# Exercise as it relates to Disease/The Improvement in Asthma, As Related to Physical Activity, Vitamins, and Antioxidant Loads

This is an analysis of the journal article “Relationship Between Oxidative Stress, Physical Activity, and Vitamin Intake in Patients with Asthma,” by Yamasaki et al (2017).

## What is the background to this research?

Asthma is a prevalent and serious respiratory disease worldwide. It is known that oxidative stress plays a triggering role in bronchial asthma. It is also known that both nutrition and physical activity both contribute to antioxidant function. The researchers investigated the relationships between oxidative stress and pulmonary function to serum vitamin levels, dietary intake, and daily activities.

## Where is the research from?

This research was conducted through the Tottori University Faculty of Medicine, in Yonago, Japan. The researchers who conducted this study have previously investigated the prevalence of asthma in Japan, with results showing approximately one in six children suffer from asthma.
The authors of this study have contributed to over 15,000 studies between them, in areas that include (but are not limited to) cardiopulmonary function and disease, gene expression, effects of nutrition on bodily functions and pathologies, physiological changes with exercise and microcellular and biochemical interactions.
The authors declare no conflict of interest with this study.

## What kind of research was this?

This study was a short term observational study. The evidence from this study demonstrated a high level of correlation with other studies in this field.

## What did the research involve?

18 patients participated in this research, with a median age of 63.3 years. All participants were healthy, with stable asthma, with no deterioration of symptoms during the 4 weeks prior to participation. All patients had diagnosed asthma as diagnosed and defined by the American Society Criteria.
Over the course of a week, the researchers collected blood and breath samples, lung function readings, a reflective, self-administered dietary history, and movement monitoring over 7 consecutive days. The researchers used these samples to analyse:
* Oxidative stress and antioxidant potential in the peripheral blood. Oxidative stress was assessed using a radical analyser system, by measuring the diacron reactive oxygen metabolite (dROM), which reflected organic hydropeptides formed by oxidative stress.
* Oxidative stress through exhaled breath condensates. All participants breathed into an EcoScreen to collect exhaled breath condensate (EBC). The H$_2$O$_2$ level was measured with a radical analyzer system. H$_2$O$_2$ is used as an inflammatory marker.
* Pulmonary function using a Chestac 33 spirometer. Forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV$_1$) were measured, and vital capacity (VC) as a percentage of predicted values were reported.
* Measurement of fractional exhaled nitric oxide (FeNO) was obtained using an Aerocrin NIOX MINO, a NO analyser. FeNO is used to measure inflammation markers in asthma.
* Serum vitamin levels were measured through a blood draw. Fractions of vitamin E, levels of retinol, vitamin C, and vitamin D were measured at an external laboratory.
* A brief self-administered diet history questionnaire (BDHQ) was undertaken, involving 58 food and drink questions, which included information over the past month. This was assessed to determine the intake of retinol, beta-carotene, and vitamins C, D and E.
* Activity was monitored by an Actigraph Accelerometer over seven days. One minute of activity was defined as one epoch, and total activity counts were calculated.
The study was limited in scope due to a small number of participants, who were all healthy, and older individuals.

## What were the basic results?

* Oxidative stress was in the "low" category, using the international observational oxidative stress scale. The participants demonstrated a slightly elevated dROM, and an in-range BAP. The levels of H$_2$O$_2$ were demonstrated as higher than normal.
* The mean percentage of pulmonary function demonstrated by the participants was 103.6% of predicted performance based on age.
* The mean FeNO level was 32.4, placing the patients at low to moderate inflammation levels.
* All serum vitamin levels were measured within normal range.
* The estimated daily vitamin intake levels were within the recommended ranges for the age group.
* The participants averaged 283.3 minutes of activity per day.

## How did the researchers interpret the results?

The researchers found no significant relationships between the index of oxidative stress and pulmonary function, levels of vitamins in serum, daily vitamin intakes, or activity levels in asthmatic patients.
The researchers suggest oxidative stress is not related to daily activity, intake of antioxidants, and pulmonary function in patients in real-life setting. The implications of findings are not over-emphasised. The authors are realistic in that they did not find a useful conclusion.

## What conclusions should be taken away from this research?

It is an oddly designed study in its duration and participant pool. The authors are correct in the interpretation of their results in a lack of correlation. Due to constraints, it is not a particularly useful study.
As this is a recent paper, it has not in turn been mentioned in anything published since. The results are linked to other papers all the way through, and correlations, or lack thereof, are marked. Where other research is mentioned, results in this paper match the ones presented in other research.

## What are the implications of this research?

This research provides minimal to no real-world implications as it is presented. However, it will add to the platform of understanding for further research.

## Further reading

* The World Health Organisation Asthma Fact Sheet.
* The National Asthma Council Australia.
* Nutrition Australia Asthma Fact Sheet

## References

* ↑ Yamasaki A et al 2017. Relationship Between Oxidative Stress, Physical Activity, and Vitamin Intake in Patients with Asthma. Yonago Acta Medica. 60(2): 86-93
* ↑ Akasawa A et al 2015. Time Trends in the Prevalence of Asthma in Japanese Children The Journal of Allergy and Clinical Immunology. 135(2): AB229
* ↑ 1986. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) and asthma. American Review of Respiratory Disease. 136(1): 225-244
* ↑ Teng Y et al 2011. Hydrogen peroxide in exhaled breath condensate in patients with asthma: a promising biomarker? American College of Chest Physicians. 140(1):108-116
* ↑ Niox 2017. Asthma: An Inflammatory Process http://www.niox.com/en/feno-asthma/.
* ↑ Trotti R, Carratelli M, Barbieri M. 2002. Performance and clinical application of a new, fast method for the detection of hydroperoxides in serum. Panminerva Medica. 44: 37-40
* ↑ Australian Government National Health and Medical Research Council. 2017. Nutrients https://www.nrv.gov.au/nutrients.
* ↑ World Health Organisation. 2017. Asthma Fact Sheet http://www.who.int/mediacentre/factsheets/fs307/en/.
* ↑ The National Asthma Council Australia. 2017. Asthma Council Internet Page https://www.nationalasthma.org.au/.
* ↑ Nutrition Australia. 2009. Nutrition Australia Asthma http://www.nutritionaustralia.org/national/resource/asthma.