Effects of Anti-Inflammatory Diet on Pulmonary Function in Pediatric Asthma

抗炎饮食对小儿哮喘肺功能的影响

• 批准号: 8649736
• 负责人: Bridget Mary Hron
• 金额: $ 6.41万
• 依托单位: BOSTON CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-01 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8649736
• 关键词: Address; Adherence; Adipose tissue; Adolescent; Adult; Affect; Age; American; Anti-Inflammatory Agents; Anti-inflammatory; Antioxidants; Asthma; Behavior Therapy; Behavioral; Blood Glucose; Body Weight decreased; C-reactive protein; CCL2 gene; Caloric Restriction; Chicago; Child; Childhood; Childhood Asthma; Chronic; Collaborations; Cross-Over Studies; Cross-Sectional Studies; Data; Development; Diet; Dietary Intervention; Disease; Erythrocyte Sedimentation Rate; Exhalation; Fabaceae; Fatty acid glycerol esters; Fiber; Fishes; Food; Forced expiratory volume function; Future; Glycemic Index; Home environment; Inflammation; Inflammatory; Insulin; Insulin Resistance; Intake; Interleukin-6; Intervention; Intestines; Macronutrients Nutrition; Measures; Mediator of activation protein; Micronutrients; Modeling; Monocyte Chemoattractant Proteins; Mucous Membrane; Multivariate Analysis; Necrosis; Nitric Oxide; Nutritional; Obesity; Omega-3 Fatty Acids; Outcome; Overweight; Participant; Patients; Physiological; Plasminogen Activator Inhibitor 1; Population; Population Heterogeneity; Principal Component Analysis; Property; Proteins; Pulmonary Function Test/Forced Expiratory Volume 1; Quality of life; Questionnaires; Randomized; Reporting; Respiratory physiology; Serum; Severities; Spirometry; Testing; Tissues; Translating; Treatment Cost; Vegetables; Vital capacity; Volatile Fatty Acids; Weight; adiponectin; airway inflammation; arm; base; chemokine; fasting glucose; feeding; fruits and vegetables; improved; indexing; inflammatory marker; insulin sensitivity; macrophage; microbiome; novel; nutrition; primary outcome; public health relevance; pulmonary function; response; secondary outcome; subcutaneous

DESCRIPTION (provided by applicant): Asthma affects nearly 10% of American children, resulting in treatment costs alone in excess of $3 billion annually. Asthma is highly correlated with obesity and quality of nutritional in multiple cross-sectional studies, although the mechanism of this association remains speculative. Limited interventional studies in adults with asthma, relying on behavioral modification, report improvements in asthma control with caloric restriction and diets enriched with antioxidants and omega-3 fatty acids. Low glycemic index and high fiber diets may decrease systemic inflammation, according to observational analyses and feeding studies, but this dietary strategy has not been investigated in this population. A diet harnessing the anti-inflammatory properties of multiple foods may improve pulmonary function, yet this strategy remains largely untested, especially in children. The specific aim of this projec is to evaluate the effects of a diet that is low in glycemic load and abundant in fiber, fruits, vegetables, legumes and omega-3 fatty acids (identified in this proposal as the "anti-inflammatory diet") on pulmonary function in lean and overweight pediatric patients with asthma. The primary endpoint will be change in forced expiratory volume in one second in response to the diet intervention. Secondary outcomes will include additional spirometry measures, fraction of exhaled nitric oxide, and assessment of symptomatic asthma control. In addition, we will identify potential physiological mechanisms relating diet with lung function, including changes in systemic and adipose-specific inflammation, insulin sensitivity, and intestinal microbiome composition. Forty patients, age 10-18 years, with moderate to severe persistent asthma will be randomized to receive an anti-inflammatory diet versus habitual diet for 6 weeks, with crossover to the opposite diet for an additional 6 weeks. Both diets will be isocaloric and weight maintaining, to isolate the effects of the dietary composition from the known beneficial effects of weight loss. During the intervention period, meals will be delivered directly to subjects' homes through a novel collaboration with LYFE Kitchen (Chicago, IL), maintaining careful control of macro- and micronutrient content. During the habitual diet, participants will consume self-prepared meals. If successful, this study will contribute to a mechanistic understanding of asthma, and could inform the development of a novel, safe and easily translatable approach to asthma management. Future studies would 1) confirm the results in larger and more heterogeneous populations; 2) translate findings into sustainable interventions and 3) further explore the underlying mechanisms relating dietary intervention to lung function.

哮喘影响近10%的美国儿童，每年仅治疗费用就超过30亿美元。在多项横断面研究中，哮喘与肥胖和营养质量高度相关，尽管这种关联的机制仍然是推测性的。在成人哮喘患者中进行的有限的干预性研究，依赖于行为矫正，报告了通过限制热量和富含抗氧化剂和ω-3脂肪酸的饮食来控制哮喘的改善。根据观察分析和喂养研究，低血糖指数和高纤维饮食可能会减少全身炎症，但这种饮食策略尚未在该人群中进行研究。节食 利用多种食物的抗炎特性可能会改善肺功能，但这种策略在很大程度上尚未得到验证，特别是在儿童中。本项目的具体目的是评估低血糖负荷和富含纤维、水果、蔬菜、豆类和ω-3脂肪酸的饮食（在本提案中被确定为“抗炎饮食”）对偏瘦和超重的哮喘儿童患者肺功能的影响。主要终点是饮食干预后1秒内用力呼气量的变化。次要结局将包括额外的肺功能测定、呼出一氧化氮分数和症状性哮喘控制评估。此外，我们将确定饮食与肺功能相关的潜在生理机制，包括全身性和脂肪特异性炎症，胰岛素敏感性和肠道微生物组组成的变化。40例年龄为10-18岁的中度至重度持续性哮喘患者将随机接受抗炎饮食与习惯性饮食治疗6周，并交叉至另一种饮食治疗6周。两种饮食都是等热量的和维持体重的，以将饮食组合物的作用与已知的有益作用分离， 减肥.在干预期间，将通过与LYFE Kitchen（芝加哥，IL）的新型合作，将膳食直接送到受试者家中，保持对宏量和微量营养素含量的仔细控制。在习惯饮食期间，参与者将食用自制的饭菜。如果成功，这项研究将有助于对哮喘的机制性理解，并可能为开发一种新颖，安全和易于翻译的哮喘管理方法提供信息。未来的研究将1）在更大和更异质的人群中证实结果; 2）将研究结果转化为可持续的干预措施; 3）进一步探索饮食干预与肺功能相关的潜在机制。