Asthma has become more prevalent over the past decade. Many patients have managed their asthma with medication and avoiding environmental triggers.

Previous research has demonstrated that diet can play a significant role in the development and symptoms in asthma. Histamine is an inflammatory mediator that has been associated with inflammation in asthma patients but its exact impact is not clear as the histamine content of food can vary significantly by a product’s maturity, time in storage, and processing. In addition, it is important to note that histamine secreting bacteria have been found at higher frequency in stool samples of asthmatic patients.

According to a new study published last week in Nutrients, researchers investigated the effect of controlling dietary histamine intake and its impact on respiratory symptoms in children with asthma.

This was a randomized crossover dietary intervention, two-period study including 18 children (10 boys and 8 girls) with mild to intermittent asthma. The research team investigated the impact of dietary histamine intake on asthma symptoms. Each child was randomized to either a high- or low-histamine diet for an 8 week-period. Following a 2-week washout period, each child was switched to the other diet for 8 weeks. Foods were ranked according to their histamine content and a dietitian advised parents to select foods specifically from the food list provided. Dietary intake was assessed from eight random 24 hour recalls with Food-Processor Nutrition Analysis Software. Asthma symptoms were assessed at baseline and after each diet period. Daily symptom scores as well as peak flow were recorded throughout the diet. The best out of 3 morning and evening Peak Expiratory Flow Rate (PEFR) were measured with flow meter and recorded on the food diary cards.

As a result, there was significantly higher air flow obstruction and an increase in disease severity following the high-histamine diet compared to lesser symptoms and more symptom-free days during a low histamine intake. This study demonstrates that diet can have a direct impact on asthma symptoms.

Since the pathophysiology of asthma is multifactorial as with many chronic diseases, there are several nutrients that should be considered to modulate the underlying dysfunction and immune response.

Previous research has demonstrated Lactobacillus supplementation improves asthma severity. Individuals receiving Lactobacillus containing probiotics all had lower asthma severity and higher ACT scores. In addition, the group that received both Lactobacillus strains demonstrated increased peak expiratory flow rates and lower IgE levels.

Low serum vitamin D levels have also been linked to an increased risk of asthma. There was a previous study from the journal Allergy which demonstrated that Vitamin D could help manage asthma attacks. Asthma patients with a Vitamin D deficiency were 25% more likely than other asthmatics to have had at least one flare-up in the recent past.

We know vitamin D has significant immunomodulatory effects and it has been shown to have an effect on asthma. Vitamin D has been shown to promote T regulatory cells and has been proposed as one of the causes of the increased prevalence of asthma.

Other nutrients to consider to relax the airways and provide anti-inflammatory properties include fish oil, magnesium, vitamin C, and curcumin.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Vassilopoulou E, Konstantinou G, et al. The Impact of Food Histamine Intake on Asthma Activity: A Pilot Study. Nutrients 5 November 2020, 12(11), 3402.

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