Treating Asthma With Plants vs. Pills

Treating Asthma with Plants vs. Supplements
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In my video Treating Asthma With Fruits and Vegetables, I highlighted a landmark study on manipulating antioxidant intake in asthma. The study found that just a few extra fruits and vegetables a day can powerfully reduce asthma exacerbation rates. If the antioxidants in the plants are ameliorating asthma, then why can’t we take antioxidant pills instead? Because antioxidant pills don’t appear to work.

Studies using antioxidant supplements on respiratory or allergic diseases have mostly shown no beneficial effects. This discrepancy between data relating to fruit and vegetable intake compared with those using antioxidant supplements may indicate the importance of the whole food, rather than individual components. For example, in the Harvard Nurse’s Health Study, women who got the most vitamin E from their diet appeared to be at half the risk for asthma, (which may help explain why nut consumption is associated with significantly lower rates of wheezing), but vitamin E supplements did not appear to help.

Men who eat a lot of apples appear to have superior lung function, as do kids who eat fresh fruit every day, as measured by FEV1 (basically how much air you can forcibly blow out in one second). The more fruit, salad, and green vegetables kids ate, the greater their lung function appeared.

Researchers are “cautious about concluding which nutrient might be responsible.” There’s vitamin C in fruits, salads, and green vegetables, but there are lots of other antioxidants, such as “vitamin P,” a term used to describe polyphenol phytonutrients found in grapes, flax seeds, beans, berries, broccoli, apples, citrus, herbs, tea, and soy. Polyphenol phytonutrients can directly bind to allergenic proteins and render them hypoallergenic, allowing them to slip under our body’s radar. If this first line of defense fails, polyphenols can also inhibit the activation of the allergic response and prevent the ensuing inflammation, and so may not only work for prevention, but for treatment as well.

Most of the available evidence is weak, though, in terms of using supplements containing isolated phytonutrients to treat allergic diseases. We could just give people fruits and vegetables to eat, but then we couldn’t perform a double-blind study to see if they work better than placebo. Some researchers decided to use pills containing plant food extracts. Plant extracts are kind of a middle ground. They are better than isolated plant chemicals, but are not as complete as whole foods. Still, since we can’t put whole foods in a capsule, we can compare the extracts to fake sugar pills that look and feel the same to see if they have an effect.

The first trial involved giving people extracts of apple skins. I’ve talked about the Japan’s big cedar allergy problem before (See Alkylphenol Endocrine Disruptors and Allergies), so apple extract pills were given every day for a few months starting right before pollen season started. The results were pretty disappointing. They found maybe a little less sneezing, but the extract didn’t seem to help their stuffy noses or itchy eyes.

What about a tomato extract? A randomized, double-blind, placebo-controlled eight-week trial was performed on perennial allergic rhinitis, this time not for seasonal pollen, but for year-round allergies to things like dust-mites. There are lots of drugs out there, but you may have to take them every day year-round, so how about some tomato pills instead? After oral administration of tomato extract for eight weeks, there was a significant improvement of total nasal symptom scores, combined sneezing, runny nose and nasal obstruction, with no apparent adverse effects.

Would whole tomatoes work even better? If only researchers would design an experiment directly comparing phytonutrient supplements to actual fruits and vegetables head-to-head against asthma, but such a study had never been done… until now. The same amazing study, highlighted in my video, Treating Asthma with Plants vs. Supplements?, that compared the seven-fruit-and-vegetables-a-day diet to the three-fruit-and-vegetables-a-day diet, after completion of its first phase, commenced a parallel, randomized, controlled supplementation trial with capsules of tomato extract, which boosted the power of five tomatoes in one little pill, and the study subjects were given three pills a day.

Who did better, the group that ate seven servings of actual fruits and vegetables a day, or the group that ate three servings a day but also took 15 supposed serving equivalents in pill form? The pills didn’t help at all. Improvements in lung function and asthma control were evident only after increased fruit and vegetable intake, which suggests that whole-food interventions are most effective. Both the supplements and increased fruit and vegetable intake were effective methods for increasing carotenoid concentrations in the bloodstream, but who cares? Clinical improvements—getting better from disease—were evident only as a result of an increase in plant, not pill, consumption. The results provide further evidence that whole-food approaches should be used to achieve maximum efficacy of antioxidant interventions.

And if this is what a few more plants can do, what might a whole diet composed of plants accomplish? See Treating Asthma and Eczema with Plant-Based Diets.

I also dealt with preventing asthma in the first place: Preventing Asthma With Fruits and Vegetables.

The theme of whole foods being more efficacious than supplements seems to come up over and over again. See for example:

More on “vitamin P” in How to Slow Brain Aging by Two Years.

The anti-inflammatory effects of nuts may explain the Harvard Nurse’s Health Study finding: Fighting Inflammation in a Nut Shell.

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my videos for free by clicking here and watch my full 2012 – 2015 presentations Uprooting the Leading Causes of Death, More than an Apple a Day, From Table to Able, and Food as Medicine.

Image Credit: Mike Mozart / Flickr

  • Panchito

    Maybe the asthma trick is in what not to eat. If they ate a pill instead of the whole fruit, they would not displaced the animal foods (could be allergenic in some people). They would eat the same diet plus the extra pill. Switching the thought process of missing something (a +$$$ pill) to taking something out (animal -$$$) could be scientific too.

    Vegan regimen with reduced medication in the treatment of bronchial asthma.: http://www.ncbi.nlm.nih.gov/pubmed/4019393

    • Joseph Gonzales R.D.

      Thanks for the study link. From the related articles it looks like yoga can help, too.

      • lilyroza

        Where does it say that (I have asthma)?

        • Joseph Gonzales R.D.

          In the study I hyperlinked, it says “The present RCT has demonstrated that adding the mind-body approach of yoga to the predominantly physical approach of conventional care results in measurable improvement in subjective as well as objective outcomes in bronchial asthma.”

  • Amanda

    As an asthma sufferer, I can say that pills help tremendously. If I take around 7,000 mg vitamin C a day, my symptoms are greatly decreased. But I have to take at least that much or no benefits. I’d like to see studies on taking much more vitamin C than what’s normally recommended.
    I’ve had friends who do vitamin C IV’s… around 50,000mg given through the blood. Prescribed by a doctor of course. It totally stops their symptoms.
    Maybe the fillers in vitamins have something to do with effectiveness?

    • Joseph Gonzales R.D.

      Hi Amanda. Thanks for you comment. I suppose the fillers could be problematic if allergic to a substance that it contains. Good to know your doctor is prescribing the high dose vitamin C and you are not injecting yourself! If it works for you and you’re finding relief then more power to ya! So many folks suffer from Asthma (like my baby cousin) that I am happy to hear when something works.

    • Matthew Smith

      Have you tried having your Vitamin D3 levels checked?

  • Tikiri

    Here’s what boggles the mind. My choice then is to either (A) pick a juicy, healthy, fruit off a tree (or buy it for peanuts at the local market) and enjoy it as a snack, or (B) pop something that has been processed to the hilt with artificial flavouring (gross), that would cost me more, has negligible benefits and perhaps even a negative side effect or two to boot. Why would we willingly spend money on something so distasteful when a perfectly tastier, healthier, cheaper option is available? What am I missing here??

    • Joseph Gonzales R.D.

      Sounds good to me! Perhaps convenience and unhealthful dietary patterns interfere with choosing fresh fruits and vegetables? Access to foods could be another part, but I agree with you 100% that choice “A” is preferred. If you have not already, please consider keeping up with the new videos posted every weekday and subscribe to the daily video feed! Thanks for your comment, Tikiri.

  • It’s unfortunate the Nutritionfacts articles do not carry citations as do the videos. I’m curious as to what “extracts” are and whether they differ from “concentrates”, as in Juice Plus.

    • b00mer

      Hi Steve,

      The following sources regarding apple and tomato extracts are hyperlinked within the text above:

      http://www.ncbi.nlm.nih.gov/pubmed/15849424

      http://www.ncbi.nlm.nih.gov/pubmed/17519582

      http://www.ncbi.nlm.nih.gov/pubmed/22854412

      • Thanks. I should have noticed that.

        • b00mer

          The hyperlinks for individual studies aren’t bolded as the video titles are, and are a rather subdued green as opposed to the bright blue we’re used to seeing. They can be easy to miss! Enjoy the articles. :)

    • Joseph Gonzales R.D.

      Thanks for asking, Steve. b00mer is right we do link the studies but they are in the hyperlinks for blogs. You can still find them. The study will go into more depth on type of extract. As for “Juice Plus” , Dr. Greger has a few videos on that supplement.

  • Jim

    Last October my son was coming to visit and he is a vegan. I bought almond milk in preparation for his arrival, so for about a week I was not drinking dairy. I began to notice that my breathing was easier. After he left I took myself off all dairy and within another week was off my asthma meds. No more daily inhaled steroids. I’m also off Benadryl now. If I get around cats and dogs for extended periods I might need a rescue inhaler, but overall my symptoms are much better.

    • Joseph Gonzales R.D.

      Wow that is amazing! Dairy can be a major allergen for many folks. I am so glad you are finding relief. That’s why i love NutritionFacts.org because the public can visit the site for free and learn about crucial nutrition topics. If you have not already, please consider keeping up with the new videos posted every weekday and subscribe to the daily video feed. Thanks, Jim.

    • Scott Carson Ausburn

      I know what you mean about dairy.When i was a kid i had asthma i drank milk back then as i got older i drank less milk but more sodas but my asthma went away.Never made the connection until about a year ago when i found out the real truth about dairy.This spring when the pollen was falling like snow everyone around me was sniffing and snorting and complaining about congestion but i was free and clear.I tell everyone i talk to about diet that if you want better health at least ditch the dairy at least ; )

  • So the big idea is more fruits and vegetables for more plant fiber. We recommend BACON! made from eggplant. Here is a link to our Vegan Bacon video. Spoiler alert: there’s turmeric in there. <3 Whirled Peas Kitchen https://youtu.be/aVcPoqhWPoc

    • Thea

      Allan: Another winner! I’ve heard of processed vegan bacon, coconut bacon, and of course, tempeh bacon. I’ve never heard of eggplant bacon before this. You make it look absolutely delicious. And I really liked how you gave the overview at the beginning.

      That’s too much work for me. But sure do hope I will get to try it some time in the future. Thanks for the link!

  • Gary

    Just a heads-up on some scary TV viewing tonight on Frontline.
    Hunting The Nightmare Bacteria.
    Can also be seen online. It gives good reason to stay healthy and avoid all hospital stays.

  • Matthew Smith

    Asthma is not dependant on Vitamin C. Vitamin D3 has been found in a number of people to treat and cure Asthma. You can read
    “The Miraculous Results Of Extremely High Doses Of The Sunshine Hormone Vitamin D3 My Experiment With Huge Doses Of D3 From 25,000 To 50,000 To 100,000 Iu A Day Over A 1 Year Period” by Jeff Bowles for more information on how to use D3 to cure Asthma. Many people are very deficient in Vitamin C and Vitamin E, those being some of the vitamins lost to the mills.

  • LilacKitty

    I’m confused about reaching 9-13 servings of fruits and vegetables, as the USDA uses cups now instead. When you refer to a serving of fruit, is that the previously used USDA serving size of about 1/2 cup for most and 1 cup for leafy greens? Or is each serving now 1 cup for most and 2 cups for leafy greens? I find references to both measurements as a serving online. I don’t think I’m the only one confused! :) Thank you so much!

    • JS Baker

      I agree with LilacKitty, this is an important question. How much exactly is a “serving?” Thank you, Drs. Greger and Gonzales, for the constant stream of life giving information.

    • Joseph Gonzales R.D.

      Good questions. The guidelines always seem to be changing. USDA now uses cups. 5 cups (servings) total of fruits and vegetables is the minimum to shoot for, but more is definitely preferred. Here is a guide to what counts as a serving for vegetables and fruits.