Songnuy Theerapan, Ninla-Aesong Putrada, Thairach Piyada, Thok-Ngaen Janjira
King Mongkut's Institute of Technology Ladkrabang, Faculty of Medicine, Bangkok, 10520, Thailand.
Department of Medical Sciences, Walailak University, School of Medicine, Nakhon Si Thammarat, 80160, Thailand.
BMC Nutr. 2025 May 2;11(1):89. doi: 10.1186/s40795-025-01078-2.
Oxidative stress contributes to the initiation of inflammatory processes in the airway passages of asthmatic patients. An antioxidant-rich diet may alleviate asthmatic outcomes; however, evidence for this is currently scant. Hence, we aimed to assess whether an antioxidant-rich diet with usual asthma care can improve clinical outcomes and pulmonary function.
We enrolled mild to moderate asthmatic children who were being treated at two primary care settings in southern Thailand from October5, 2021 to May11, 2022. Participants were randomly assigned into a control group (n = 33) that received usual asthma care and an experimental group (n = 48) that received tomato juice and mixed fruit juice along with usual care for an 8-week period. Questionnaire, Inhaled Corticosteroids (ICS) dose usage, Asthma Control Test (ACT), Pediatric Asthma Quality of Life Questionnaire (PAQLQ), Pulmonary Function Test (PFT) and serum antioxidant levels (lycopene, beta-carotene and ascorbic acid) were compared for the 1st and 2nd visits.
A total of 80 participants completed the study with one control group participant lost in the follow up. Compared with the control group, the experimental group showed significant improvement in ACT scores (1.083 v.-0.786; p-value, 0.005) and PAQLQ total scores (2.208 v. -4.250; p-value, 0.002). In addition, serum beta-carotene increased in an experimental group after the 8-week duration (0.706 v. 0.783; p-value, 0.006) but not significantly changed in mean difference when compared with the control group (p-value, 0.879). However, ICS dose usage, PFT, and serum lycopene or ascorbic acid levels did not show significant differences over the 8-week study. Good compliance and low side effects regarding the fruit juice consumption were observed among participants.
The antioxidant-rich diet supplementation with usual care in asthmatic children may improve asthma control, quality of life and serum beta-carotene level. Nevertheless, the intervention did not change ICS dose usage, PFT or other serum antioxidant levels. With favorable palatability and low undesirable effects, tomato juice and mixed fruit juice may be used as an adjuvant therapy to the regular childhood asthma care. The results suggest that for further investigation, a larger sample size and long-term multi-center trial are warranted.
The clinical trial described in this paper was retrospectively registered on 29 May 2023 at The Thai Clinical Trials Registry under the registration number (ID: TCTR 20230529001).
氧化应激促进哮喘患者气道炎症过程的起始。富含抗氧化剂的饮食可能改善哮喘结局；然而，目前对此的证据不足。因此，我们旨在评估富含抗氧化剂的饮食联合常规哮喘治疗能否改善临床结局和肺功能。
我们纳入了2021年10月5日至2022年5月11日在泰国南部两个初级保健机构接受治疗的轻至中度哮喘儿童。参与者被随机分为对照组（n = 33），接受常规哮喘治疗；以及实验组（n = 48），在常规治疗的基础上，连续8周饮用番茄汁和混合果汁。在第1次和第2次就诊时，比较问卷、吸入性糖皮质激素（ICS）剂量使用情况、哮喘控制测试（ACT）、儿童哮喘生活质量问卷（PAQLQ）、肺功能测试（PFT）和血清抗氧化剂水平（番茄红素、β-胡萝卜素和抗坏血酸）。
共有80名参与者完成了研究，1名对照组参与者在随访中失访。与对照组相比，实验组的ACT评分（1.083对-0.786；p值，0.005）和PAQLQ总分（2.208对-4.250；p值，0.002）有显著改善。此外，8周后实验组血清β-胡萝卜素升高（0.706对0.783；p值，0.006），但与对照组相比，平均差异无显著变化（p值，0.879）。然而，在为期8周的研究中，ICS剂量使用、PFT以及血清番茄红素或抗坏血酸水平均无显著差异。参与者对果汁饮用的依从性良好且副作用低。
在哮喘儿童中，富含抗氧化剂的饮食补充联合常规治疗可能改善哮喘控制、生活质量和血清β-胡萝卜素水平。然而，该干预措施并未改变ICS剂量使用、PFT或其他血清抗氧化剂水平。由于口感良好且不良影响低，番茄汁和混合果汁可作为儿童常规哮喘治疗的辅助疗法。结果表明，为进一步研究，有必要进行更大样本量的长期多中心试验。
本文所述的临床试验于2023年5月29日在泰国临床试验注册中心进行回顾性注册，注册号为（ID：TCTR 20230529001）。
