Abstract
Background: Increased dietary vitamin E intake is associated with a reduced incidence of asthma, and combinations of antioxidant supplements including vitamin E are effective in reducing ozone induced bronchoconstriction. A study was undertaken to investigate the effect of supplementation with vitamin E for 6 weeks on bronchial hyperresponsiveness in atopic adults with asthma.
Methods: 72 participants from a clinical trial register of adults with asthma were randomised to receive 500 mg natural vitamin E or matched placebo for 6 weeks in a placebo controlled, double blind parallel group clinical trial. Inclusion criteria included age 18–60 years, maintenance treatment of at least one dose of inhaled corticosteroid per day, a positive skin prick test to one of three common allergens, and bronchial hyperresponsiveness to methacholine (defined as a dose provoking a 20% fall in forced expiratory volume in 1 second (FEV1) (PD20) of 12.25 µmol). Secondary outcomes were FEV1, forced vital capacity, mean morning and evening peak flow, symptom scores, bronchodilator use, and serum immunoglobulin E levels.
Results: In the primary intention to treat analysis the change in PD20 was similar in the vitamin E and placebo groups with a mean difference of +0.25 doubling doses of methacholine (95% confidence interval –0.67 to +1.16 greater with vitamin E). There was no effect of vitamin E supplementation on any other measure of asthma control, either in the intention to treat or per protocol analysis. There was also no effect of vitamin E supplementation on serum immunoglobulin levels.
Conclusion: Dietary supplementation with vitamin E adds no benefit to current standard treatment in adults with mild to moderate asthma.
Full Text
The Full Text of this article is available as a PDF (87.6 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Baker J. C., Tunnicliffe W. S., Duncanson R. C., Ayres J. G. Dietary antioxidants and magnesium in type 1 brittle asthma: a case control study. Thorax. 1999 Feb;54(2):115–118. doi: 10.1136/thx.54.2.115. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Barnes N. C., Marone G., Di Maria G. U., Visser S., Utama I., Payne S. L. A comparison of fluticasone propionate, 1 mg daily, with beclomethasone dipropionate, 2 mg daily, in the treatment of severe asthma. International Study Group. Eur Respir J. 1993 Jun;6(6):877–885. [PubMed] [Google Scholar]
- Bieri J. G., Tolliver T. J., Catignani G. L. Simultaneous determination of alpha-tocopherol and retinol in plasma or red cells by high pressure liquid chromatography. Am J Clin Nutr. 1979 Oct;32(10):2143–2149. doi: 10.1093/ajcn/32.10.2143. [DOI] [PubMed] [Google Scholar]
- Bodner C., Godden D., Brown K., Little J., Ross S., Seaton A. Antioxidant intake and adult-onset wheeze: a case-control study. Aberdeen WHEASE Study Group. Eur Respir J. 1999 Jan;13(1):22–30. doi: 10.1183/09031936.99.13102299. [DOI] [PubMed] [Google Scholar]
- Britton J. R., Pavord I. D., Richards K. A., Knox A. J., Wisniewski A. F., Lewis S. A., Tattersfield A. E., Weiss S. T. Dietary antioxidant vitamin intake and lung function in the general population. Am J Respir Crit Care Med. 1995 May;151(5):1383–1387. doi: 10.1164/ajrccm.151.5.7735589. [DOI] [PubMed] [Google Scholar]
- Butland B. K., Strachan D. P., Anderson H. R. Fresh fruit intake and asthma symptoms in young British adults: confounding or effect modification by smoking? Eur Respir J. 1999 Apr;13(4):744–750. doi: 10.1034/j.1399-3003.1999.13d08.x. [DOI] [PubMed] [Google Scholar]
- Chan A. C. Partners in defense, vitamin E and vitamin C. Can J Physiol Pharmacol. 1993 Sep;71(9):725–731. doi: 10.1139/y93-109. [DOI] [PubMed] [Google Scholar]
- Fogarty A., Britton J. The role of diet in the aetiology of asthma. Clin Exp Allergy. 2000 May;30(5):615–627. doi: 10.1046/j.1365-2222.2000.00766.x. [DOI] [PubMed] [Google Scholar]
- Fogarty A., Lewis S. A., Scrivener S. L., Antoniak M., Pacey S., Pringle M., Britton J. Oral magnesium and vitamin C supplements in asthma: a parallel group randomized placebo-controlled trial. Clin Exp Allergy. 2003 Oct;33(10):1355–1359. doi: 10.1046/j.1365-2222.2003.01777.x. [DOI] [PubMed] [Google Scholar]
- Grievink L., Zijlstra A. G., Ke X., Brunekreef B. Double-blind intervention trial on modulation of ozone effects on pulmonary function by antioxidant supplements. Am J Epidemiol. 1999 Feb 15;149(4):306–314. doi: 10.1093/oxfordjournals.aje.a009814. [DOI] [PubMed] [Google Scholar]
- Hijazi N., Abalkhail B., Seaton A. Diet and childhood asthma in a society in transition: a study in urban and rural Saudi Arabia. Thorax. 2000 Sep;55(9):775–779. doi: 10.1136/thorax.55.9.775. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kelly F. J., Mudway I., Blomberg A., Frew A., Sandström T. Altered lung antioxidant status in patients with mild asthma. Lancet. 1999 Aug 7;354(9177):482–483. doi: 10.1016/S0140-6736(99)01812-7. [DOI] [PubMed] [Google Scholar]
- McConnell Rob, Berhane Kiros, Gilliland Frank, London Stephanie J., Islam Talat, Gauderman W. James, Avol Edward, Margolis Helene G., Peters John M. Asthma in exercising children exposed to ozone: a cohort study. Lancet. 2002 Feb 2;359(9304):386–391. doi: 10.1016/S0140-6736(02)07597-9. [DOI] [PubMed] [Google Scholar]
- Pengo Vittorio, Lensing Anthonie W. A., Prins Martin H., Marchiori Antonio, Davidson Bruce L., Tiozzo Francesca, Albanese Paolo, Biasiolo Alessandra, Pegoraro Cinzia, Iliceto Sabino. Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism. N Engl J Med. 2004 May 27;350(22):2257–2264. doi: 10.1056/NEJMoa032274. [DOI] [PubMed] [Google Scholar]
- Rahman I., Morrison D., Donaldson K., MacNee W. Systemic oxidative stress in asthma, COPD, and smokers. Am J Respir Crit Care Med. 1996 Oct;154(4 Pt 1):1055–1060. doi: 10.1164/ajrccm.154.4.8887607. [DOI] [PubMed] [Google Scholar]
- Romieu I., Meneses F., Ramirez M., Ruiz S., Perez Padilla R., Sienra J. J., Gerber M., Grievink L., Dekker R., Walda I. Antioxidant supplementation and respiratory functions among workers exposed to high levels of ozone. Am J Respir Crit Care Med. 1998 Jul;158(1):226–232. doi: 10.1164/ajrccm.158.1.9712053. [DOI] [PubMed] [Google Scholar]
- Romieu Isabelle, Sienra-Monge Juan José, Ramírez-Aguilar Matiana, Téllez-Rojo Martha María, Moreno-Macías Hortensia, Reyes-Ruiz Norma Isabel, del Río-Navarro Blanca Estela, Ruiz-Navarro María Xóchitl, Hatch Gary, Slade Ralph. Antioxidant supplementation and lung functions among children with asthma exposed to high levels of air pollutants. Am J Respir Crit Care Med. 2002 Sep 1;166(5):703–709. doi: 10.1164/rccm.2112074. [DOI] [PubMed] [Google Scholar]
- Smit H. A., Grievink L., Tabak C. Dietary influences on chronic obstructive lung disease and asthma: a review of the epidemiological evidence. Proc Nutr Soc. 1999 May;58(2):309–319. doi: 10.1017/s0029665199000427. [DOI] [PubMed] [Google Scholar]
- Trenga C. A., Koenig J. Q., Williams P. V. Dietary antioxidants and ozone-induced bronchial hyperresponsiveness in adults with asthma. Arch Environ Health. 2001 May-Jun;56(3):242–249. doi: 10.1080/00039890109604448. [DOI] [PubMed] [Google Scholar]
- Troisi R. J., Willett W. C., Weiss S. T., Trichopoulos D., Rosner B., Speizer F. E. A prospective study of diet and adult-onset asthma. Am J Respir Crit Care Med. 1995 May;151(5):1401–1408. doi: 10.1164/ajrccm.151.5.7735592. [DOI] [PubMed] [Google Scholar]
- Yan K., Salome C., Woolcock A. J. Rapid method for measurement of bronchial responsiveness. Thorax. 1983 Oct;38(10):760–765. doi: 10.1136/thx.38.10.760. [DOI] [PMC free article] [PubMed] [Google Scholar]