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Nutritional Interventions to Improve Asthma-Related Outcomes through Immunomodulation: A Systematic Review.

  • 2020-12-16
  • Nutrients 12(12)
    • Lieve van Brakel
    • Ronald P Mensink
    • Geertjan Wesseling
    • Jogchum Plat

Study Design

Type
Systematic Review
Population
studies that reported both asthma-related outcomes as well as immunological parameters
Methods
systematic review of 28 studies divided over six nutritional clusters
  • Rigorous Journal
Asthma is a chronic inflammatory disease of the airways, characterized by T-helper (Th) 2 inflammation. Current lifestyle recommendations for asthma patients are to consume a diet high in fruits and vegetables and to maintain a healthy weight. This raises the question of whether other nutritional interventions may also improve asthma-related outcomes and whether these changes occur via immunomodulation. Therefore, we systematically reviewed studies that reported both asthma-related outcomes as well as immunological parameters and searched for relations between these two domains. A systematic search identified 808 studies, of which 28 studies met the inclusion criteria. These studies were divided over six nutritional clusters: herbs, herbal mixtures and extracts (N = 6); supplements (N = 4); weight loss (N = 3); vitamin D3 (N = 5); omega-3 long-chain polyunsaturated fatty acids (LCPUFAs) (N = 5); and whole-food approaches (N = 5). Fifteen studies reported improvements in either asthma-related outcomes or immunological parameters, of which eight studies reported simultaneous improvements in both domains. Two studies reported worsening in either asthma-related outcomes or immunological parameters, of which one study reported a worsening in both domains. Promising interventions used herbs, herbal mixtures or extracts, and omega-3 LCPUFAs, although limited interventions resulted in clinically relevant results. Future studies should focus on further optimizing the beneficial effects of nutritional interventions in asthma patients, e.g., by considering the phenotypes and endotypes of asthma.

Research Insights

  • Vitamin D3→Improved Asthma-Related Outcome

    Fifteen studies reported improvements in either asthma-related outcomes or immunological parameters, of which eight studies reported simultaneous improvements in both domains.

    Effect
    Neutral
    Effect size
    Small
    Dose
    Not specified in abstract
  • Vitamin D3→Improved Immune Function

    Fifteen studies reported improvements in either asthma-related outcomes or immunological parameters, of which eight studies reported simultaneous improvements in both domains.

    Effect
    Neutral
    Effect size
    Small
    Dose
    Not specified in abstract
  • Vitamin D3→Worsened Asthma-Related Outcomes

    Two studies reported worsening in either asthma-related outcomes or immunological parameters, of which one study reported a worsening in both domains.

    Effect
    Neutral
    Effect size
    Small
    Dose
    Not specified in abstract
  • Vitamin D3→Worsened Immunological Parameters

    Two studies reported worsening in either asthma-related outcomes or immunological parameters, of which one study reported a worsening in both domains.

    Effect
    Neutral
    Effect size
    Small
    Dose
    Not specified in abstract
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