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Fish Fat May Reduce Children’s Asthma Risk
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New findings support results of prior research; inhalers may raise risk of severe attacks

by Craig Weatherby

Asthma is a very common, often disabling, and potentially fatal condition. About one in 10 children and one in 20 adults suffer its effects.

Asthma's origins remain somewhat mysterious but its symptoms stem from an inappropriate inflammatory response in the body, triggered by the immune system.

Key Points

  • Asthmatic mothers who eat plenty of oily fish may reduce their children’s risk of asthma, or reduce its severity.
  • Young children who eat plenty of oily fish, whole grains, or dairy may reduce their risk of asthma, or its severity.
  • Short-acting (but not long-acting) inhalers may increase the risk of severe asthma attacks.

One of the chief benefits of long-chain marine omega-3s is their ability to reduce excessive levels of inflammation in the body.  They exert this effect via their influence on the body’s production of a variety of chemicals involved in inflammation, including eicosanoids, platelet activating factor, free radicals, cytokines, and others.

Medical researchers explore the effects of various anti-inflammatory foods and drugs in an effort to deliver relief to asthma sufferers, and help prevent it from developing in children.

Scientists engage in two kinds of studies in this area. Observational studies look for statistical relationships between diet and rates of asthma and/or levels of pro-inflammatory chemicals related to asthma, while clinical trials test various substances versus a placebo, to see if they reduce the risk or severity of asthma, and/or blood levels of pro-inflammatory chemicals.

Mothers’ diets affect children’s asthma risk

The results of two clinical studies published this year—one by US researchers, another by Dutch investigators—indicate that pregnant mothers with asthma who eat oily fish, which are inherently high in omega-3s significantly reduce their children’s risk of developing asthma.

In contrast, mothers who ate fish sticks actually raised their children’s risk of asthma. This is not surprising, since the kinds of fish used in sticks are lean white fish low in omega-3s, while the bread coating typically contains three pro-inflammatory elements: refined flour, omega-6 fatty acids and hydrogenated fatty acids.

It seems safe to assume that the omega-3s in fish fat accounts for preventive and symptom-reduction effects of oil-rich dietary fish, given the findings of research designed to test this hypothesis.  In 2003, Australian researchers published the results of a placebo-controlled clinical study in which pregnant women took omega-3 supplements or a placebo starting five months after conception, until delivery.

In this study, the children of the mothers taking omega-3 supplements produced lower levels of pro-inflammatory chemicals (cytokines) in response to common allergens, and were three times less likely to exhibit an allergic reaction to eggs at one year of age.

The same Australian research team published the results of a related study in 2003. This one tested the effects of maternal omega-3 supplements on children who were deemed at high risk of developing eczema (another inflammatory disorder).  The results showed positive preventive results similar to those seen in their asthma-prevention study.

We should note that the greatest therapeutic effect in eczema is seen when patients take supplemental doses of an anti-inflammatory omega-6 fatty acid called GLA, which some people’s bodies have difficulty making from dietary omega-6 fatty acids.  Nonetheless, the positive effects seen in this study support the anti-inflammatory benefits of marine omega-3s.

Whole grains and dairy may also help

It seems that fish rich in omega-3s aren’t the only foods that might reduce risk of allergies in children. The Dutch team whose findings we cited above also found a comparably strong link between higher consumption of whole grains and reduced allergy risk in children.

Another Dutch team published the results of an observational study in 2003, which indicate that higher consumption of dairy foods or whole grain bread by children yields a lower risk of asthma at age three. This same study found no benefit from higher fish consumption, but the type of fish—a key factor—was not defined.

Note: The belief that dairy foods aggravate or promote asthma is common, and may well be true in some cases, given the varied reactions human bodies exhibit in response to any given food in the context of a health condition. But our search of the medical databases found only evidence that diets relatively high in dairy foods either help prevent asthma, or have no effect one way or the other on its development.

Among the fish highest in omega-3s, the ones lowest in manmade contaminants are wild salmon, sablefish, herring, anchovies, sardines, and young, low-weight tuna.

Inhalers may induce severe asthma attacks

The results of a new study appearing in the current issue of the journal “Nature” indicate that short-acting inhalers used by asthmatics for symptomatic relief might increase the likelihood of an acute attack.

An international team of researchers analyzed daily lung function measurements taken in a large group of asthma patients during a clinical trial in New Zealand.  The results show that regular use of the inhale commonly used by asthmatics for relief can increase the instability of lung function, and increase the likelihood of an acute attack.

Their analysis of the fluctuation of airway obstruction in a population of 80 asthmatics over an 18-month period showed that asthma is a dynamic process that can develop a long- term pattern. It appears that regular use of a long-acting bronchodilator (salmeterol) decreases risk of airway obstruction but a widely used short-acting bronchodilator (albuterol) increases the long-term risk.


Omega-3s and asthma prevention

  • Salam MT, Li YF, Langholz B, Gilliland FD. Maternal fish consumption during pregnancy and risk of early childhood asthma. J Asthma. 2005 Jul-Aug;42(6):513-8.
  • Tabak C, Wijga AH, de Meer G, Janssen NA, Brunekreef B, Smit HA. Diet and asthma in Dutch school children (ISAAC-2). Thorax. 2005 Oct 21; [Epub ahead of print]
  • Mihrshahi S, Peat JK, Webb K, Oddy W, Marks GB, Mellis CM; CAPS Team. Effect of omega-3 fatty acid concentrations in plasma on symptoms of asthma at 18 months of age. Pediatr Allergy Immunol. 2004 Dec;15(6):517-22.
  • Nafstad P, Nystad W, Magnus P, Jaakkola JJ. Asthma and allergic rhinitis at 4 years of age in relation to fish consumption in infancy. J Asthma. 2003 Jun;40(4):343-8.
  • Wijga AH, Smit HA, Kerkhof M, de Jongste JC, Gerritsen J, Neijens HJ, Boshuizen HC, Brunekreef B; PIAMA. Association of consumption of products containing milk fat with reduced asthma risk in pre-school children: the PIAMA birth cohort study. Thorax. 2003 Jul;58(7):567-72.
  • Dunstan JA, Mori TA, Barden A, Beilin LJ, Taylor AL, Holt PG, Prescott SL. Fish oil supplementation in pregnancy modifies neonatal allergen-specific immune responses and clinical outcomes in infants at high risk of atopy: a randomized, controlled trial. J Allergy Clin Immunol. 2003 Dec;112(6):1178-84.
  • Dunstan JA, Mori TA, Barden A, Beilin LJ, Taylor AL, Holt PG, Prescott SL. Fish oil supplementation in pregnancy modifies neonatal allergen-specific immune responses and clinical outcomes in infants at high risk of atopy: a randomized, controlled trial. J Allergy Clin Immunol. 2003 Dec;112(6):1178-84.
  • Woods RK, Walters EH, Raven JM, Wolfe R, Ireland PD, Thien FC, Abramson MJ. Food and nutrient intakes and asthma risk in young adults. Am J Clin Nutr. 2003 Sep;78(3):414-21.
  • Woods RK, Weiner JM, Abramson M, Thien F, Walters EH. Do dairy products induce bronchoconstriction in adults with asthma? J Allergy Clin Immunol. 1998 Jan;101(1 Pt 1):45-50.

Asthma and inhalers

  • Frey U, Brodbeck T, Majumdar A, Robin Taylor D, Ian Town G, Silverman M, Suki B. Risk of severe asthma episodes predicted from fluctuation analysis of airway function. Nature. 2005 Dec 1;438(7068):667-70.

Anti-Inflammatory effects of omega-3s

  • Miles EA, Allen E, Calder PC. In vitro effects of eicosanoids derived from different 20-carbon fatty acids on production of monocyte-derived cytokines in human whole blood cultures. Cytokine. 2002;20: 215-223.
  • Dooper MM, Wassink L, M’Rabet L, Graus YM. The modulatory effects of prostaglandin-E on cytokine production by human peripheral blood mononuclear cells are independent of the prostaglandin subtype. Immunol. 2002;107:152-159.
  • Bagga D, Wang L, Farias-Eisner R, Glaspy JA, Reddy ST. Differential effects of prostaglandin derived from ?-6 and ?-3 polyunsaturated fatty acids on COX-2 expression and IL-6 secretion. Proc Nat Acad Sci USA. 2003;100:1751-1756.
  • Levy BD, Clish CB, Schmidt B, Gronert K, Serhan CN. Lipid mediator class switching during acute inflammation: signals in resolution. Nature Immunol. 2001;2: 612-619.
  • Serhan CN, Jain A, Marleau S, Clish C, Kantarci A, Behbehani B, Colgan SP, Stahl GL, Merched A, Petasis NA, Chan L, Van Dyke TE. Reduced inflammation and tissue damage in transgenic rabbits overexpressing 15-lipoxygenase and endogenous anti-inflammatory lipid mediators. J. Immunol. 2003;171:6856-6865.
  • Vancheri C, Mastruzzo C, Sortino MA, Crimi N. The lung as a privileged site for the beneficial actions of PGE2. Trends Immunol. 2004;25:40-46.
  • Priante G, Bordin L, Musacchio E, Clari G, Baggio B. Fatty acids and cytokine mRNA expression in human osteoblastic cells: a specific effect of arachidonic acid. Clin Sci. 2002;102:403-409.
  • Bordin L, Prianti G, Musacchio E, Giunco S, Tibaldi E, Clari G, Baggio B. Arachidonic acid-induced IL-6 expression is mediated by PKC-a activation in osteoblastic cells. Biochem. 2003;42:4485-4491.
  • Curtis CL, Hughes CD, Flannery CR, Little CB, Harwood JL, Caterson B. n-3 fatty acids specifically modulate catabolic factors involved in articular cartilage degradation. J Biol Chem. 2000;275:721-724.
  • Curtis CL, Rees SG, Little CB, Flannery CR, Hughes CE, Wilson C, Dent CM, Otterness IG, Harwood JL Caterson B. Pathologic indicators of degradation and inflammation in human osteoarthritic cartilage are abrogated by exposure to n-3 fatty acids. Arth Rheum. 2002;46:1544-1553.
  • Novak TE, Babcock TA, Jho DH, Helton WS, Espat NJ. NF-?B inhibition by ?-3 fatty acids modulates LPS-stimulated macrophage TNF-a transcription. Am J Physiol. 2003;284:L84-L89.
  • Serhan CN, Clish CB, Brannon J, Colgan SP, Chiang N, Gronert K. Novel functional sets of lipid-derived mediators with antiinflammatory actions generated from omega-3 fatty acids via cyclooxygenase 2-nonsteroidal antiinflammatory drugs and transcellular processing. J Exp Med. 2000;192:1197-1204.
  • Marcheselli VL, Hong S, Lukiw WJ, Tian XH, Gronert K, Musto A, Hardy M, Gimenez JM, Chiang N, Serhan CN, Bazan NG. Novel docosanoids inhibit brain ischemia-reperfusion-mediated leukocyte infiltration and pro-inflammatory gene expression. J Biol Chem. 2003;278: 43807-43817.
  • Camandola S, Leonarduzzi G, Musso T, Varesio L, Carini R, Scavazza A, Chiarpotto E, Baeuerle PA, Poli G. Nuclear factor ?B is activated by arachidonic acid but not by eicosapentenoic acid. Biochem Biophys Res Commun. 1996;229:643-647.
  • Ross JA, Moses AG, Fearon KC. The anti-catabolic effects of n-3 fatty acids. Curr Opin Clin Nutr Metab Care. 1999;2:219-226.
  • Calder PC. N-3 polyunsaturated fatty acids and inflammation: from molecular biology to the clinic. Lipids 2003;38:342-352.

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