Asthma in Food points of view

Respiratory Disease is defined as medical conditions which affect the breathing organ and tissues including Inflammatory lung disease, Obstructive lung diseases, Restrictive lung diseases, Respiratory tract infections, trachea, bronchi, bronchioles, alveoli, the nerves and  muscles breathing , etc.
 Asthma is a chronic inflammatory disease affecting the air way of the lung with recurring symptoms, such as wheezing, chest tightness, shortness of breath, and coughing. The disease affects people of all ages, and mostly starts during childhood. According to American academy, allergy, asthma and immunology, about 1 in 10 children (10%) had asthma and 1 in 12 adults (8%) had asthma in 2009. (about 25 million, or 8% of the U.S. population)(1).
Epidemiological studies, linking foods in reduced risk and treatment have not been conclusive(a)(b)(c)(d), but certain foods have been found to be effectively.

A. Types vegetable reduced risk of asthma
1. Garlic
Garlic (Allium sativum) is a species in the onion genus, belonging to family Amaryllidaceae, native to central Asia. It has been used popularly in traditional and Chinese medicine in treating common cold and flu to the Plague, blood pressure cholesterol levels, natural antibiotic, etc.
Diallyl disulfide (DADS), a major organosulfur compound found in garlic, in an ovalbumin-induced model of allergic asthma and RAW264.7 cells, showed to inhibit the proinflammatory proteins, through up regulation of Nrf-2/HO-1 and down regulation of NF-κB pathways(2). According to the study by Tarbiat Modares University, purified aged garlic extract exhibited the protective effect of asthma through a significant decrease in the hallmark criteria of allergic airway inflammation levels(3).

2. Tomatoes
Tomato is a red, edible fruit, genus Solanum, belongs to family Solanaceae, native to South America. Because of its health benefits, tomato is grown world wide for commercial purpose
and often in green house.
High-antioxidant diet is associated to reduced risk of asthma, according to University of Newcastle, whole foods intake such as tometoes showed to alter clinical asthma outcomes of patient who were in low antioxidant given tomato extract (45 mg lycopene/d)(4). The  John Hunter Hospital study also supported the role of tomato juice and extract in reduced airway neutrophil influx with tomato extract also reduced sputum neutrophil elastase activity(5). Naringenin chalcone, the other polyphenols found in the skin of red tomatoes, showed to suppresses asthmatic symptoms through inhibition of Th2 cytokine production from CD4 T(6).

3. Seaweeds
Marine algae have been used as food products and herbal medicine in many countries throughout human history with an abundance of algae floral. In recent studies, marine algae may consist great sources of  chemical ingredients in treating inflammatory and allergic disorders, such as such as asthma, atopic dermatitis, and allergic rhinitis (7)(8). According to the study at Pukyong National University, many marine macro- and microalgae have been reported to have potential to ameliorate the effect of asthma and further studies are needed to identify the molecular mechanism of this disease to apply those marine resources against asthma effectively(9). Iota-Carrageenan, derived from red seaweed showed to be potent against anti-rhinoviralas (HRVs may worsen COPD and asthma) its effectively prevents the replication of HRV1A, HRV2, HRV8, HRV14, HRV16, HRV83 and HRV84 in primary human nasal epithelial cells in culture(10).

4. Ginger
Ginger (Zingiber officinale) or ginger root is the genus Zingiber, belonging to the family Zingiberaceae, native to Tamil. It has been used in traditional and Chinese medicine to treat dyspepsia, gastroparesis, constipation, edema, difficult urination, colic, etc.
Purified components of ginger was found to be effective in relax airway smooth muscle (ASM), through involvement of PDE4D inhibition and cytoskeletal regulatory proteins. Together with other chemical constituents such as β-agonists, 6-gingerol, 8-gingerol, or 6-shogaol may augment existing asthma therapy, insisted by Columbia University study(11). Quercetin, a chemical compound found in ginger, relaxed airway smooth muscle via cAMP-mediated pathways and augments β-agonist relaxation(12). The Columbia University Medical Center study also found many ginger's isolated active components, [6]-gingerol, [8]-gingerol, and [6]-shogaol, relax ASM, and [8]-gingerol attenuated airway hyperresponsiveness, in part by altering [Ca(2+)](i) regulation(13).

5. Broccoli
Broccoli is a mustard/cabbage plant, belong to the family Brassicaceae. It has large flower heads, usually green in color and the mass of flower heads is surrounded by leaves and evolved from a wild cabbage plant on the continent of Europe.
Sulforaphane, a major chemical compound found in broccoli sprout demonstrated the potential preventive and therapeutic potential of broccoli or broccoli sprouts rich in glucoraphanin for reducing the impact of particulate pollution on allergic disease and asthma, according to David Geffen School of Medicine at UCLA(14).In (OVA)-induced murine asthma model, Sulforaphane significantly alleviated the OVA-induced airway hyperresponsiveness possiblt through suppressed the increase in the levels of SOCS-3 and GATA-3 and IL-4 expression in the OVA-challenged mice(15).

6. Spinach
Spinach is an edible flowering plant in the genus Spinacia, belongs to the family of Amaranthaceae and native to central and southwestern Asia. It is considered as a healthy plant containing vary vitamins and minerals. aqueous extract of spinach, in ovalbumin-induced asthmatic model. exerted strong anti-asthmatic effects through induction of a decrease in the CD4+ cell number, IL-4/13, and other molecular markers in the lung(16).

B. Types of fruits reduced risk of asthma
1. Apple
Apple is the pomaceous fruit of the apple tree, a species of the rose family Rosaceae. It is one of the most widely cultivated tree fruits. The tree is originated in Central Asia. Drinking apple juice from concentrate at least once a day (compared with less than once a month) might be negatively associated with current wheeze (17a). According to the Cornell University, phenolics, flavonoids and carotenoids of apple may play a key role in reducing chronic disease risk, including asthma(17)(18)(19). The study at the King's College London, showed a possibly protective effect of apple in reduced risk of apple with the presence of other flavonoids or polyphenols on obstructive lung disease, instead of catechins, flavonols and flavones(20). According to the Brigham and Women's Hospital, Belladonna alkaloids, derived from the thorn-apple plant were used to treat asthma in 1905, and chemically synthesized entities in this class are still in use today(21). 

2. Grape
Grape is a woody vines of the genus Vitis, belong to the family Vitaceae, native to southern Turkey.
Polyphenols found in Fermented Grape Marc (FGM) may be effective in exhibited several immunomodulating activities, including decreased oxidative burst of human polymorphonuclear cells and monocytes of which induced anti-allergic and anti inflammatory effects in chronic asthma(22). According to the study of Graduate School of Science, Kitasato University, Fermented Grape Marc (FGM) also suppressed both phases of type-I allergic responses, through a fraction extractable with acetone(23).

3. Strawberry
Strawberries is a genius of Fragaria × ananassa belongs to the family Roseaceae. They have been grown all over the world with suitable climate for commercial profits and for health benefits.
Gallic acid (3,4,5-trihydroxybenzoic acid), a polyphenyl natural products found abundantly in gallnut  inhibited  inflammatory allergic diseases, through blocking histamine release and pro-inflammatory cytokine expression(24). The Johannes Gutenberg University, also suggested that the composition of Gallic acid, methyl gallate and quercetin in animal study showed significant effects with with one certain fraction (GG II, 3 days, 3 x 2 mg/kg) in reduced allergen- and PAF-induced bronchial reactions by more than 70%(25).

C. Seed and Nut
1. Sesame oil
Sesame is a species of Sesamum indicum and belong to the family of Pedaliaceae, native to to sub-saharan Africa. The tree can grow to 1.6 to 3.3 ft tall and is mainly cultivated for their seeds. Sesame oil, a natural product with anti-inflammatory property showed to inhibited pulmonary edema and decreased interleukin (IL)-1 β and IL-6 levels in bronchoalveolar lavage fluid in OVA-treated mice through inhibition of systemic IgE level in allergic asthma(26).

2. Faxseed
Flax seed is native to the region of the eastern Mediterranean to India and also known as common flax or linseed. Flax is an erect annual plant, it can grow to 1.2 m tall. The leaves are 20–40 mm long and 3 mm broad. Suggestions of saturated and n-6 fatty acids and concomitant decrease in n-3 fatty acids may be a major driver of the increase in the incidence of inflammatory diseases such as asthma, allergy, and atherosclerosis. According to the Wake Forest University, dietary supplementation with flaxseed oil affects the biochemistry of fatty acid metabolism through the balance of proinflammatory mediators and atherogenic lipids, affecting the modulation of inflammatory diseases(27) and patients with asthma and allergic rhinitis may benefit from hydration and a diet low in sodium, omega-6 fatty acids, and transfatty acids, but high in omega-3 fatty acids (i.e., fish, almonds, walnuts, pumpkin, and flax seeds)(28).
3. Sunflower seed
Sunflower is a genus of Helianthus, belong to the family Asteraceae and native to the Americas. It grow to heights between 5–12 ft. Sunflower seeds are usually classified by the difference of their husks and are considered as healthy snack of a meal.
Helianthus annuus (Sunflower) seed (HAS) aqueous extract, may consist a potential in reducing the asthma-like symptoms induced by a mouse ovalbumin challenge model(29).

C. Others
1. Green Tea
Green tea contains more amount of antioxidants than any drinks or food with the same volume, and is the leaves of Camellia sinensis, undergone minimal oxidation during processing, originated from China. Green tea has been a precious drink in traditional Chinese culture and used exceptional in socialization for more than 4000 thousand years. Because of their health benefits, they have been cultivated for commercial purposes all over the world.
According to teh study at State University of New York Downstate Medical Center, green tea extract (GTE), and its major catechin, consisted an immunoregulatory effects through suppression of IgE production by peripheral blood mononuclear cells of allergic asthmatic patinets(30) and B cell production of IgE without inducing apoptosis(31). Other study suugested a anti asthmatic effect of aqueous extract of Camellia sinensis through increasing the expression level of tumor necrosis factor-beta and interferon-gamma and decreasing the expression of anti-asthmatic cytokines in the lung(32).

2. Fish and fish oil
Consumption of fish has also been related to lower airway hyperreactivity among children and higher lung function in adults, according to Pan American Health Organization and National Institute of Public Health(33) and fish oil supplements, administered in a dosage of 1 to 1.2 g of EPA and DHA per day, also may be helpful to some patients with asthma(34).According to Ewha Womans University, asthmatic patient were found to consume fewer amounts of kimchi  and fish but had a higher cereal intake than those without asthma(35).

3. Whole grain
Wholegrain is cereal grains containing cereal germ, endosperm, and bran. According to the study by National Institute of Public Health and the Environment, intake of whole grain is associated to reduced risk asthma and  may have a protective effect against asthma in children(36).  Other study suggested that whole grain and high in fruits, vegetables, and low in alcohol and fatty foods may be useful for prevention of cardiovascular disease and cancer, to protect respiratory health in both children and adults(37).

4. Coffee
Coffee made from the roasted seeds of the genus Coffee, belonging to the family Rubiaceae native to southern Arabia.  Strong evidence suggested that drinking coffee reduced risk of asthma. according to Istituto Centrale di Statistica, caffeine intake has a bronchodilator effect in asthma, and  long-term moderate coffee consumption may not only reduce symptoms, but also prevent the clinical manifestation of bronchial asthma(38) and people who drank coffee on a regular basis had a 29% reduction in the odds of having current asthma(39). The University of London aslo suggested that caffeine appears to improve airways function modestly, for up to four hours, in people with asthma(40).

Taking altogether, some foods have been found effectively in reduced risk and treatment of asthma and allergic induced asthmatic disease. Further studies with large sample size and multi centers are necessary to identify the ingredients for improvement of validation. As always, all articles written by Kyle J. Norton are for information & education only, please consult your Doctor & Related field specialist before applying

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References
(1) American academy, allergy, asthma and immunology(AAAAI)
(a) Association between nutrition and the evolution of multimorbidity: The importance of fruits and vegetables and whole grain products by Ruel G¹, Shi Z, Zhen S, Zuo H, Kröger E, Sirois C, Lévesque JF, Taylor AW.(PubMed)
(b) Dietary factors associated with lifetime asthma or hayfever diagnosis in Australian middle-aged and older adults: a cross-sectional study by Rosenkranz RR¹, Rosenkranz SK, Neessen KJ.(PubMed)
(c) Protective effect of fruits, vegetables and the Mediterranean diet on asthma and allergies among children in Crete by Chatzi L¹, Apostolaki G, Bibakis I, Skypala I, Bibaki-Liakou V, Tzanakis N, Kogevinas M, Cullinan P.(PubMed)
(d) Effect of diet on asthma and allergic sensitisation in the International Study on Allergies and Asthma in Childhood (ISAAC) Phase Two by Nagel G¹, Weinmayr G, Kleiner A, Garcia-Marcos L, Strachan DP; ISAAC Phase Two Study Group.(PubMed)
(2) Diallyl-disulfide, an organosulfur compound of garlic, attenuates airway inflammation via activation of the Nrf-2/HO-1 pathway and NF-kappaB suppression by Shin IS¹, Hong J, Jeon CM, Shin NR, Kwon OK, Kim HS, Kim JC, Oh SR, Ahn KS.(PubMed)
(3) Purified aged garlic extract modulates allergic airway inflammation in BALB/c mice by Zare A¹, Farzaneh P, Pourpak Z, Zahedi F, Moin M, Shahabi S, Hassan ZM.(PubMed)
(4) Manipulating antioxidant intake in asthma: a randomized controlled trial by Wood LG¹, Garg ML, Smart JM, Scott HA, Barker D, Gibson PG.(PubMed)
(5) Lycopene-rich treatments modify noneosinophilic airway inflammation in asthma: proof of concept by Wood LG¹, Garg ML, Powell H, Gibson PG.(PubMed)
(6) Naringenin chalcone suppresses allergic asthma by inhibiting the type-2 function of CD4 T cells by Iwamura C¹, Shinoda K, Yoshimura M, Watanabe Y, Obata A, Nakayama T.(PubMed)
(7) Potential targets for anti-inflammatory and anti-allergic activities of marine algae: an overview BY Vo TS¹, Ngo DH, Kim SK.(PubMed)
(8) Antiallergic benefit of marine algae in medicinal foods by Kim SK¹, Vo TS, Ngo DH.(PubMed)
(9) Marine macro- and microalgae as potential agents for the prevention of asthma: hyperresponsiveness and inflammatory subjects by Senevirathne M¹, Kim SK.(PubMed)
(10) Iota-Carrageenan is a potent inhibitor of rhinovirus infection by Grassauer A¹, Weinmuellner R, Meier C, Pretsch A, Prieschl-Grassauer E, Unger H.(PubMed)
(11) Active components of ginger potentiate β-agonist-induced relaxation of airway smooth muscle by modulating cytoskeletal regulatory proteins by Townsend EA¹, Zhang Y, Xu C, Wakita R, Emala CW.(PubMed)
(12) Quercetin acutely relaxes airway smooth muscle and potentiates β-agonist-induced relaxation via dual phosphodiesterase inhibition of PLCβ and PDE4 by Townsend EA¹, Emala CW Sr.(PubMed)
(13) Effects of ginger and its constituents on airway smooth muscle relaxation and calcium regulation by Townsend EA¹, Siviski ME, Zhang Y, Xu C, Hoonjan B, Emala CW.(PubMed)
(14) Sulforaphane-rich broccoli sprout extract attenuates nasal allergic response to diesel exhaust particles by Heber D¹, Li Z, Garcia-Lloret M, Wong AM, Lee TY, Thames G, Krak M, Zhang Y, Nel A.(PubMed)
(15) Sulforaphane inhibits the Th2 immune response in ovalbumin-induced asthma by Park JH¹, Kim JW, Lee CM, Kim YD, Chung SW, Jung ID, Noh KT, Park JW, Heo DR, Shin YK, Seo JK, Park YM.(PubMed)
(16) Amelioration of asthmatic inflammation by an aqueous extract of Spinacia oleracea Linn by Heo JC¹, Park CH, Lee HJ, Kim SO, Kim TH, Lee SH.(PubMed)
(17) Apple phytochemicals and their health benefits by Boyer J¹, Liu RH.(PubMed)
(17a) Childhood asthma and fruit consumption by Okoko BJ¹, Burney PG, Newson RB, Potts JF, Shaheen SO.(PubMed)
(18) A comprehensive review of apples and apple components and their relationship to human health by Hyson DA.(PubMed)
(19) Dietary antioxidants and asthma in adults: population-based case-control study by Shaheen SO¹, Sterne JA, Thompson RL, Songhurst CE, Margetts BM, Burney PG.(PubMed)
(20) Dietary intake of flavonoids and asthma in adults by Garcia V¹, Arts IC, Sterne JA, Thompson RL, Shaheen SO.(PubMed)
(21) Asthma: one hundred years of treatment and onward by Chu EK¹, Drazen JM.(PubMed)
(22) Immunomodulating and Anti-Allergic Effects of Negroamaro and Koshu Vitis vinifera Fermented Grape Marc (FGM) by Marzulli G, Magrone T, Vonghia L, Kaneko M, Takimoto H, Kumazawa Y, Jirillo E(PubMed)
(23) Suppression of type-I allergic responses by oral administration of grape marc fermented with Lactobacillus plantarum by Tominaga T¹, Kawaguchi K, Kanesaka M, Kawauchi H, Jirillo E, Kumazawa Y.(PubMed)
(24) Gallic acid inhibits histamine release and pro-inflammatory cytokine production in mast cells by Kim SH¹, Jun CD, Suk K, Choi BJ, Lim H, Park S, Lee SH, Shin HY, Kim DK, Shin TY.(PubMed)
(25) Antiasthmatic effects of Galphimia glauca, gallic acid, and related compounds prevent allergen- and platelet-activating factor-induced bronchial obstruction as well as bronchial hyperreactivity in guinea pigs by Dorsch W¹, Bittinger M, Kaas A, Müller A, Kreher B, Wagner H.(PubMed)
(26) Sesame oil attenuates ovalbumin-induced pulmonary edema and bronchial neutrophilic inflammation in mice by Hsu DZ¹, Liu CT, Chu PY, Li YH, Periasamy S, Liu MY.(PubMed)
(27) Mechanisms by which botanical lipids affect inflammatory disorders by Chilton FH¹, Rudel LL, Parks JS, Arm JP, Seeds MC.(PubMed)
(28) Respiratory and allergic diseases: from upper respiratory tract infections to asthma by Jaber R.(PubMed)
(29) Aqueous extract of the Helianthus annuus seed alleviates asthmatic symptoms in vivo by Heo JC¹, Woo SU, Kweon MA, Park JY, Lee HK, Son M, Rho JR, Lee SH.(PubMed)
(30) Green tea (Camelia sinensis) mediated suppression of IgE production by peripheral blood mononuclear cells of allergic asthmatic humans by Wu SY¹, Silverberg JI, Joks R, Durkin HG, Smith-Norowitz TA.(PubMed)
(31) Green tea (Camelia sinensis) suppresses B cell production of IgE without inducing apoptosis by Hassanain E¹, Silverberg JI, Norowitz KB, Chice S, Bluth MH, Brody N, Joks R, Durkin HG, Smith-Norowitz TA.(PubMed)
(32) An aqueous extract of green tea Camellia sinensis increases expression of Th1 cell-specific anti-asthmatic markers by Heo JC¹, Rho JR, Kim TH, Kim SY, Lee SH.(PubMed)
(33) Diet and obstructive lung diseases by Romieu I¹, Trenga C.(PubMed)
(34) Respiratory and allergic diseases: from upper respiratory tract infections to asthma by Jaber R.(PubMed)
(35) Association between kimchi intake and asthma in Korean adults: the fourth and fifth Korea National Health and Nutrition Examination Survey (2007-2011) by Kim H¹, Oh SY, Kang MH, Kim KN, Kim Y, Chang N.(PubMed)
(36) Diet and asthma in Dutch school children (ISAAC-2) by Tabak C¹, Wijga AH, de Meer G, Janssen NA, Brunekreef B, Smit HA.(PubMed)
(37) Dietary factors in the pathogenesis of asthma and chronic obstructive pulmonary disease by Denny SI¹, Thompson RL, Margetts BM.(PubMed)
(38) Coffee drinking and prevalence of bronchial asthma by Pagano R¹, Negri E, Decarli A, La Vecchia C.(PubMed)
(39) Caffeine intake and asthma symptoms by Schwartz J¹, Weiss ST.(PubMed)
(40) Caffeine for asthma by Welsh EJ¹, Bara A, Barley E, Cates CJ.(PubMed)