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Allan, A., & Devereux, G. (2011). Diet and asthma: Nutrition implications from prevention to treatment. Journal of the American Dietetic Association, 111(2), 258-268. Retrieved from http://dx.doi.org/10.1016/j.jada.2010.10.048

Berman, A., Kozier, B., & Erb, G. L. (2012). Fundamentals of nursing (2nd ed.). Frenchs Forest, Australia: Pearson.

Brown, Diane, Edwards, Helen, Lewis, Sharon Mantik, Dirksen, Shannon Ruff, Heitkemper, Margaret M., O'Brien, Patricia Graber, . . . Camera, Ian. (2012). Lewis's medical-surgical nursing : Assessment and management of clinical problems (3rd ed.). Chatswood, N.S.W.: Mosby/Elsevier.

Farrell, M., & Dempsey, J. (2011). Smeltzer & bare’s textbook of medical-surgical nursing (2nd ed.). Sydney, Australia: Lippincott Williams & Wilkins.

Garcia-Larsen, V., Giacco, S. R., Moreira, A., Bonini, M., Haahtela, T., Bonini, S., Delgado, L. (2016). Dietary intake and risk of asthma in children and adults: protocol for a systematic review and meta-analysis. Clinical and translational allergy, 6(1), 1.

Julia, V., Macia, L., & Dombrowicz, D. (2015). The impact of diet on asthma and allergic diseases. Nature Reviews Immunology, 15(5), 308-322.

Leavy, O. (2014). Asthma and allergy: Diet and airway inflammation. Nature Reviews. Immunology, 14(2), 64-65. doi:10.1038/nri3612

Luna-Pech, J. A., Torres-Mendoza, B. M., Garcia-Cobas, C. Y., Navarrete-Navarro, S., & Elizalde-Lozano, A. M. (2014). Normocaloric diet improves asthma-related quality of life in obese pubertal adolescents. International archives of allergy and immunology, 163(4), 252-258.

Ma, J., Strub, P., Lavori, P. W., Buist, A. S., Camargo, C. A., Nadeau, K. C., ... & Xiao, L. (2013). DASH for asthma: a pilot study of the DASH diet in not-well-controlled adult asthma. Contemporary clinical trials, 35(2), 55-67.

Milan, S. J., Hart, A., & Wikinson, W. (2013). Vitamin C for asthma and exercise-induced bronchoconstriction. Retrieved from Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD010391.pub2/abstract

Misso, N. L., & Thompson, P. J. (2013). Oxidative stress and antioxidant deficiencies in asthma: potential modification by diet. Redox Report.

Rance, K., & O'Laughlen, M. (2011). Obesity and Asthma: A Dangerous Link in Children. The Journal for Nurse Practitioners,7(4), 287-292.

Sexton, P., Black, P., Metcalf, P., Wall, C. R., Ley, S., Wu, L., ... & Kolbe, J. (2013). Influence of Mediterranean diet on asthma symptoms, lung function, and systemic  inflammation: a randomized controlled trial. Journal of Asthma, 50(1), 75-81.

Silveira, D. H., Zhang, L., Prietsch, S. O., Vecchi, A. A., & Susin, L. R. O. (2015). Association between dietary habits and asthma severity in children. Indian pediatrics, 52(1), 25-30.

Suskind, R. M. (2013). Immunologic mechanisms and the role of nutrition. Principles and Practice of Environmental Medicine, 159.

Uysalol, M., Mutlu, L. C., Saracoglu, G. V., Karasu, E., Guzel, S., Kayaoglu, S., & Uzel, N. (2013). Childhood asthma and vitamin D deficiency in Turkey: is there cause and effect relationship between them?. Italian journal of pediatrics, 39(1), 1.

Wendell, S. G., Baffi, C., & Holguin, F. (2014). Fatty acids, inflammation, and asthma. Journal of Allergy and Clinical Immunology, 133(5), 1255-1264.

Wood, l, G., Garg, M. L., Smart, J. M., Scott, H. A., Barker, D. & Gibson, G. (2012). Manipulating antioxidant intake in asthma: a randomized controlled trial. Retrieved from : The American Journal of Clinical Nutrition. http://ajcn.nutrition.org/content/96/3/534

Zaknun, D., Schroecksnadel, S., Kurz, K., & Fuchs, D. (2012). Potential Role of Antioxidant Food Supplements, Preservatives and Colorants in the Pathogenesis of Allergy and Asthma. International Archives of Allergy and Immunology, 157(2), 113-124.

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Asthma is defined as a chronic disease of the respiratory system with multiple triggering mechanisms resulting in a clinical situation of reversible airflow obstruction (Farrell, & Dempsey, 2011). This chronic disease is most generally identified in childhood, although it is being identified now throughout adulthood due to a wider range of triggering mechanisms (Berman, Kozier, & Erb, 2012).  It is estimated that there are 300 million people affected by the disease world-wide and a further 100 million people world-wide are estimated to be affected by the disease in 2025 (Allan & Devereux, 2011). One of the triggering mechanisms that are being suggested to be causing an increase of asthma is that of our diets which are characterised by being high in fat and lacking in essential vitamins and antioxidants; these diets are then suggested to influence airway inflammation (Allan & Devereux, 2011; Leavy, 2014). This poster aims to decipher whether or not diet’s can be used to control or even cure asthma with both positive and negative arguments being raised before a conclusion is presented.

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For many years it has been debated and investigated the link between dietary habits and asthma. In this time there have been many theories regarding a host of different diets and dietary factors in the suppression of asthmatic symptoms. There has been evidence to show that a link between vitamin D deficiency increases the severity of asthma however holds negligible impact towards causing asthma (Uysalol & et al., 2013).

While there has been evidence to suggest that obesity is factor is asthma and diet causes obesity there has been little substantiated evidence to suggest that any dietary factor substantially influences change (Silveira & et al., 2015).

It has been suggested that oxidants and antioxidants may play a role in the alleviation of asthma symptoms. The theory is that dietary antioxidant acts on the epithelial lining of the lungs, and may reduce oxidative damage; this reduction of oxidative damage results in reducing bronchoconstriction and inflammation in asthma patients (Wood et al., 2012). From a systematic review of the evidence for the efficacy of vitamin C supplementation in the treatment of asthma, it was concluded that there were no significant effects and that the evidence was insufficient (Milan, Hart, & Wikinson, 2013). Other studies involving the use of vitamin C and E supplements in patients with mild asthma also concluded that there was no significant benefit to users (Misso & Thompson, 2013).

The strongest argument so far for both symptom alleviation and improvement in quality of life amongst asthmatic patients are the DASH diet and the Mediterranean diet.  The DASH and Mediterranean diet are both characterized by high consumption of vegetables with a moderate consumption of protein as well as low consumption of saturated fatty acids from animal sources. These diets however have two key marked differences; the Mediterranean diet promotes consumption of high monounsaturated fatty acids from olive oil as well as the regular consumption of red wine (Ma & et al., 2013). Though there have not yet been any relevant studies regarding the efficacy of the DASH diet in asthma management there has been some supporting evidence for marked improvement of asthma symptoms when adherence to the Mediterranean diet is followed (Sexton & et al., 2013).

The promotion of these diets based on the slight supporting evidence would however be both unreasonable and unethical considering that these trials do not specify a set meal plan for either the Mediterranean or the DASH diet because they have not been well regulated. Any supporting evidence for either diet is therefore discredited due to a lack of parameters being set for the studies which causes all the data to henceforth be unreliable.

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COULD FOOD BE THE MEDICINE WE NEED FOR ASTHMA?                                                                                           Diet is a key factor in asthma management and needs to be modified to reduce the risk of asthma exacerbations. Agree or disagree?

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COULD FOOD BE THE MEDICINE WE NEED FOR ASTHMA?                                                                                           Diet is a key factor in asthma management and needs to be modified to reduce the risk of asthma exacerbations. Agree or disagree?

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Asthma prevalence and poor asthma control represent a major problem for public health as they cause a socio-economic burden, particularly in Australia and New Zealand with fast growing economies where the highest rates of the disease have been reported. Contributing factors may include changes in lifestyle, easier access to food, reduced intake of fresh fruits and vegetables, less fibre, food additives and an increased overall intake of foods rich in refined sugar (Zaknun, Schroecksnadel, Kurz & Fuchs, 2012).

Certain conditions such as obesity & gastro-oesophageal reflux disease are risk factors that can increase the likelihood of asthma in susceptible patients (Brown et al., 2012). These conditions are caused by diet and therefore diet already plays a role in having asthma. It is also a known fact that oxidative stress and airway inflammation are central features in the manifestation of asthma which may be caused by the lack of antioxidants and key nutrients (Garcia-Larsen et al., 2016). Current evidence suggests that antioxidant vitamins C and E and a higher intake of fresh vegetables and fruits might have a protective effect on asthma.

Malnutrition has been shown to lead to immune dysfunction and impaired immunocompetence which then in turn increases the bodies’ vulnerability to illness and infections (Julia, Macia & Dombrowicz, 2015). States of malnutrition result from consuming a diet in which nutrients are either lacking or excessive. The hormones leptin, cytokines interleukin-6 and tumor necrosis factor-a associated with obesity have been found at similar elevation levels in both obese and asthmatic patients which suggests a link between the two (Wendell, Baffi & Holguin, 2014).

Various research models have confirmed that obesity exacerbates allergic asthma and that the observed effects are not solely dependent upon TH2 cell responses. IL-17A-producing lymphoid cells are required for the increased basal antigen-independent airway hyperactivity that is induced by a high-fat diet or by genetic obesity (Rance & O’Laughlen, 2011). Furthermore, high fat meals have been shown to cause an increase in airway neutrophilia which causes impaired bronchodilator recovery in obese patients with asthma (Suskind, R. M. 2013).

Malnutrition, specifically obesity, is an independent predisposal factor for atopy, a heightened immune response to allergens suggesting additional asthma indicators (Wendell, Baffi & Holguin, 2014). The connection between asthma and obesity is through the impairment that an excess of adipose tissue causes to the body’s ability to adequately respire (Suskind, R. M. 2013). In extension to this introduction of a normocaloric diet without any dietary restrictions shows a marked improvement in asthmatic symptoms for obese children and adolescents diagnosed with asthma and restrictive calorie diets have shown to improve the same for adults (Luna-Pech et al., 2014)

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To completely agree and support the statement that diet is in fact a key factor in asthma management there needs to be more significant studies surrounding human trials and diet related purely to the sufficient management of asthma and reducing exacerbation's. Without enough supporting evidence regarding the efficacy of the use of diet management in symptom reduction for asthma we could not as a health care professional recommend its inclusion within asthma management plans. Current studies do not adequately show how modifying the diet of patients in our care would effectively assist with their asthma management or reduction of exacerbation's; therefore we disagree with this statement until further clinical evidence can prove otherwise.