Article Text

Download PDFPDF
Dietary antioxidants and asthma in adults
  1. B D Patel1,2,
  2. A A Welch1,
  3. S A Bingham4,
  4. R N Luben1,
  5. N E Day1,
  6. K-T Khaw1,
  7. D A Lomas3,
  8. N J Wareham5
  1. 1Department of Public Health and Primary Care, Institute of Public Health, Cambridge CB2 2SR, UK
  2. 2Department of Respiratory Medicine, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter EX2 5DW, UK
  3. 3Department of Medicine, Cambridge Institute for Medical Research, Cambridge CB2 2XY, UK
  4. 4MRC Dunn Nutrition Unit, Cambridge Institute for Medical Research, Cambridge CB2 2XY, UK
  5. 5MRC Epidemiology Unit, Elsie Widdowson Laboratory, Cambridge CB1 9NL, UK
  1. Correspondence to:
    Dr N J Wareham
    MRC Epidemiology Unit, Elsie Widdowson Laboratory, Cambridge CB1 9NL, UK; nick.wareham{at}


Background: Several antioxidant nutrients have been reported to be inversely associated with asthma. A study was undertaken to assess the independent associations of these nutrients with asthma in adults.

Methods: A nested case-control study was performed in 515 adults with physician diagnosed asthma and 515 matched controls using dietary data obtained from 7 day food diaries. The main outcome measures were physician diagnosed asthma and current symptomatic asthma (diagnosed asthma and self-reported wheeze within the previous 12 months).

Results: Cases were similar to controls in age, sex, social class, and daily energy intake but had a lower median intake of fruit (132.1 v 149.1 g/day, p⩽0.05). 51.5% of the population reported zero consumption of citrus fruit; relative to these individuals, people who consumed >46.3 g/day had a reduced risk of diagnosed and symptomatic asthma (OR adjusted for potential confounders 0.59 (95% CI 0.43 to 0.82) and 0.51 (95% CI 0.33 to 0.79), respectively). In nutrient analysis, dietary vitamin C and manganese were inversely and independently associated with symptomatic asthma (adjusted OR per quintile increase 0.88 (95% CI 0.77 to 1.00) for vitamin C and 0.85 (95% CI 0.74 to 0.98) for manganese), but only manganese was independently associated with diagnosed asthma (OR 0.86 (95% CI 0.77 to 0.95)). Adjusted plasma levels of vitamin C were significantly lower in symptomatic cases than in controls (54.3 v 58.2 μmol/l, p = 0.003).

Conclusions: Symptomatic asthma in adults is associated with a low dietary intake of fruit, the antioxidant nutrients vitamin C and manganese, and low plasma vitamin C levels. These findings suggest that diet may be a potentially modifiable risk factor for the development of asthma.

  • BMI, body mass index
  • FEV1, forced expiratory volume in 1 second
  • FVC, forced vital capacity
  • HLQ, health and lifestyle questionnaire
  • NRHS, Norfolk respiratory health survey
  • antioxidants
  • asthma
  • diet
  • epidemiology

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Published Online First 7 February 2006

  • Bipen Patel is funded by the NHS Executive Anglia and Oxford R&D. Nicholas Wareham is a Wellcome Trust Senior Clinical Fellow. EPIC-Norfolk is supported by grant funding from the Cancer Research Campaign, the Medical Research Council, the Stroke Association, the British Heart Foundation, the Department of Health, the Europe Against Cancer Programme Commission of the European Union, and the Ministry of Agriculture, Fisheries and Food.

  • The authors have no competing interests.

Linked Articles

  • Airwaves
    Wisia Wedzicha