyunsaturated fatty acids (n-3 PUFA) have been demonstrated both in vitro and in vivo. The results of epidemiological studies suggest that fish consumption has a beneficial effect on lung function and prevalence of asthma. However, data from intervention trials have not revealed a beneficial effect of n-3 PUFA supplementation in patients with established disease.
To study the effects of short-term n-3 PUFA supplementation in addition to maintenance therapy on exhaled nitric oxide in asthmatic patients.
A double-blind, placebo-controlled trial was undertaken in 20 women with asthma. Patients received either a combination of eicosapentaenoic acid and docosahexaenoic acid plus 10 mg vitamin E or placebo twice daily for 2 weeks. The primary outcome measure was the fraction of exhaled nitric oxide (FeNO) and the secondary outcomes were asthma control (score on theAsthma Control Questionnaire [ACQI) and lung function (forced expiratory volume in 1 second [FEV1]).
No significant differences were observed in FeNO, ACQ score, or FEV1 between patients receiving n-3 PUFA supplementation and those receiving placebo.
Short-term dietary supplementation with n-3 PUFA in women with stable asthma was not associated with statistically significant changes in FeNO, asthma control, or lung function.
It has been postulated that dietary antioxidants may influence the expression of allergic diseases and asthma. To test this hypothesis a case-control study was performed, nested in a cross sectional study of a random sample of adults, to investigate the relationship between allergic disease and dietary antioxidants.
The study was performed in rural general practices in Grampian, Scotland. A validated dietary questionnaire was used to measure food intake of cases, defined, firstly, as people with seasonal allergic-type symptoms and, secondly, those with bronchial hyperreactivity confirmed by methacholine challenge, and of controls without allergic symptoms or bronchial reactivity.
Cases with seasonal symptoms did not differ from controls except with respect to the presence of atopy and an increased risk of symptoms associated with the lowest intake of zinc. The lowest intakes of vitamin C and manganese were associated with more than fivefold increased risks of bronchial reactivity. Decreasing intakes of magnesium were also significantly associated with an increased risk of hyperreactivity.
This study provides evidence that diet may have a modulatory effect on bronchial reactivity, and is consistent with the hypothesis that the observed reduction in antioxidant intake in the British diet over the last 25 years has been a factor in the increase in the prevalence of asthma over this period.
The purpose of this study was to investigate, in smokers, whether the oxidative balance of their dietary pattern affected mortality risk. To evaluate the oxidative balance of the dietary pattern, an oxidative balance score was constructed that summarized the combined intake of dietary antioxidants (vitamin C and beta-carotene) and a prooxidant (iron). The low oxidative balance score group included smokers with a diet high in vitamin C and beta-carotene and/or low in iron and the high oxidative balance score group included those with a diet low in vitamin C and beta-carotene and/or high in iron. Using the 10-y follow-up mortality data from the Belgian Interuniversity Research on Nutrition and Health (BIRNH) study, the association of this oxidative balance score with all-cause, cardiovascular disease (CVD) and total cancer mortality was investigated in 2814 male smokers. In multivariate-adjusted Cox models, men in the highest oxidative balance score group had a higher relative risk (RR) of all-cause [RR = 1.44, 95% confidence interval (CI): 1.13, 1.82] and of total cancer mortality (RR = 1.62, 95% CI: 1.07, 2.45) compared with men in the lowest score group. This association was less pronounced for CVD mortality risk and was not significant (RR = 1.31, 95% CI: 0.86, 2.00). The risk of all-cause and total cancer mortality was driven principally by the high score group, which suggested a threshold effect for risk rather than a linear trend. The findings are consistent with the hypothesis that the oxidative balance of the diet is associated with subsequent mortality. Smokers whose diet is unbalanced in terms of anti- and prooxidants may therefore benefit from a recommendation to consume more servings of fresh fruits and vegetables and less meat.
To evaluate whether acute effects of ozone, nitrogen dioxide, and particulates with mass median diameter less than 10 micro m could be attenuated by antioxidant vitamin supplementation, we conducted a randomized trial using a double-blinded design. Children with asthma (n = 158) who were residents of Mexico City were randomly given a daily supplement of vitamins (50 mg/day of vitamin E and 250 mg/day of vitamin C) or a placebo and were followed from October 1998 to April 2000. Pulmonary function tests were carried out twice a week in the morning. During the follow-up observation period, the mean 1-hour maximum ozone level was 102 ppb (SD = 47), and the mean 24-hour average PM(10) level was 56.7 micro g/m(3) (SD = 27.4). In children with moderate and severe asthma, ozone levels 1 day before spirometry were inversely associated significantly with forced expiratory flow (FEF(25-75)) (-13.32 ml/second/10 ppb; p = 0.000), FEV(1) (-4.59 ml/10 ppb; p = 0.036), and peak expiratory flow (PEF) (-15.01 ml/second/10 ppb; p = 0.04) in the placebo group after adjusting for potential confounding factors. No association between ozone and lung functions was observed in the supplement group. We observed significant differences in lung function decrements between groups for FEF(25-75) and PEF. Our results suggest that supplementation with antioxidants might modulate the impact of ozone exposure on the small airways of children with moderate to severe asthma.
The purpose of this study was to investigate, in smokers, whether the oxidative balance of their dietary pattern affected mortality risk. To evaluate the oxidative balance of the dietary pattern, an oxidative balance score was constructed that summarized the combined intake of dietary antioxidants (vitamin C and beta-carotene) and a prooxidant (iron). The low oxidative balance score group included smokers with a diet high in vitamin C and beta-carotene and/or low in iron and the high oxidative balance score group included those with a diet low in vitamin C and beta-carotene and/or high in iron. Using the 10-y follow-up mortality data from the Belgian Interuniversity Research on Nutrition and Health (BIRNH) study, the association of this oxidative balance score with all-cause, cardiovascular disease (CVD) and total cancer mortality was investigated in 2814 male smokers. In multivariate-adjusted Cox models, men in the highest oxidative balance score group had a higher relative risk (RR) of all-cause [RR = 1.44, 95% confidence interval (CI): 1.13, 1.82] and of total cancer mortality (RR = 1.62, 95% CI: 1.07, 2.45) compared with men in the lowest score group. This association was less pronounced for CVD mortality risk and was not significant (RR = 1.31, 95% CI: 0.86, 2.00). The risk of all-cause and total cancer mortality was driven principally by the high score group, which suggested a threshold effect for risk rather than a linear trend. The findings are consistent with the hypothesis that the oxidative balance of the diet is associated with subsequent mortality. Smokers whose diet is unbalanced in terms of anti- and prooxidants may therefore benefit from a recommendation to consume more servings of fresh fruits and vegetables and less meat.
International guidelines on asthma management indicate that the primary goal of treatment should be optimum asthma control. The aim of this study was to develop and validate the Asthma Control Questionnaire (ACQ). The authors generated a list of all symptoms used to assess control and sent it to 100 asthma clinicians who were members of guidelines committees (18 countries). They scored each symptom for its importance in evaluating asthma control. From the 91 responses, the five highest scoring symptoms were selected for the ACQ. In addition, there is one question on beta2-agonist use and another on airway calibre (total questions=7). The ACQ was tested in a 9-week observational study of 50 adults with symptomatic asthma. The ACQ and other measures of asthma health status were assessed at baseline, 1, 5 and 9 weeks. In patients whose asthma was stable between clinic visits, reliability of the ACQ was high (intraclass correlation coefficient (ICC)=0.90). The questionnaire was very responsive to change in asthma control (p<0.0001). Cross-sectional and longitudinal validity were supported by correlations between the ACQ and other measures of asthma health status being close to a priori predictions. In conclusion, the Asthma Control Questionnaire has strong evaluative and discriminative properties and can be used with confidence to measure asthma control.
Ozone exposure aggravates asthma, as has been demonstrated in both controlled exposures and epidemiologic studies. In the current double-blind crossover study, the authors evaluated the effects of dietary antioxidants (i.e., 400 IU vitamin E/500 mg vitamin C) on ozone-induced bronchial hyperresponsiveness in adult subjects with asthma. Seventeen subjects were exposed to 0.12 ppm of ozone or to air for 45 min during intermittent moderate exercise. Bronchial hyperresponsiveness was assessed with 10-min sulfur dioxide (i.e., 0.10 ppm and 0.25 ppm) inhalation challenges. Subjects who were given dietary antioxidants responded less severely to sulfur dioxide challenge than subjects given a placebo (i.e., forced expiratory volume in the 1st sec: -1.2% vs. 4.4%, respectively; peak flow: +2.2% vs. -3.0%, respectively; and mid-forced expiratory flow: +2.0% vs. -4.3%, respectively). Effects were more pronounced when subjects were grouped by response to sulfur dioxide at the screening visit. The results suggest that dietary supplementation with vitamins E and C benefits asthmatic adults who are exposed to air pollutants.
A protective role for dietary antioxidants in asthma has been proposed. However, epidemiological evidence to implicate antioxidant vitamins is weak, and data on the role of flavonoid-rich foods and antioxidant trace elements are lacking. We carried out a population-based case-control study in South London, UK, to investigate whether asthma is less common and less severe in adults who consume more dietary antioxidants. Participants were aged 16-50 yr and registered with 40 general practices. Asthma was defined by positive responses to a standard screening questionnaire in 1996, and complete information about usual diet was obtained by food frequency questionnaire from 607 cases and 864 controls in 1997. After controlling for potential confounding factors and total energy intake, apple consumption was negatively associated with asthma (odds ratio [OR] per increase in frequency group 0.89 [95% confidence interval [CI]: 0.82 to 0.97]; p = 0.006). Intake of selenium was also negatively associated with asthma (OR per quintile increase 0.84 [0.75 to 0.94]; p = 0.002). Red wine intake was negatively associated with asthma severity. The associations between apple and red wine consumption and asthma may indicate a protective effect of flavonoids. The findings for dietary selenium could have implications for health policy in Britain where intake has been declining.
Chronic ulcerative colitis (UC) patients frequently require iron supplementation to remedy anemia due to blood loss. However, the effect of iron supplementation on UC-associated carcinogenesis is unknown. In this study, the effect of an iron-enriched diet on dextran sulfate sodium-induced acute and chronic colitis in mice was assessed. In a short-term study, mice administered 1% DSS in the drinking fluid and an AIN76A diet containing increasing levels of iron exhibited dose-dependent increases in the severity of acute UC as compared to mice fed a control diet. A marked increase in iron deposition on the epithelial surface of the colon and in the inflamed areas and immunostaining for iNOS and nitrotyrosine were observed in the animals supplemented with diets containing different levels of iron. In a long-term carcinogenesis experiment, a twofold iron-enriched diet significantly increased colorectal tumor incidence (14/16, 88%) as compared with animals fed the control diet (3/16, 19%; P < 0.001). The present findings have implications for the management of human UC and suggest that dietary iron can enhance UC and its associated carcinogenesis by augmenting oxidative and nitrosative stress.