Skip to main content Accessibility help
×
Home

Nutrient intake is a predictor of lung function in obese asthmatic adolescents undergoing interdisciplinary therapy

  • Lydiane C. Rodrigues (a1), João F. Mota (a1), Flávia C. Corgosinho (a1), Deborah C. L. Masquio (a2), Ana R. Dâmaso (a2), Sérgio Tufik (a2), Marco T. de Mello (a3), Nádia C. Cheik (a4) and Patrícia L. da Silva Agostinho (a5)...

Abstract

Asthma-obesity is a multifactorial disease with specific asthma phenotypes that aggravate due to overweight and an unbalanced diet. Furthermore, obese asthmatic patients are corticotherapy-resistant. Therefore, the aims of the present study were to evaluate the effects of an interdisciplinary intervention on food consumption, body composition, lung function and adipokines in asthmatic and non-asthmatic obese adolescents and to investigate the influence of nutrients on lung function. Obese non-asthmatic (n 42) and obese asthmatic (n 21) adolescents of both sexes were enrolled in the present study. Food intake, adipokine levels, body composition, asthma symptoms and lung function were assessed across the study. After the intervention of 1 year, there was a reduction (P ≤ 0·01) in BMI, body fat percentage, visceral and subcutaneous fat and an increase (P ≤ 0·01) in lean mass and all lung function variables in both groups, except the relation between forced expiratory volume in 1 s and forced vital capacity (FEV1:FVC) in non-asthmatic patients. Moreover, both groups decreased lipid and cholesterol consumption (P ≤ 0·01). The highest energy consumption (β = −0·021) was associated with lower values of FVC. Similarly, carbohydrate consumption (β = −0·06) and cholesterol were negative predictors (β = −0·05) in FEV1:FVC. However, the consumption of Ca (β = 0·01), fibres (β = 1·34) and vitamin A (β = 0·01) were positive predictors of FEV1:FVC. Asthma-obesity interdisciplinary treatment promoted an improvement on food consumption and lung function in adolescents and demonstrated that the consumption of nutrients influenced an increase in lung function.

Copyright

Corresponding author

*Corresponding author: Lydiane C. Rodrigues, fax +55 6232096273, email lydianec@gmail.com

References

Hide All
1. Dobbs, R, Sawers, C, Thompson, F, et al. (2014) The Obesity Crisis. New York: McKinsey Global Institute.
2. Global Initiative for Asthma – GINA (2017) Global Strategy for Asthma Management and Prevention – Online Appendix 2017 Update. London: GINA.
3. Rasmussen, F & Hancox, RJ (2014) Mechanisms of obesity in asthma. Curr Opin Allergy Clin Immunol 14, 3543.
4. Lang, JE (2012) Obesity, nutrition, and asthma in children. Pediatr Allergy Immunol Pulmonol 25, 6475.
5. Ford, ES (2005) The epidemiology of obesity and asthma. J Allergy Clin Immunol 115, 897909.
6. Beuther, DA & Sutherland, ER (2007) Overweight, obesity, and incident asthma: a meta-analysis of prospective epidemiologic studies. Am J Resp Crit Care Med 175, 661666.
7. Brumpton, B, Langhammer, A, Romundstad, P, et al. (2013) General and abdominal obesity and incident asthma in adults: the HUNT study. Eur Respir J 41, 323339.
8. Papoutsakis, C, Chondronikola, M, Antonogeorgos, G, et al. (2015) Associations between central obesity and asthma in children and adolescents: a case–control study. J Asthma 52, 128134.
9. Azizpour, Y, Delpishe, A, Montazeri, Z, et al. (2018) Effect of childhood BMI on asthma: a systematic review and meta-analysis of case–control studies. BMC Pediatr 18, 143.
10. Hayden, ML, Stoloff, SW, Colice, GL, et al. (2012) Exercise-induced bronchospasm: a case study in a nonasthmatic patient. J Am Acad Nurse Pract 24, 1923.
11. Tassoudis, V, Ieropoulos, H, Karanikolas, M, et al. (2016) Bronchospasm in obese patients undergoing elective laparoscopic surgery under general anesthesia. Springerplus 5, 435.
12. Mohanan, S, Tapp, H, McWilliams, A, et al. (2014) Obesity and asthma: pathophysiology and implications for diagnosis and management in primary care. Exp Biol Med 239, 15311540.
13. Dixon, AE & Poynter, ME (2016) Mechanisms of asthma in obesity pleiotropic aspects of obesity produce distinct asthma phenotypes. Am J Respir Cell Mol Biol 54, 601608.
14. Ellwood, P, Asher, MI, Garcia-Marcos, L, et al. (2013) Do fast foods cause asthma, rhinoconjunctivitis and eczema? Global findings from the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three Thorax 68, 351360.
15. Harte, AL, Varma, MC, Tripathi, G, et al. (2012) High fat intake leads to acute postprandial exposure to circulating endotoxin in type 2 diabetic subjects. Diabetes Care 35, 375382.
16. Halns, I, Baines, KJ, Berthon, BS, et al. (2017) Soluble fibre meal challenge reduces airway inflammation and expression of GPR43 and GPR41 in asthma. Nutrients 9, E57.
17. Shore, SA & Cho, Y (2016) Obesity and asthma: microbiome-metabolome interactions. Am J Respir Crit Care Med 54, 609617.
18. Sideleva, O, Black, K & Dixon, AE (2013) Effects of obesity and weight loss on airway physiology and inflammation in asthma. Pulm Pharmacol Ther 26, 455458.
19. Han, YY, Forno, E, Holguin, F, et al. (2015) Diet and asthma: an update. Curr Opin Allergy Clin Immunol 15, 369374.
20. Berthon, BS, Macdonald-Wicks, LK, Gibson, PG, et al. (2013) Investigation of the association between dietary intake, disease severity and airway inflammation in asthma. Respirology 18, 447454.
21. Maslowski, KM, Vieira, AT, Ng, A, et al. (2009) Regulation of inflammatory responses by gut microbiota and chemoattractant receptor GPR43. Nature 461, 12821286.
22. Boulet, LP (2013) Asthma and obesity. Clin Exp Allergy 43, 821.
23. Gruchala-Niedoszytko, M, Malgorzewicz, S, Niedoszytko, M, et al. (2013) The influence of obesity on inflammation and clinical symptoms in asthma. Adv Med Sci 58, 1521.
24. Scott, HA, Jensen, ME & Wood, LG (2014) Dietary interventions in asthma. Curr Pharm Des 20, 10031010.
25. Lee, H, Lee, S & Choue, R (2013) Obesity, inflammation and diet. Pediatric Gastroenterol Hepatol Nutr 16, 143152.
26. Luna-Pech, JA, Torres-Mendoza, BM, Luna-Pech, JA, et al. (2014) Normocaloric diet improves asthma-related quality of life in obese pubertal adolescents. Int Arch Allergy Immonol 163, 252258.
27. Da Silva, PL, De Mello, MT, Cheik, NC, et al. (2012) Interdisciplinary therapy improves biomarkers profile and lung function in obese asthmatic adolescents. Pediatr Pulmonol 47, 817.
28. Sociedade Brasileira de Pneumologia e Tisologia (2012) Diretrizes da Sociedade Brasileira de Pneumologia e Tisologia para o manejo da asma (Guidelines of the Brazilian Society of Pulmonology and Asthma for asthma management). J Bras Pneumol 38, Suppl. 1, S1S46.
29. Dias, J & Farzan, S (2014) Clinical implications of obese-asthma phenotypes. Immunol Allergy Clin North Am 34, 739751.
30. Liu, X, Lin, R, Zhao, B, et al. (2016) Correlation between oxidative stress and the NF–κB signaling pathway in the pulmonary tissues of obese asthmatic mice. Mol Med Rep 13, 11271134.
31. Marshall, WA & Tanner, JM (1969) Variations in pattern of pubertal changes in girls. Arch Dis Child 44, 291303.
32. Marshall, WA & Tanner, J M (1970) Variations in pattern of pubertal changes in boys. Arch of Dis Child 45, 1323.
33. Kuczmarski, RJ, Ogden, CL, Guo, SS, et al. (2002) 2000 CDC growth charts for the United States: methods and development. National Center for Health Statistics. Vital Health Stat 11, 1190.
34. Lohman, TG, Roche, AF & Martorrel, R (1991) Anthropometric: Standardization Reference Manual, abbreviated ed., p. 30 [Martorrel, R, editor]. Champaign, IL: Human Kinetic Books.
35. Ribeiro-Filho, FF, Faria, AN, Azjen, S, et al. (2003) Methods of estimation of visceral fat: advantages of ultrasonography. Obes Res 11, 14881494.
36. American Thoracic Society (2014) Guidelines for assessing and managing asthma risk at work, school, and recreation. Am J Respir Crit Care Med 169, 873881.
37. Sociedade Brasileira de Pneumologia e Tisiologia (2002) Diretrizes para teste de função pulmonar (Pulmonary function test guidelines). J Bras Pneumol 28, 112.
38. Knudson, RJ, Lebowitz, MD, Holberg, CJ, et al. (1983) Changes in the normal maximal expiratory flow-volume curve with growth and aging. Am Rev Respir Dis 127, 725734.
39. Sociedade Brasileira de Pneumologia e Tisiologia (2006) IV Diretrizes Brasileiras para Manejo da Asma (IV Brazilian Guidelines for Asthma Management). J Bras Pneumol 32, 447474.
40. Bateman, ED, Hurd, SS., Barnes, PJ, et al. (2008) Global Strategy for Asthma Management and Prevention: GINA executive summary. Eur Respir J 31, 143178.
41. Anção, MS, Cuppari, L, Tudisco, ES, et al. (2002) NutWin – Programa de Apoio a Nutrição Versão 2.5 (Nutrition Support Program Version 2.5) [software]. São Paulo: Centro de Informática em Saúde, Universidade Federal de São Paulo/Escola Paulista de Medicina.
42. National Research Council (2000) Dietary Reference Intakes (DRI): Applications in Dietary Assessment. Washington, DC: National Academies Press.
43. Corgosinho, FC, Elia, CA, Tufik, S, et al. (2015) Beneficial effects of a multifaceted 1-year lifestyle intervention on metabolic abnormalities in obese adolescents with and without sleep-disordered breathing. Metab Syndr Relat Disord 13, 110118.
44. Donnelly, JE, Blair, SN, Jakicic, JM, et al. (2009) American College of Sports Medicine. American College of Sports Medicine Position Stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc 41, 459471.
45. Craig, CL, Marshall, AL, Sjöström, M, et al. (2003) International Physical Activity Questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 35, 13811395.
46. Rosner, B (2011) Fundamentals of biostatistics. In Descriptive Statistics, 7th ed., pp. 539. Stamford, CT: Cengage Learning.
47. Mukaka, MM (2012) A guide to appropriate use of correlation coeficiente in medical reserch. Malawi Med J 24, 6971.
48. Egan, KB, Ettinger, AS, Dewan, AT, et al. (2015) Longitudinal associations between asthma and general and abdominal weight status among Norwegian adolescents and young adults: the HUNT Study. Pediatr Obes 10, 345352.
49. Juel, CT & Urlrik, CR (2013) Obesity and asthma impacto n severity, asthma control, and response to therapy. Respir Care 58, 867873.
50. Ahmadizar, F, Uijverberg, JH, Arets, HCM, et al. (2016) Childhood obesity in relation to poor asthma control and exacerbation: a meta-analysis. Eur Respir J 48, 10631073.
51. Huang, F, Del-Rio, BE, Torres-Alcantara, S, et al. (2017) Adipokines, asymmetrical dimethylarginine, and pulmonar function in adolescentes with asthma and obesity. J Asthma 54, 153161.
52. Jensen, ME, Gibson, PG, Collins, CE, et al. (2013) Diet-induced weight loss in obese children with asthma: a randomized controlled trial. Clin Exp Allergy 43, 775–184.
53. Campos, RMDS, Masquio, DCL, Corgosinho, FC, et al. (2018) Relationship between adiponectin and leptin on osteocalcin in obese adolescents during weight loss therapy. Arch Endocrinol Metab 62, 275284.
54. Lausten-Thomsen, U, Christiansen, M, Louise Hedley, P, et al. (2016) Reference values for serum leptin in healthy non-obese children and adolescents. Scand J Clin Lab Invest 76, 561567.
55. Elloumi, M, Ben-Ounis, O, Makni, E, et al. (2009) Effect of individualized weight-loss programmes on adiponectin, leptin and resistin levels in obese adolescent boys. Acta Paediatr 98, 14871493.
56. Andersen, CJ (2018) Impact of dietary cholesterol on the pathophysiology of infectious and autoimmune disease. Nutrients 10, E764.
57. Yarrow, JF, Beggs, LA, Conover, CF, et al. (2012) Influence of androgens on circulating adiponectin in male and female rodents. PLOS ONE 7, e47315.
58. Bottner, A, Kratzsch, J, Muller, G, et al. (2004) Gender differences of adiponectin levels develop during the progression of puberty and are related to serum androgen levels. J Clin Endocrinol Metab 89, 40534061.
59. Xi, H, Zhang, L, Guo, Z, et al. (2011) Serum leptin concentration and its effect on puberty in Naqu Tibetan adolescents. J Physiol Anthropol 30, 111117.
60. Wabitsch, M, Blum, WF, Muche, R, et al. (1997) Contribution of androgens to the gender difference in leptin production in obese children and adolescents. Clin Invest 100, 808813.
61. Department of Agriculture and U.S. Department of Health and Human Services (2015) Dietary Guidelines for Americans 2015–2020, 8th ed. Washington, DC: Office of Disease Prevention and Health Promotion.
62. Grundy, SM (2016) Does dietary cholesterol matter? Curr Atheroscler 18, 68.
63. Berger, S, Ramon, G, Vishwanathan, R, et al. (2015) Dietary cholesterol and cardiovascular disease: a systematic review and meta-analysis. Am J Clin Nutr 102, 276294.
64. Miettinen, TA & Gylling, H (2000) Cholesterol absorption efficiency and sterol metabolism in obesity. Atherosclerosis 153, 241248.
65. Chen, YC, Tung, KY, Tsai, CH, et al. (2013) Lipid profiles in children with and without asthma: interaction of asthma and obesity on hyperlipidemia. Diabetol Metab Syndr 7, 2025.
66. Ramaraju, K, Krishnamurthy, S, Maamidi, S, et al. (2013) Is sérum cholesterol a risk factor for asthma? Lug India 30, 295301.
67. Veldauizen, R, Nag, K, Orgeig, S, et al. (1998) The role of lipids in pulmonar surfactante. Biochim Biophys Acta 1408, 90108.
68. Fessler, MB (2017) A new frontier in immunometabolism: cholesterol in lug health and disease. Ann Am Thorac Soc 14, Suppl. 5, S399S405.
69. Wood, LG (2017) Diet, obesity and asthma. Ann Am Thorac Soc 14, Suppl. 5, S332S338.
70. Patel, C, Ghanim, H, Ravishankar, S, et al. (2007) Geration of prolonged reactive oxygen species and activation of nuclear factor-kB a high-fat, high-carbohydrate meal in the obese. J Clin Endocrinol Metab 92, 44764479.
71. Johnson, JB, Summer, W & Cutler, RG (2007) Alterate day calorie restriction improves clinical findings and reduces markers of oxidative stress and inflammation in overweight adults with moderate asthma. Free Radic Biol Med 42, 665675.
72. Intitute of Medicine (2005) Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington, DC: National Academies Press.
73. Hijazi, N, Abalkhail, B & Seaton, A (2000) Diet and childhood asthma in a society in transition: a study in urban and rural Saudi Arabia. Thorax 55, 775779.
74. Hanson, C, Lyden, E, Rennard, S, et al. (2016) The relationship between dietary fiber intake and lung function in the National Health and Nutrition Examination Surveys. Ann Am Thorac Soc 13, 643650.
75. Barranco, P, Delgado, J, Gallego, LT, et al. (2012) Asthma, obesidade y dieta (Asthma, obesity and diet). Nutr Hosp 27, 138145.
76. Han, YY, Blatter, J, Brehm, JM, et al. (2013) Diet and asthma: vitamins and methyl donors. Lancet Respir Med 1, 813822.
77. Allen, S, Britton, JR & Leonardi-Bee, (2009) Association between antioxidant vitamins and asthma outcome measures: systematic reviev and meta-analysis. Thorax 64, 610619.

Keywords

Type Description Title
PDF
Supplementary materials

Rodrigues et al. supplementary material
Rodrigues et al. supplementary material

 PDF (241 KB)
241 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed