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.

描述（由申请人提供）：哮喘会影响近10％的美国儿童，仅导致每年超过30亿美元的治疗费用。在多个横截面研究中，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投机。哮喘成年人的介入有限研究，依赖行为修饰，报告哮喘控制的改善，并通过热量限制和富含抗氧化剂和omega-3脂肪酸的饮食进行改善。根据观察性分析和喂养研究，低血糖指数和高纤维饮食可能会降低全身性炎症，但是这种饮食策略尚未在该人群中进行研究。饮食 利用多种食物的抗炎特性可以改善肺功能，但这种策略在很大程度上未经测试，尤其是在儿童中。该ProJEC的具体目的是评估血糖负荷较低的饮食效果，并且在纤维，水果，蔬菜，豆类和omega-3脂肪酸（在本提案中鉴定为“抗炎饮食”）对瘦和超重儿科患者的肺功能。主要终点将是响应饮食干预措施的一秒钟强迫呼气量的变化。次要结果将包括额外的肺活量测定指标，呼出一氧化氮的一部分以及对症状性哮喘控制的评估。此外，我们将确定与肺功能有关的潜在生理机制，包括系统性和脂肪特异性炎症的变化，胰岛素敏感性和肠道微生物组组成。 40名患者10-18岁，中度至重度持续性哮喘将被随机分配，以接受抗炎饮食与惯性饮食6周，跨越饮食持续6周。两种饮食都将是等量平衡的和维持重量的，以将饮食成分的影响与已知 减肥。在干预期间，通过与Lyfe Kitchen（伊利诺伊州芝加哥）的新型合作，将直接将餐点直接交付给对象的房屋，并仔细控制宏观和微量营养素含量。在习惯性饮食中，参与者将食用自准备的饭菜。如果成功，这项研究将有助于对哮喘的机械理解，并可以为一种新颖，安全且易于翻译的哮喘管理方法提供信息。未来的研究将1）确认更大，更异质的人群的结果； 2）将发现转化为可持续干预措施，3）进一步探索饮食干预与肺功能有关的基本机制。