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Nutrition and Lung Disease

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: closed (15 March 2023) | Viewed by 39762

Special Issue Editors

Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, The Netherlands
Interests: clinical nutrition; COPD; lung cancer; metabolism; pulmonary rehabilitation; muscle
Faculty of Health, Medicine & Life Sciences, Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
Interests: nutrition; metabolic phenotyping; lifestyle; interventions; lung disease

Special Issue Information

Dear Colleagues,

Lung diseases are a global health problem in which high disease burden and mortality risk is not only caused by the respiratory impairment itself, but also by acute exacerbations and extra-pulmonary disease manifestations. Dietary habits and specific nutrients are involved in the development as well as progression of acute and chronic lung diseases and related comorbidities. From this broad perspective, this Special Issue will focus on the role of nutrition as a modifiable factor in the prevention and management of lung disease. We therefore welcome the submission of manuscripts describing original research or reviewing the scientific literature, preferably systematically, on this topic.

Prof. Dr. Annemie M. W. J. Schols
Dr. Rosanne J. H. C. G. Beijers
Guest Editors

Manuscript Submission Information

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Keywords

  • acute lung disease
  • chronic lung disease
  • prevention
  • management
  • extrapulmonary manifestations
  • pathophysiology

Published Papers (11 papers)

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Research

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19 pages, 675 KiB  
Article
Mediterranean Diet and Lung Function in Adults Current Smokers: A Cross-Sectional Analysis in the MEDISTAR Project
by Roxana-Elena Catalin, Francisco Martin-Lujan, Patricia Salamanca-Gonzalez, Meritxell Palleja-Millan, Felipe Villalobos, Antoni Santigosa-Ayala, Anna Pedret, Rosa M. Valls-Zamora, Rosa Sola and on behalf of the MEDISTAR Research Group Investigators
Nutrients 2023, 15(5), 1272; https://doi.org/10.3390/nu15051272 - 03 Mar 2023
Cited by 1 | Viewed by 2383
Abstract
Background: Previous studies have shown that adherence to the Mediterranean Diet (MeDi) has a positive impact on lung function in subjects with lung disease. In subjects free of respiratory diseases, but at risk, this association is not yet well established. Methods: Based on [...] Read more.
Background: Previous studies have shown that adherence to the Mediterranean Diet (MeDi) has a positive impact on lung function in subjects with lung disease. In subjects free of respiratory diseases, but at risk, this association is not yet well established. Methods: Based on the reference data from the MEDISTAR clinical trial (Mediterranean Diet and Smoking in Tarragona and Reus; ISRCTN 03.362.372), an observational study was conducted with 403 middle-aged smokers without lung disease, treated at 20 centres of primary care in Tarragona (Catalonia, Spain). The degree of MeDi adherence was evaluated according to a 14-item questionnaire, and adherence was defined in three groups (low, medium, and high). Lung function were assessed by forced spirometry. Logistic regression and linear regression models were used to analyse the association between adherence to the MeDi and the presence of ventilatory defects. Results: Globally, the pulmonary alteration prevalence (impaired FEV1 and/or FVC) was 28.8%, although it was lower in participants with medium and high adherence to the MeDi, compared to those with a low score (24.2% and 27.4% vs. 38.5%, p = 0.004). Logistic regression models showed a significant and independent association between medium and high adherence to the MeDi and the presence of altered lung patterns (OR 0.467 [95%CI 0.266, 0.820] and 0.552 [95%CI 0.313, 0.973], respectively). Conclusions: MeDi adherence is inversely associated with the risk impaired lung function. These results indicate that healthy diet behaviours can be modifiable risk factors to protect lung function and reinforce the possibility of a nutritional intervention to increase adherence to MeDi, in addition to promoting smoking cessation. Full article
(This article belongs to the Special Issue Nutrition and Lung Disease)
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10 pages, 1087 KiB  
Article
Gender Differences in Vitamin D Status and Determinants of Vitamin D Insufficiency in Patients with Chronic Obstructive Pulmonary Disease
by Maria Minter, Hanna Augustin, Jenny van Odijk and Lowie E. G. W. Vanfleteren
Nutrients 2023, 15(2), 426; https://doi.org/10.3390/nu15020426 - 13 Jan 2023
Cited by 6 | Viewed by 2427
Abstract
Low vitamin D levels are common in Chronic Obstructive Pulmonary Disease (COPD) and have been associated with various adverse COPD-related outcomes. Recent data on vitamin D status in representative COPD cohorts in Scandinavia is lacking. This study aimed to assess vitamin D status [...] Read more.
Low vitamin D levels are common in Chronic Obstructive Pulmonary Disease (COPD) and have been associated with various adverse COPD-related outcomes. Recent data on vitamin D status in representative COPD cohorts in Scandinavia is lacking. This study aimed to assess vitamin D status and determinants of vitamin D insufficiency in patients with COPD who were attending a specialist secondary care COPD clinic in Southwestern Sweden. All patients who visited the COPD clinic for their first medical visit during two periods, 2017–2018 and 2021, were included in this observational study. Measurements of 25-Hydroxyvitamin D (25(OH)D), clinical data and documentation of supplements containing vitamin D were collected retrospectively from patients’ medical records. Multivariable logistic regression analysis was performed to identify determinants of the primary outcome, vitamin D insufficiency (25(OH)D < 50 nmol/L). A total of 667 patients were included, and 33% had vitamin D insufficiency. The median 25(OH)D was 62 nmol/L (43.5–83.1 nmol/L). Vitamin D insufficiency was related to the male gender, current smoking habits, a lack of supplements containing vitamin D and the winter season for blood sampling. In conclusion, vitamin D insufficiency is common in patients with COPD. Men had significantly lower levels of vitamin D but took vitamin D-containing supplements less frequently compared to women. Our findings can help clinicians to identify patients who are at risk of vitamin D insufficiency and allow correction with supplementation where appropriate. Full article
(This article belongs to the Special Issue Nutrition and Lung Disease)
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13 pages, 750 KiB  
Article
Maternal Diet Quality during Pregnancy and Allergic and Respiratory Multimorbidity Clusters in Children from the EDEN Mother–Child Cohort
by Rosalie Delvert, Manel Ghozal, Karine Adel-Patient, Manik Kadawathagedara, Barbara Heude, Marie-Aline Charles, Isabella Annesi-Maesano, Muriel Tafflet, Bénédicte Leynaert, Raphaëlle Varraso, Blandine de Lauzon-Guillain and Annabelle Bédard
Nutrients 2023, 15(1), 146; https://doi.org/10.3390/nu15010146 - 28 Dec 2022
Cited by 3 | Viewed by 2496
Abstract
We investigated the associations between maternal diet quality and allergic and respiratory diseases in children. Analyses were based on 1316 mother–child pairs from the EDEN mother–child cohort. Maternal diet quality during pregnancy was assessed through a food-based score (the Diet Quality), a nutrient-based [...] Read more.
We investigated the associations between maternal diet quality and allergic and respiratory diseases in children. Analyses were based on 1316 mother–child pairs from the EDEN mother–child cohort. Maternal diet quality during pregnancy was assessed through a food-based score (the Diet Quality), a nutrient-based score (the PANDiet), and the adherence to guidelines for main food groups. Clusters of allergic and respiratory multimorbidity clusters up to 8 years were identified using Latent Class Analysis. Associations were assessed by adjusted multinomial logistic regressions. Four clusters were identified for children: “asymptomatic” (67%, reference group), “asthma only” (14%), “allergies without asthma” (12%), “multi-allergic” (7%). These clusters were not associated with mother diet quality assessed by both scores. Children from mothers consuming legumes once a month or less were at higher risk of belonging to the “multi-allergic” cluster (odds ratio (OR) (95% confidence interval (95%CI)) = 1.60 (1.01;2.54)). No association was found with other food groups or other clusters. In our study, allergic and respiratory multimorbidity in children was described with four distinct clusters. Our results suggest an interest in legumes consumption in the prevention of allergic diseases but need to be confirmed in larger cohorts and randomized control trials. Full article
(This article belongs to the Special Issue Nutrition and Lung Disease)
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18 pages, 717 KiB  
Article
Plant-Based Diets and the Incidence of Asthma Symptoms among Elderly Women, and the Mediating Role of Body Mass Index
by Wassila Ait-hadad, Annabelle Bédard, Rosalie Delvert, Laurent Orsi, Sébastien Chanoine, Orianne Dumas, Nasser Laouali, Nicole Le Moual, Bénédicte Leynaert, Valérie Siroux, Marie-Christine Boutron-Ruault and Raphaëlle Varraso
Nutrients 2023, 15(1), 52; https://doi.org/10.3390/nu15010052 - 22 Dec 2022
Cited by 2 | Viewed by 15822
Abstract
We aimed to test the hypothesis that adherence to a healthful plant-based diet (hPDI) is associated with a subsequent decrease in the incidence of asthma symptoms, with an opposite association with adherence to an unhealthful plant-based diet (uPDI). In addition, we evaluated a [...] Read more.
We aimed to test the hypothesis that adherence to a healthful plant-based diet (hPDI) is associated with a subsequent decrease in the incidence of asthma symptoms, with an opposite association with adherence to an unhealthful plant-based diet (uPDI). In addition, we evaluated a potential mediating role of body mass index (BMI) and the modifying effect of smoking. Among 5700 elderly women from the French Asthma-E3N study with dietary data in 1993 and 2005, we assessed the incidence of asthma symptoms in 2018 among women with no asthma symptoms in 2011. BMI was evaluated in 2008. Mediation analyses in the counterfactual framework were used to disentangle total, direct, and indirect effects mediated by BMI. We found that both healthful and unhealthful plant-based diets were associated with a lower incidence of asthma symptoms over time, mediated by BMI (OR (95%CI) for the indirect effect: 0.94 (0.89–1.00) for hPDI and 0.92 (0.70–1.00) for uPDI)). Associations with both healthful and unhealthful PDIs were mediated by changes in BMI by 33% and 89%, respectively. Plant-based diets (healthful and unhealthful) were associated with subsequently reduced incidences of asthma symptoms over time, partly or almost totally mediated by BMI according to their nutritional quality. Full article
(This article belongs to the Special Issue Nutrition and Lung Disease)
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13 pages, 3313 KiB  
Article
Uteroplacental Insufficiency Causes Microbiota Disruption and Lung Development Impairment in Growth-Restricted Newborn Rats
by Yu-Chen S. H. Yang, Hsiu-Chu Chou, Yun-Ru Liu and Chung-Ming Chen
Nutrients 2022, 14(20), 4388; https://doi.org/10.3390/nu14204388 - 19 Oct 2022
Cited by 6 | Viewed by 1445
Abstract
Preclinical studies have demonstrated that intrauterine growth retardation (IUGR) is associated with reduced lung development during the neonatal period and infancy. Uteroplacental insufficiency (UPI), affecting approximately 10% of human pregnancies, is the most common cause of IUGR. This study investigated the effects of [...] Read more.
Preclinical studies have demonstrated that intrauterine growth retardation (IUGR) is associated with reduced lung development during the neonatal period and infancy. Uteroplacental insufficiency (UPI), affecting approximately 10% of human pregnancies, is the most common cause of IUGR. This study investigated the effects of UPI on lung development and the intestinal microbiota and correlations in newborn rats with IUGR, using bilateral uterine artery ligation to induce UPI. Maternal fecal samples were collected on postnatal day 0. On postnatal days 0 and 7, lung and intestinal microbiota samples were collected from the left lung and the lower gastrointestinal tract. The right lung was harvested for histological assessment and Western blot analysis. Results showed that UPI through bilateral uterine artery ligation did not alter the maternal gut microbiota. IUGR impaired lung development and angiogenesis in newborn rats. Moreover, on postnatal day 0, the presence of Acinetobacter and Delftia in the lungs and Acinetobacter and Nevskia in the gastrointestinal tract was negatively correlated with lung development. Bacteroides in the lungs and Rodentibacter and Romboutsia in the gastrointestinal tract were negatively correlated with lung development on day 7. UPI may have regulated lung development and angiogenesis through the modulation of the newborn rats’ intestinal and lung microbiota. Full article
(This article belongs to the Special Issue Nutrition and Lung Disease)
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12 pages, 567 KiB  
Article
Longitudinal Analysis of Quadriceps Muscle Strength in Patients with Previous COVID-19 Hospitalization and in Patients with Post-Acute Sequelae following Mild COVID-19
by Anouk A. F. Stoffels, Esther L. van Voorthuizen, Hieronymus W. H. van Hees, Jeannette B. Peters, Hanneke A. C. van Helvoort, Nicol C. Voermans, Jonne Doorduin and Bram van den Borst
Nutrients 2022, 14(20), 4319; https://doi.org/10.3390/nu14204319 - 15 Oct 2022
Cited by 5 | Viewed by 1836
Abstract
Muscle weakness is a prominent symptom in post-acute sequelae of COVID-19 (PASC). However, few studies have objectively and longitudinally assessed muscle strength after varying COVID-19 severity grades. This observational study aimed to explore the prevalence, determinants, and 1.5 years change of quadriceps muscle [...] Read more.
Muscle weakness is a prominent symptom in post-acute sequelae of COVID-19 (PASC). However, few studies have objectively and longitudinally assessed muscle strength after varying COVID-19 severity grades. This observational study aimed to explore the prevalence, determinants, and 1.5 years change of quadriceps muscle weakness in 98 patients discharged from COVID-19 hospitalization and in 50 patients with PASC following mild COVID-19. Isometric quadriceps maximal voluntary contraction (MVC) was assessed on a computerized dynamometer at three visits. Also, in a subgroup of 14 post-COVID-19 patients with quadriceps muscle weakness, muscle thickness and echo intensity were determined by muscle ultrasound of nine upper and lower extremity muscles. Muscle weakness was found in 59% of post-hospitalized patients and in 65% of those with PASC following mild COVID-19 at ~14 weeks after acute COVID-19. Whereas during ~1.5 years follow-up MVC modestly improved, muscle weakness prevalence remained unchanged. Hospital length of stay and diabetes mellitus were identified as possible predictors of muscle weakness following COVID-19 hospitalization. No predictors could be identified in those with PASC following mild COVID-19. Ultrasound outcomes revealed no large structural abnormalities. In conclusion, clinically relevant muscle weakness is common after COVID-19 and its long-term improvement is poor. Future studies with relevant control groups are warranted to confirm our data. Full article
(This article belongs to the Special Issue Nutrition and Lung Disease)
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10 pages, 299 KiB  
Article
Evaluation of Simplified Diet Scores Related to C-Reactive Protein in Heavy Smokers Undergoing Lung Cancer Screening
by Federica Sabia, Alessandra Borgo, Alessandra Lugo, Paola Suatoni, Daniele Morelli, Silvano Gallus, Anna Villarini and Ugo Pastorino
Nutrients 2022, 14(20), 4312; https://doi.org/10.3390/nu14204312 - 15 Oct 2022
Viewed by 1205
Abstract
The aim of this study was to assess the relationship between adherence to a healthy diet, such as the Mediterranean diet (MedDiet), and C-reactive protein (CRP) in Italian heavy smokers undergoing an LDCT screening program (bioMILD trial), using scores calculated by simple [...] Read more.
The aim of this study was to assess the relationship between adherence to a healthy diet, such as the Mediterranean diet (MedDiet), and C-reactive protein (CRP) in Italian heavy smokers undergoing an LDCT screening program (bioMILD trial), using scores calculated by simple questionnaires. Simple formats of food frequency questionnaires were administered to a sample of 2438 volunteers, and the adherence to a healthy diet was measured by the validated 14-point MEDAS and by two adaptations proposed by us: 17-item revised-MEDAS and 18-item revised-MEDAS. The OR of CRP ≥ 2 mg/L for 1-point increase in 14-point MEDAS score was 0.95 (95% CI 0.91–0.99), for 17-point score was 0.94 (95% CI 0.91–0.98), and for 18-point score was 0.92 (95% CI 0.88–0.97). These inverse associations remained statistically significant also after further adjustment for body mass index. These results showed the efficacy of simplified scores and their relationship with lower levels of CRP in a population of heavy smokers. This suggests that a targeted nutritional intervention might achieve a substantial reduction in CRP levels. The findings will be prospectively tested in a new randomized study on primary prevention during lung cancer screening. Full article
(This article belongs to the Special Issue Nutrition and Lung Disease)
17 pages, 2079 KiB  
Article
Body Composition-Specific Asthma Phenotypes: Clinical Implications
by Xin Zhang, Ke Deng, Yulai Yuan, Lei Liu, Shuwen Zhang, Changyong Wang, Gang Wang, Hongping Zhang, Lei Wang, Gaiping Cheng, Lisa G. Wood and Gang Wang
Nutrients 2022, 14(12), 2525; https://doi.org/10.3390/nu14122525 - 17 Jun 2022
Viewed by 2194
Abstract
Background: Previous studies have indicated the limitations of body mass index for defining disease phenotypes. The description of asthma phenotypes based on body composition (BC) has not been largely reported. Objective: To identify and characterize phenotypes based on BC parameters in patients with [...] Read more.
Background: Previous studies have indicated the limitations of body mass index for defining disease phenotypes. The description of asthma phenotypes based on body composition (BC) has not been largely reported. Objective: To identify and characterize phenotypes based on BC parameters in patients with asthma. Methods: A study with two prospective observational cohorts analyzing adult patients with stable asthma (n = 541 for training and n = 179 for validation) was conducted. A body composition analysis was performed for the included patients. A cluster analysis was conducted by applying a 2-step process with stepwise discriminant analysis. Logistic regression models were used to evaluate the association between identified phenotypes and asthma exacerbations (AEs). The same algorithm for cluster analysis in the independent validation set was used to perform an external validation. Results: Three clusters had significantly different characteristics associated with asthma outcomes. An external validation identified the similarity of the participants in training and the validation set. In the training set, cluster Training (T) 1 (29.4%) was “patients with undernutrition”, cluster T2 (18.9%) was “intermediate level of nutrition with psychological dysfunction”, and cluster T3 (51.8%) was “patients with good nutrition”. Cluster T3 had a decreased risk of moderate-to-severe and severe AEs in the following year compared with the other two clusters. The most important BC-specific factors contributing to being accurately assigned to one of these three clusters were skeletal muscle mass and visceral fat area. Conclusion: We defined three distinct clusters of asthma patients, which had distinct clinical features and asthma outcomes. Our data reinforced the importance of evaluating BC to determining nutritional status in clinical practice. Full article
(This article belongs to the Special Issue Nutrition and Lung Disease)
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13 pages, 1126 KiB  
Article
The Association between Daily Dietary Intake of Riboflavin and Lung Function Impairment Related with Dibutyl Phthalate Exposure and the Possible Mechanism
by Jilei Lin, Siying Cheng, Jing Zhang, Shuhua Yuan, Lei Zhang, Jinhong Wu, Jiande Chen, Mingyu Tang, Yabin Hu, Shilu Tong, Liebin Zhao and Yong Yin
Nutrients 2022, 14(11), 2282; https://doi.org/10.3390/nu14112282 - 29 May 2022
Cited by 2 | Viewed by 1901
Abstract
This study aimed to evaluate the relationship between the daily dietary intake of riboflavin (DDIR) and impaired lung function associated with dibutyl phthalate (DBP) exposure. Data of 4631 adults in this national cross-sectional survey were included. Urinary mono-benzyl phthalate (MBP) was used to [...] Read more.
This study aimed to evaluate the relationship between the daily dietary intake of riboflavin (DDIR) and impaired lung function associated with dibutyl phthalate (DBP) exposure. Data of 4631 adults in this national cross-sectional survey were included. Urinary mono-benzyl phthalate (MBP) was used to evaluate the level of DBP exposure. The ln-transformed urinary creatinine-corrected MBP (ln(MBP/UCr)) level was used in the statistical models. High DDIR was defined as the DDIR ≥1.8 mg per day. The results of lung function impairment and high monocytes were significantly higher in the highest MBP group compared with the lowest MBP group. A significant interaction between ln(MBP/UCr) and DDIR (Pinteraction = 0.029) was detected for the risk of lung function impairment. The risk of lung function impairment (ORquartiles4 vs. 1 1.85, 95% CI, 1.27–2.71; Ptrend = 0.018) and high neutrophils (ORquartiles4 vs. 1 1.45, 95% CI, 1.06–1.97; Ptrend = 0.018) was significantly higher in the highest vs. the lowest quartile of MBP in participants with low/normal DDIR but not in in participants with high DDIR. The results of this study showed that high DDIR was associated with less lung function impairment related with DBP exposure, and the inhibiting of the neutrophil recruitment might be the potential mechanism. Full article
(This article belongs to the Special Issue Nutrition and Lung Disease)
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Review

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13 pages, 509 KiB  
Review
Nutritional State and COPD: Effects on Dyspnoea and Exercise Tolerance
by Angela Tramontano and Paolo Palange
Nutrients 2023, 15(7), 1786; https://doi.org/10.3390/nu15071786 - 06 Apr 2023
Cited by 7 | Viewed by 2727
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a disease that is spreading worldwide and is responsible for a huge number of deaths annually. It is characterized by progressive and often irreversible airflow obstruction, with a heterogeneous clinical manifestation based on disease severity. Along with [...] Read more.
Chronic Obstructive Pulmonary Disease (COPD) is a disease that is spreading worldwide and is responsible for a huge number of deaths annually. It is characterized by progressive and often irreversible airflow obstruction, with a heterogeneous clinical manifestation based on disease severity. Along with pulmonary impairment, COPD patients display different grades of malnutrition that can be linked to a worsening of respiratory function and to a negative prognosis. Nutritional impairment seems to be related to a reduced exercise tolerance and to dyspnoea becoming a major determinant in patient-perceived quality of life. Many strategies have been proposed to limit the effects of malnutrition on disease progression, but there are still limited data available to determine which of them is the best option to manage COPD patients. The purpose of this review is to highlight the main aspects of COPD-related malnutrition and to underline the importance of poor nutritional state on muscle energetics, exercise tolerance and dyspnoea. Full article
(This article belongs to the Special Issue Nutrition and Lung Disease)
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22 pages, 2069 KiB  
Review
Negative Effects of Chronic High Intake of Fructose on Lung Diseases
by Adrián Hernández-Díazcouder, Javier González-Ramírez, Fausto Sanchez, José J. Leija-Martínez, Gustavo Martínez-Coronilla, Luis M. Amezcua-Guerra and Fausto Sánchez-Muñoz
Nutrients 2022, 14(19), 4089; https://doi.org/10.3390/nu14194089 - 01 Oct 2022
Cited by 3 | Viewed by 4091
Abstract
In the modern diet, excessive fructose intake (>50 g/day) had been driven by the increase, in recent decades, of the consumption of sugar-sweetened beverages. This phenomenon has dramatically increased within the Caribbean and Latin American regions. Epidemiological studies show that chronic high intake [...] Read more.
In the modern diet, excessive fructose intake (>50 g/day) had been driven by the increase, in recent decades, of the consumption of sugar-sweetened beverages. This phenomenon has dramatically increased within the Caribbean and Latin American regions. Epidemiological studies show that chronic high intake of fructose related to sugar-sweetened beverages increases the risk of developing several non-communicable diseases, such as chronic obstructive pulmonary disease and asthma, and may also contribute to the exacerbation of lung diseases, such as COVID-19. Evidence supports several mechanisms—such as dysregulation of the renin–angiotensin system, increased uric acid production, induction of aldose reductase activity, production of advanced glycation end-products, and activation of the mTORC1 pathway—that can be implicated in lung damage. This review addresses how these pathophysiologic and molecular mechanisms may explain the lung damage resulting from high intake of fructose. Full article
(This article belongs to the Special Issue Nutrition and Lung Disease)
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