Diet and Asthma: 3 Vitamins Impacting Your Asthma

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Can Vitamins Improve Your Asthma?

Can Food Improve My Asthma
Can Food Improve My Asthma.

Are diet and asthma related? “You are what you eat” is a phrase I have heard time and again. Many asthmatics would love to know that a particular diet will improve their asthma control or decrease the amount of medication they need.

Diet is directly related to a number of health conditions, such as heart disease and high cholesterols, and eating a healthy diet decreases risk. However, whether specific vitamin supplementation will improve your asthma is a much more complicated topic.

The hypothesis goes something like this:

  • Asthma and other atopic conditions have increased, primarily in Western, industrialized countries.
  • A changing diet is one of the significant differences between Western, industrialized countries and countries that have not seen increases in atopic diseases.
  • Western lifestyles are generally associated with:

  1. decreased fruit and vegetable (foods high in antioxidant vitamins and carotenoids) intake resulting in lower vitamins E and A.
  2. decreased sun exposure (increased time indoors and increased use of sunscreen) resulting in lower levels of vitamin D

  • These dietary changes have led to a rising incidence of asthma and other atopic diseases.

Research looking at populations like this has a number of inherent risks you should be aware of. Just because a population with poorly controlled asthma is noted to have some vitamin deficiency, that does not mean that supplementation will improve asthma or that the vitamin deficiency caused the poorly controlled asthma.

It could be that the vitamin deficiency is more of a marker of a less healthy diet or lifestyle in general. It could be that lifestyle with multiple different factors that are leading to increased risk or control. There is further debate in nutritional medicine as to whether supplementation provides the same benefits as a well-rounded diet rich in certain nutrients.

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Water Soluble vs. Fat Soluble Vitamins

Vitamins
Vitamins. Getty Images- Photographer's Choice

If you choose to supplement your diet with vitamins it is important to understand the difference between water soluble and fat soluble vitamins.

Fat-soluble vitamins (A,E,D, and K) travel through your body, as the name implies, in fats. When stored these vitamins tend to stay in tissues. This means that if you take too much of a vitamin that this can result in a condition called hypervitaminosis (too much of the vitamin in your body).

With water-soluble vitamins, you are much less likely to develop hypervitaminosis because they are not stored in tissues and are excreted in the urine. However, all vitamins can lead to side effects so talk with your doctor before beginning a supplementation program.

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Vitamin D

Salmon steak, fortified cereals (cornflakes), glass of milk and egg yolk, all sources of Vitamin D
Dorling Kindersley / Getty Images

Vitamin D is a fat-soluble vitamin that is common in dairy products. It is essential for bone health.

Most people will get vitamin D through fortified foods and supplements as typical diets do not contain enough foods that are good sources of vitamin D to achieve sufficient levels.

What It Does

Vitamin D is thought to impact the levels of certain immune cells in the pathophysiology of asthma and decrease the inflammatory response caused by a viral respiratory infection.

Numerous studies have demonstrated a relationship between vitamin D and asthma. Higher levels of vitamin D have been found to protect against the development of asthma and recurrent wheeze in childhood. Similarly, adequate levels in early childhood are associated with protection against asthma in later life.

Asthmatics have been found to be vitamin D deficient in multiple studies and low levels are associated with increased asthma symptoms, increased airway hyperreactivity, and poorer asthma control.

However, results of vitamin D supplementation have been mixed. Some studies have demonstrated decreased exacerbations while others have not. Some studies have demonstrated benefit in select populations of asthmatics such as those with elevated eososinophils, IgE levels or those with steroid resistant asthma. Likewise, studies looking at objective measures such as spirometry have demonstrated mixed results.

Foods With Plenty of Vitamin D

If you want to increase your vitamin D intake you can increase:

  • Salmon
  • Mackerel
  • Mushrooms
  • Milk
  • Yogurt
  • Cheese

Spending more time outdoors in the sun will also increase vitamin D levels.

Can I Take Too Much Vitamin D?

Vitamin D is generally thought of as safe when taking recommended amounts but high doses can lead to high levels of calcium in the blood resulting in kidney stones, confusion, constipation, nausea, and vomiting.

Bottom Line For My Asthma

While vitamin D seems to have an impact on immune function at various points in the pathophysiology of asthma the data is too inconsistent to recommend vitamin D as an adjunctive asthma treatment. However, if you feel that you are at risk of vitamin D deficiency it is probably worth getting your levels checked and making sure your levels are normal.

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Vitamin C

C vitamin splash
Stefan Cioata / Getty Images

Vitamin C is a water-soluble antioxidant that is common in fruits and vegetables. It is touted as a defense against the common cold and an immunity booster.

Most people eating a healthy diet will get enough vitamin C without requiring supplementation.

What It Does

Vitamin C has anti-inflammatory and antioxidant properties that make it of potential interest in asthma. Western diets have low levels of vitamin C and this is hypothesized to impact asthma.

Antioxidants normally prevent the damaging effects of oxidative stress and reactive oxygen species produced by inflammatory cells in the lungs. The idea is that low intake of antioxidants such as vitamin C leads to an imbalance that favors chronic inflammation and damage to the lungs.

Research studies have found that some asthmatics with low levels of vitamin C experience more asthma symptoms, suggesting that supplementation might improve asthma. Low levels are reported by patients and confirmed in their blood and lungs.

However, studies looking at supplementation were small and demonstrated mixed results with objective measures of asthma control such as FEV1,

Foods With Plenty of Vitamin C

If you want to increase your vitamin C intake you can increase:

  • Bell peppers
  • Broccoli
  • Green leafy vegetables
  • Lemons
  • Oranges
  • Strawberries
  • Tomatoes

Can I Take Too Much Vitamin C?

Vitamin C is generally thought of as safe but high doses can lead to nausea, diarrhea, kidney stones.

Bottom Line For My Asthma

While there is evidence both for and against the benefit of vitamin C supplementation in terms of your asthma control, there is not enough to recommend that all or certain asthmatics include supplementation as part of their treatment plan.

A Cochrane review of vitamin C for asthma concluded that a definitive conclusion was not possible due to lack of research and recommended further study to clarify the topic.

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Vitamin E

Cut and Uncut Avocados
Michael Pole / Getty Images

Vitamin E is a fat-soluble vitamin found in certain nuts, seeds, oils, and green leafy vegetables. Many patients take vitamin E supplements as a preventive measure to decrease risk a wide range of disorders including heart disease, cancer, and Parkinson’s disease.

Eating a healthy diet makes it unlikely you will have vitamin E deficiency requiring supplementation.

What It Does

Vitamin E has anti-inflammatory and antioxidant effects in the lung and decreases certain inflammatory markers such as neutrophils. Like vitamin C, low levels of vitamin E have been demonstrated in both the diet, blood, and lungs.

Low levels of vitamin E are also associated with evidence of poor lung function and higher levels were associated with decreased asthma severity and improved lung function.
Studies looking at vitamin E in pregnancy are conflicting as to whether this impacts the development of childhood asthma even though higher levels of vitamin E were indicative of lower IgE.

Foods With Plenty of Vitamin E

If you want to increase your vitamin E intake, you can increase:

  • Avocado
  • Almond and other nuts
  • Broccoli
  • Fish
  • Olive oil
  • Shellfish like shrimp
  • Spinach
  • Squash
  • Sunflower seeds
  • Tofu

Can I Take Too Much Vitamin E?

Yes. People taking the recommended daily amount are unlikely to develop side effects and vitamin E is generally considered safe.

Taking too much vitamin E has been associated with and increased risk of bleeding and hemorrhagic stroke as well as congestive heart failure. Too much vitamin E can lead to rash, nausea, diarrhea, stomach cramping, weakness, headache, and visual changes.

Bottom Line for My Asthma

The evidence both for and against the benefit of vitamin E supplementation in terms of your asthma control led the previously mentioned Cochrane review to conclude that a definitive recommendation was not possible without further research. There is not enough evidence to recommend that all or certain asthmatics include supplementation as part of their treatment plan at this time.

Sources: 

Han YY, Forno E, Holguin F, Celedón JC. Diet and Asthma: An Update. Curr Opin Allergy Clin Immunol. 2015 Aug;15(4):369–74.

Junfang Jiao and Mario Castro. Vitamin D and asthma: current perspectives. Curr Opin Allergy Clin Immunol2015,15:375 –382.

Kaur B, Rowe BH, Stovold E. Vitamin C supplementation for asthma. Cochrane Database of Systematic Reviews 2009, Issue 1.

Misso NLA, Brooks-Wildhaber J, Ray S, Vally H, Thompson PJ. Plasma concentrations of dietary and nondietary antioxidants are low in severe asthma.​​ European Respiratory Journal 2005;26:257–64.

Patel BD, Welch AA, Bingham SA, Luben RN, Day NE, Khaw K-T, et al. Dietary antioxidants and asthma in adults. Thorax 2006;61:388–93.

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