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By Karen Alexander, Oncology Wellness Specialist

04/06/2018

Does Diet Impact Asthma Outcomes?

According to the CDC, about 25 million Americans (7.6 percent of adults and 8.4 percent of children) have asthma. This condition is more common in children than adults, and it’s more common in boys than girls. Asthma is a chronic condition in which the airways narrow in response to certain stimuli.

Asthma is usually divided into two types:

  • Allergic asthma (triggered by allergens stimuli)
  • Non-allergic asthma (triggered by anxiety, stress, exercise, cold air, dry air, hyperventilation, smoke, viruses, or other irritants)

Genetics and environmental factors play a critical role in asthma initiation. Environmental factors may include allergen exposure (e.g., dust mite, cockroach, pet dander, pollen, and mold), perinatal factors (poor maternal nutrition, prematurity, low birthweight, and lack of breastfeeding) and diet (See details below). Initial symptoms include cough, dyspnea, and a tight feeling in the chest. Signs and symptoms also include wheezing, increased respiratory rate, labored breathing, and increased heart rate but low oxygenation. Diagnosis of asthma is done with a breathing test. People living with asthma are advised to avoid asthma triggers and to take drugs to keep airways open. These drugs may include medications to provide quick relief and/or medications to provide long-term control.

In recent years, several researchers have studied the impact of different dietary patterns on lung conditions, such as asthma. Below is a summary of the most relevant findings:

Obesity
Obesity is a condition that has been linked to increased inflammation markers. Epidemiological studies have demonstrated the association between obesity and asthma, and weight loss may improve at least one asthma symptom.

Inflammatory effect caused by the Western diet
Chronic inflammation of the airways is a key component of asthma, which may be moderated by dietary intake. The Western diet, which includes high intake of refined grains, processed and red meats, and desserts, have pro-inflammatory effects. Western diet is characterized by an excessive consumption of total energy, saturated fat and omega-6, sugar and sodium and it is low in omega-3, fiber, micronutrients (including folate and magnesium), antioxidants, and phytochemicals (e.g., carotenoids, flavonoids).

Fats
High fat intake is characteristic of the Western diet. In adults with severe asthma, high fat and low fiber intake may increase inflammation.

Processed Meats
Processed meat (cured meat, deli meat) is a common ingredient in the Western diet. 22 percent of the meat consumed in the U.S. is processed. In 2015, the pre-packed and deli sliced meat sector was worth $13.4 billion in the US. Cured meat has recently been classified as carcinogenic by the World Health Organization. High cured meat intake is a risk factor not only for cancer (colorectal and lung), but also for several chronic diseases such as decreased lung function, COPD symptoms, exacerbations or incidence of lung symptoms, and even mortality. Nitrite in cured meats may lead to nitrosative stress and oxidative stress related lung damage and asthma. Researchers have found a relation between cured meat intake, inflammation and asthma exacerbations. A recent study found that high cured meat intake (more than 4 servings per week) is associated with worsening asthma symptoms over time, through a direct effect, and to a lesser extent an effect mediated through weight (body mass index).

Fortunately there are some healthy eating patterns that may help. The Mediterranean Diet is a plant-based diet with anti-inflammatory properties characterized by high consumption of fruit, vegetables, legumes, complex carbohydrates, fish, and olive oil. The health benefits of the Mediterranean diet are attributed to the content of fiber, antioxidants, protein, and moderate amounts of fat-predominantly from mono-unsaturated and omega-3.

Fruits and Vegetables
Fruit and vegetable intake may lower airway inflammation and reduce risk of wheezing and asthma. Fruit and vegetables should be encouraged from early stages of life and on.

Fiber and Gut Flora
Microbiota is the community of microorganisms (bacteria) that live in the digestive tracts of humans. There are many types of bacteria living in our guts, and many factors can influence the balance of good versus bad flora. Bad flora has been linked with Western diet and other poor diets and is related with health conditions such as obesity, metabolic syndrome, increased risk of colorectal cancer, and other health conditions. Good flora is linked to plant based diets (such as the Mediterranean diet) and has shown health benefits such as enhancing the immune system, anti-inflammatory effects, and reduced risk of cancer, among others. Fruits and vegetables are rich in fiber. Fiber is fermented by gut bacteria and increases the production of short-chain fatty acids which have been shown to reduce the risk of inflammatory diseases, Type 2 diabetes, obesity, heart disease and other conditions. High fiber diets have been shown to help against airway allergic responses by lowering airway inflammation.  

If you are interested in learning more about the Mediterranean diet visit www.oldwayspt.org. Below is a recipe that is a great substitute for sub sandwiches with deli meat.

Recipe of the Week: Grilled Chicken Pitas

Ingredients
3 boneless, skinless chicken breasts (about 1 1/2 pounds)
3 tablespoons plus 2 teaspoons fresh lemon juice, divided
3 tablespoons soy sauce
1 clove garlic, minced
2 teaspoons dried oregano, divided
2 small tomatoes, finely chopped
1 cup crumbled feta cheese (1/4 pound)
1/4 cup olive oil

Ingredients for the yogurt sauce:
8 ounces (1 cup) unflavored yogurt
1 clove garlic, minced
1/4 cup finely chopped walnuts
1 tablespoon olive oil
Olive oil cooking spray
1 large Vidalia or purple onion, cut into thin rings
6 pita breads
1/2 head romaine lettuce, finely chopped
One 10.6-ounce jar kalamata olives, drained, halved, and pitted, or other black olives
12 slices bacon, fried crisp
Alfalfa sprouts
Salt
Freshly ground black pepper

Directions
Rinse the chicken breast and pat dry. Combine 3 tablespoons lemon juice, soy sauce, garlic and 1 teaspoon of the oregano in a glass dish. Add the chicken, turn to coat, and cover with plastic wrap. Allow the chicken breast to marinate for 30 minutes at room temperature or overnight in the refrigerator.
Combine the tomatoes and feta cheese in a small glass dish. Add the remaining 2 teaspoons lemon juice, the olive oil, and the remaining 1 teaspoon oregano, and stir to combine. Allow to sit at room temperature for 30 minutes.

For the yogurt sauce:
In a small bowl, whisk together the yogurt, garlic, walnuts, and olive oil. Cover and refrigerate until ready to use.
Preheat a grill to medium heat.
Spray a grill basket with olive oil. Grill the chicken breasts over medium heat for 8 to 10 minutes, until no longer pink in the thickest portion of each breast. Spread the onion rings over the surface of the basket and grill while the chicken is cooking. Turn the basket frequently. The onion rings will blacken as they cook; this will also take 8 to 10 minutes. When the chicken and onion rings are cooked, place the pita breads on the grill for about 2 minutes per side, until grill marks show. Slice the chicken into very thin pieces.
At serving time, put out all of the ingredients and allow each person to assemble sandwiches: Split each pita. Place several slices of grilled chicken, 3 or 4 slivers of onion, a tablespoon of tomato-feta mixture, lettuce, olives, and 1 or 2 slices of bacon into each pita. Top with yogurt sauce and a wad of alfalfa sprouts. Add salt and pepper, to taste. Fold up the sides of the pita and enjoy!

*Recipe via Food Network 

Have a wonderful weekend!

Karen Alexander, BSND, MSCN

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