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Better Health News and Comment

An Apple a Day Keeps Asthma Away
By Jeremy Appleton, ND

Healthnotes Newswire — People who eat more apples are less likely to develop asthma than are those who eat few, according to new research published in the American Journal of Respiratory and Critical Care Medicine.1 The study also found that high intake of foods rich in the mineral selenium reduce asthma risk. Among those who already have asthma, consumption of 1 to 2 glasses of red wine per day was associated with reduced severity of the disease.

This is the first study to report a protective effect of high apple intake on asthma, and the first to report a protective effect of high red wine intake on asthma severity. Previous research has consistently found reduced levels of selenium in the blood of adults with asthma,2 so the protective effects of a selenium-rich diet were somewhat anticipated.

Asthma is an inflammatory condition of the airways, where breathing becomes restricted due to constriction of small air passages in the lungs, called bronchi. Allergies and stress are common triggers of asthma attacks.

What do red wine, apples, and selenium-rich foods (e.g., seafood, meat, eggs, whole grains, legumes, Brazil nuts) have in common? The answer is that they are all rich in antioxidants. Apples and red wine are both high in flavonoids, which have powerful antioxidant properties. However, there are hundreds of different flavonoids in the human diet, and many in apples and red wine. Which ones are responsible for the effects observed in this study? It is not possible to say with certainty. The authors of the study suggest that the blue-black pigments (anthocyanins) found in grapes, berries, and many other plants may be key, since they are present in both apples and red wine. Anthocyanins are powerful antioxidants and free radical scavengers. These flavonoids could reduce asthma inflammation through a variety of known mechanisms.

Selenium may also be capable of suppressing the inflammation of asthma. Selenium, itself an antioxidant, is required to activate one of the most important antioxidants found in the body, called glutathione. Glutathione is thought to protect against oxidative stress in the air passages and could thus mitigate the signs and symptoms of asthma. Interestingly, glutathione and anthocyanins have shown uniquely synergistic properties in test tube research, in which they recycle one another back to their active forms and may increase each other’s efficacy.3

For reasons beyond those suggested by the current research, it appears prudent to eat apples 2 to 4 times per week, drink a glass of red wine in the evening, and eat plenty of whole grains. Do the results of the new study mean that people with asthma should take selenium or flavonoid supplements? Unfortunately, the research does not go far enough to make such a conclusion possible. Population-based studies such as this one are only able to establish associations, not cause-and-effect relationships. Selenium, for example, may only be a marker for some other component of the diet that protects against asthma. Population-based studies can suggest a direction for future research, but controlled clinical trials of individual nutrients would be required to state with confidence that any particular supplement could help people with asthma.

Controlled clinical trials have been conducted for several nutritional and herbal supplements. In fact, one small clinical trial has even been conducted on selenium, in which supplementation with 100 mcg of sodium selenite (a form of selenium) per day for 14 weeks resulted in clinical improvement in six of eleven people with asthma, compared with only one of ten in the placebo group.4

People with asthma, in addition to following the dietary advice suggested by the new study, may also want to consider other supplements, such as fish oil (rich in eicosapentaenoic acid, or EPA),5 lycopene,6 magnesium,7 8 vitamin B6,9 10 and vitamin C.11 Research on all of these nutrients is fairly preliminary and, in some cases (such as vitamin C and fish oil), contradictory. Herbs that have demonstrated some efficacy against asthma in preliminary studies include boswellia,12 coleus,13 ephedra,14 ivy leaf, picrorhiza,15 16 and tylophora.17 18 As with the nutrient supplements discussed above, research on these herbal preparations is of a preliminary nature, and contradictory evidence also exists for some of them.

Asthma is a potentially serious medical condition and should always be treated under the care and supervision of a qualified healthcare practitioner.

1. Shaheen SO, Sterne JAC, Thompson RL, et al. Dietary antioxidants and asthma in adults. Am J Crit Care Med 2001;164:1823–8.
2. Fogerty A, Britton J. The role of diet in the aetiology of asthma. Clin Exp Allergy 2000;30:615–27.
3. Olenschleger G, Treusch G. Reduced glutathione and anthocyans: Redox cycling and redox recycling in living systems. Praxis-Telegramm 1994;6:1–20.
4. Hasselmark L, Malmgren R, Zetterstrom O, Unge G. Selenium supplementation in intrinsic asthma. Allergy 1993;48:30–6.
5. Nagakura T, Matsuda S, Shichijyo K, et al. Dietary supplementation with fish oil rich in omega-3 polyunsaturated fatty acids in children with bronchial asthma. Eur Respir J 2000;16:861–5.
6. Neuman I, Nahum H, Ben-Amotz A. Reduction of exercise-induced asthma oxidative stress by lycopene, a natural antioxidant. Allergy 2000;55:1184–9.
7. Rylander R, Dahlberg C, Rubenowitz E. Magnesium supplementation decreases airway responsiveness among hyperreactive subjects. Magnesium-Bulletin 1997;19:4–6.
8. Hill J, Micklewright A, Lewis S, Britton J. Investigation of the effect of short-term change in dietary magnesium intake in asthma. Eur Respir J 1997;10:2225–9.
9. Collipp PJ, Goldzier S III, Weiss N, et al. Pyridoxine treatment of childhood bronchial asthma. Ann Allergy 1975;35:93–7.
10. Reynolds RD, Natta CL. Depressed plasma pyridoxal phosphate concentrations in adult asthmatics. Am J Clin Nutr 1985;41:684–8.
11. Schachter EN, Schlesinger A. The attenuation of exercise-induced bronchospasm by ascorbic acid. Ann Allergy 1982;49:146–51.
12. Gupta I, Gupta V, Parihar A, et al. Effects of Boswellia serrata gum resin in patients with bronchial asthma: results of a double-blind, placebo-controlled, 6-week clinical study. Eur J Med Res 1998;3:511–4.
13. Bauer K, Dietersdorfer F, Sertl K, et al. Pharmacodynamic effects of inhaled dry powder formulations of fenoterol and colforsin in asthma. Clin Pharmacol Ther 1993;43:76–83.
14. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Foods, Drugs, and Cosmetics, 2nd ed. New York: John Wiley and Sons, 1996, 227–9.
15. Rajaram D. A preliminary clinical trial of Picrorrhiza kurroa in bronchial asthma. Indian J Pharmacol 1975;7:95–6.
16. Shan BK, Kamat SR, Sheth UK. Preliminary report of use of Picrorrhiza kurroa root in bronchial asthma. J Postgrad Med 1977;23:118–20.
17. Shivpuri DN, Menon MPS, Prakash D. A crossover double-blind study on Tylophora indica in the treatment of asthma and allergic rhinitis. J Allergy 1969;43:145–50.
18. Shivpuri DN, Singhal SC, Parkash D. Treatment of asthma with an alcoholic extract of Tylophora indica: a cross-over, double-blind study. Ann Allergy 1972;30:407–12.

Jeremy Appleton, ND, is a licensed naturopathic physician, writer, and educator in the field of evidence-based complementary and alternative medicine. Dr. Appleton is Chair of Nutrition at the National College of Naturopathic Medicine.

This article is provided by Healthnotes for theBetterHealthStore. Copyright © 2001 Healthnotes, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.


Information presented at is for educational purposes only; statements about products and health conditions have not been evaluated by the U.S. Food & Drug Administration. Copyright ©2007 Inc.