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Tue, Mar 26, 2019

Lung Function and Chronic Obstructive Pulmonary Disease
The Health Benefits of Fruits and Vegetables



Asthma and chronic obstructive pulmonary disease (COPD – primarily chronic bronchitis and emphysema) are diseases of the lung airways. In 1996, over 14 million cases each of chronic bronchitis and asthma were reported in the United States (61). Over 2 million people had emphysema. COPD deaths ranked 4th in the country.


The etiology of these diseases may involve oxidative processes. Antioxidants and foods that are rich in antioxidants, including fruit, have been proposed to protect airways against oxidant-mediated damage (62). Smit et al. reviewed the available epidemiological data in 1999 and concluded that there was increasing evidence for a beneficial effect of fruit and vegetable consumption on indicators of asthma and COPD(63). Several recent studies have added to the data suggesting a positive association between fruit consumption and lung health, particularly in middle-aged men (62, 64, 65). A cross-sectional study of men in Finland, Italy, and the Netherlands showed that men consuming higher amounts of fruit (above median intake of 117-150 grams per day) had significantly higher forced expiratory volume (FEV), a measure of pulmonary function (62). Antioxidant intake (vitamin C, vitamin E, and ß-carotene) above the median tended to be positively associated with pulmonary function although not statistically significant. A cross-sectional study of 2512 Welshmen (aged 45-59) used more advanced technology to measure FEV than the above investigation and confirmed that intake of fruits, and to a lesser extent vegetables, was associated with improved lung function (65). Apples appeared to be particularly protective. During five years of follow-up of the men in the Welsh study it was found that eating five or more apples per week tended to delay a decline in lung function.


A protective effect of apples on lung function was also observed in a more recent cross-sectional study of men and women living in three Dutch cities (64). The goal of the study was to determine the relationship between self-reported COPD symptoms, pulmonary function, and dietary intake of several flavonoids. Apples and onions were the main source (after tea) of the flavonoids being studied (catechins, flavonols, and flavones). Catechin intake showed a beneficial association with FEV and all COPD symptoms. Flavonol and flavone intake was associated with reduced prevalence of chronic cough but not FEV. An average intake of 55 grams/day of solid fruits (including apples and pears) was positively associated with FEV and inversely associated with COPD symptoms. Similar, but slightly weaker associations, were reported with intake of citrus and other fruits. Importantly, the main dietary source of flavonoids in this study was tea, but tea intake was not associated with pulmonary function or COPD. This suggests that fruit might contain a mixture of protective compounds beyond the flavonoids examined in this study.


These observational studies demonstrate a positive association between fruit and vegetable (particularly fruit) intake and pulmonary function and support earlier work suggesting a beneficial effect of fruit and vegetable intake. However, it will be important to see if dietary intervention studies confirm the potential benefits.


“…These observational studies demonstrate a positive association between fruit and vegetable (particularly fruit) intake and pulmonary function and support earlier work suggesting a beneficial effect of fruit and vegetable intake.”

 

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