Specialized Diets for Asthma

(INHALE Trial)

Overseen By John P Kirwan, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Pennington Biomedical Research Center

Must not be taking: Diabetes medications

Disqualifiers: Diabetes, COPD, Renal failure, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

15 Participants Needed

Trial Summary

What is the purpose of this trial?

Determine to what extent three distinct dietary approaches improve asthma control and lung function.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but it requires that your asthma medication has been stable for at least 2 months before joining. This suggests you should continue your current asthma treatment without changes.

What data supports the effectiveness of specialized diets for asthma treatment?

Research suggests that healthier diets, like the Mediterranean diet, are linked to fewer asthma symptoms and better asthma control. A study found that people with healthier eating habits had fewer asthma symptoms and better asthma management. ^{1 2 3 4 5}

Is the DGA Diet safe for humans?

The Dietary Guidelines for Americans (DGA) provide recommendations for a healthy diet aimed at preventing chronic diseases like heart disease. While specific safety data from intervention trials is not available, the guidelines are generally considered safe for the general population. ^{6 7 8 9 10}

How does the DGA, KETO, and MCT Diet treatment for asthma differ from other treatments?

This treatment focuses on specialized diets, such as the DGA, KETO, and MCT diets, which aim to manage asthma by altering dietary patterns rather than using medication. These diets may help reduce inflammation and improve asthma symptoms by emphasizing whole foods and reducing processed foods, which is different from traditional asthma treatments that typically involve inhalers or medications. ^{4 5 11 12 13}

Research Team

Jacob T Mey, PhD, RD

Principal Investigator

Pennington Biomedical Research Center

Eligibility Criteria

This trial is for adults aged 18-65 with a BMI of 18.5-29.99 who have asthma diagnosed by a specialist and partly controlled or uncontrolled symptoms, as shown by an Asthma Control Test score ≤22. Participants must have stable asthma medication use and own a device compatible with the ZEPHYRx platform.

Inclusion Criteria

My asthma has been diagnosed by a specialist.

Your body mass index (BMI) is between 18.5 and 29.99.

I am between 18 and 65 years old.

Exclusion Criteria

I do not have serious heart, lung, kidney, or liver conditions.

Pregnant or nursing women

Your blood pressure is very high and not well controlled.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Lead-in

Participants undergo a lead-in period before starting the dietary interventions

1 week

Dietary Intervention

Participants follow three distinct 7-day dietary approaches with a washout period between each

21+ weeks

Visits at the end of each diet period

Follow-up

Participants are monitored for safety and effectiveness after the dietary interventions

4 weeks

Treatment Details

Interventions

• DGA Diet
• KETO Diet
• MCT Diet

Trial Overview The study aims to compare how three diets—MCT Diet, DGA Diet, and KETO Diet—affect asthma control and lung function in participants. It will determine which dietary approach may be most beneficial for improving health outcomes in asthmatics.

Participant Groups

Group I: Medium Chain Triglyceride Supplemented DGA Experimental Treatment 1 Intervention

7 days of a diet consistent with the Dietary Guidelines for Americans supplemented with medium chain triglycerides (MCT).

Group II: Ketogenic Diet Experimental Treatment 1 Intervention

7 days of a ketogenic diet (KETO).

Group III: Dietary Guidelines for Americans Experimental Treatment 1 Intervention

7 days of a diet consistent with the Dietary Guidelines for Americans (DGA).

DGA Diet is already approved in United States for the following indications:

Approved in United States as Dietary Guidelines for Americans for:

• General health and wellness
• Chronic disease prevention
• Weight management

Who Is Running the Clinical Trial?

Pennington Biomedical Research Center

Lead Sponsor

Trials

314

Recruited

183,000+

National Heart, Lung, and Blood Institute (NHLBI)

Collaborator

Trials

3,987

Recruited

47,860,000+

Findings from Research

This systematic review aims to evaluate the relationship between dietary intake and asthma risk in both children and adults, following PRISMA guidelines and utilizing a comprehensive approach to analyze recent epidemiological studies.

The results of this review will contribute to evidence-based clinical practice guidelines on lifestyle interventions for managing asthma, potentially influencing dietary recommendations for asthma prevention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dietary intake and risk of asthma in children and adults: protocol for a systematic review and meta-analysis. Garcia-Larsen, V., Del Giacco, SR., Moreira, A., et al.[2020]

In a study of 34,766 participants, a healthier diet was linked to fewer asthma symptoms, with significant reductions in symptom scores for both men and women, particularly noted with the Alternate Healthy Eating Index 2010 (AHEI-2010).

Among the 2,609 participants with asthma, a healthier diet was associated with better asthma control, showing a strong effect in men and a borderline significant effect in women, suggesting dietary improvements could enhance asthma management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Associations between dietary scores with asthma symptoms and asthma control in adults. Andrianasolo, RM., Kesse-Guyot, E., Adjibade, M., et al.[2019]

In a study of 54,672 French females, no overall dietary patterns were linked to the incidence of asthma, but specific dietary habits were associated with asthma severity.

A 'Western' dietary pattern was linked to a higher risk of frequent asthma attacks, while a 'nuts and wine' dietary pattern was associated with a lower risk of such attacks, suggesting that diet may influence asthma exacerbations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dietary patterns and asthma in the E3N study. Varraso, R., Kauffmann, F., Leynaert, B., et al.[2022]

A systematic review of ten observational studies involving 153 to over 70,000 individuals found no strong evidence linking a Western diet pattern to the incidence or prevalence of asthma in adults.

While the studies did not show a clear connection between diet and the onset of asthma, there were some indications that a Western diet might be associated with increased asthma morbidity, suggesting that diet could still play a role in the severity of asthma symptoms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Association between Western diet pattern and adult asthma: a focused review. Brigham, EP., Kolahdooz, F., Hansel, N., et al.[2022]

In a study of 1486 Chinese adults, MSG intake was not found to be associated with asthma, suggesting that dietary MSG may not be a risk factor for the condition.

However, a 'traditional' dietary pattern, characterized by high consumption of rice, wheat flour, and vegetables, was positively associated with asthma, indicating that certain dietary habits may influence asthma prevalence.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Monosodium glutamate intake, dietary patterns and asthma in Chinese adults. Shi, Z., Yuan, B., Wittert, GA., et al.[2021]

The study successfully modeled dairy-free and vegan adaptations of the Healthy Vegetarian Dietary Pattern (HVDP) using foods already recommended in the 2020 Dietary Guidelines for Americans, showing that minimal changes were needed to maintain nutritional adequacy.

Both the dairy-free and vegan models provided sufficient nutrients to meet Dietary Reference Intakes (DRIs) for most age and sex groups, although zinc was the only nutrient that fell below the DRI for males, indicating these adaptations can effectively support diverse dietary needs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Modeling Dairy-Free Vegetarian and Vegan USDA Food Patterns for Nonpregnant, Nonlactating Adults. Hess, JM.[2023]

Updates to the Dietary Guidelines for Americans (DGAs) have led to more recent diet quality indices that show a stronger association with the risk of coronary artery disease, based on a study of 3267 participants from the Framingham Heart Study.

While adherence to any dietary index was linked to a lower risk of cardiovascular diseases overall, the improvements in diet indices did not show a significant impact on the risk of stroke or heart failure.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Diet Indices Reflecting Changes to Dietary Guidelines for Americans from 1990 to 2015 Are More Strongly Associated with Risk of Coronary Artery Disease Than the 1990 Diet Index. Rebholz, CM., Kim, H., Ma, J., et al.[2022]

An 8-week study involving 52 overweight and obese women found that following a Dietary Guidelines for Americans (DGA) diet led to a significant reduction in systolic blood pressure by approximately 9 mm Hg, indicating potential cardiovascular benefits.

However, neither the DGA diet nor the typical American diet (TAD) had an impact on fasting insulin, glucose levels, or lipid profiles, suggesting that simply changing dietary patterns may not affect these metabolic markers in the short term.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized controlled-feeding trial based on the Dietary Guidelines for Americans on cardiometabolic health indexes. Krishnan, S., Adams, SH., Allen, LH., et al.[2023]

Adherence to the DASH diet and the 2015-2020 Dietary Guidelines for Americans is linked to a lower likelihood of obesity among Canadian adults, based on analysis of dietary recall data from over 23,000 participants across two survey cycles.

While the Mediterranean diet showed a similar trend, its association with obesity was not statistically significant in the more recent data, suggesting that DASH and DGA may be more effective dietary patterns for weight management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adherence to a priori dietary patterns in relation to obesity: results from two cycles of the Canadian National Nutrition Survey. Ng, AP., Jessri, M., L'Abbé, MR.[2023]

The 2020-2025 Dietary Guidelines for Americans provide updated recommendations aimed at improving nutritional health and reducing the risk of chronic diseases among the population.

These guidelines emphasize the importance of a balanced diet, including a variety of fruits, vegetables, whole grains, and lean proteins, while also addressing the need to limit added sugars, saturated fats, and sodium.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Dietary Guidelines for Americans (2020-2025): Pulses, Dietary Fiber, and Chronic Disease Risk-A Call for Clarity and Action. Thompson, HJ.[2021]

Diets rich in fruits, vegetables, antioxidants, omega-3 fatty acids, and soluble fiber, like the Mediterranean diet, may help reduce asthma risk and improve management, especially in young children, although the evidence is mixed.

Conversely, a Westernized diet high in saturated fats, refined grains, and sugars may contribute to inflammation, potentially leading to the development and worsening of asthma symptoms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Nutrition in Asthma. Williams, EJ., Berthon, BS., Stoodley, I., et al.[2022]

In a study of 1174 adults across five European countries, two dietary patterns were identified: one high in meats and potatoes, and another rich in fish, fruits, and vegetables, but neither showed a strong association with asthma or its symptoms.

The lack of consistent associations between these dietary patterns and asthma suggests that other factors may influence respiratory health, highlighting the complexity of dietary impacts on asthma across different populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dietary patterns and risk of asthma: results from three countries in European Community Respiratory Health Survey-II. Hooper, R., Heinrich, J., Omenaas, E., et al.[2021]

Despite advancements in asthma diagnosis and treatment, mortality rates have been rising in developed countries over the past 10-15 years, potentially due to factors like pollution, delays in seeking care, and changes in asthma education.

The authors suggest that dietary changes, particularly increased consumption of polyunsaturated fats and refined foods, may contribute to worsening asthma management and inflammation in the airways.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Asthma mortality: another opinion--is it a matter of life and ... bread? Chang, CC., Phinney, SD., Halpern, GM., et al.[2019]

References

1. England pubmed.ncbi.nlm.nih.gov

Dietary intake and risk of asthma in children and adults: protocol for a systematic review and meta-analysis. [2020]

2. England pubmed.ncbi.nlm.nih.gov

Associations between dietary scores with asthma symptoms and asthma control in adults. [2019]

3. England pubmed.ncbi.nlm.nih.gov

Dietary patterns and asthma in the E3N study. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Association between Western diet pattern and adult asthma: a focused review. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Monosodium glutamate intake, dietary patterns and asthma in Chinese adults. [2021]

6. United States pubmed.ncbi.nlm.nih.gov

Modeling Dairy-Free Vegetarian and Vegan USDA Food Patterns for Nonpregnant, Nonlactating Adults. [2023]

7. United States pubmed.ncbi.nlm.nih.gov

Diet Indices Reflecting Changes to Dietary Guidelines for Americans from 1990 to 2015 Are More Strongly Associated with Risk of Coronary Artery Disease Than the 1990 Diet Index. [2022]

8. United States pubmed.ncbi.nlm.nih.gov

A randomized controlled-feeding trial based on the Dietary Guidelines for Americans on cardiometabolic health indexes. [2023]

9. England pubmed.ncbi.nlm.nih.gov

Adherence to a priori dietary patterns in relation to obesity: results from two cycles of the Canadian National Nutrition Survey. [2023]

10. Switzerland pubmed.ncbi.nlm.nih.gov

The Dietary Guidelines for Americans (2020-2025): Pulses, Dietary Fiber, and Chronic Disease Risk-A Call for Clarity and Action. [2021]

11. United States pubmed.ncbi.nlm.nih.gov

Nutrition in Asthma. [2022]

12. England pubmed.ncbi.nlm.nih.gov

Dietary patterns and risk of asthma: results from three countries in European Community Respiratory Health Survey-II. [2021]

13. England pubmed.ncbi.nlm.nih.gov

Asthma mortality: another opinion--is it a matter of life and ... bread? [2019]