title: Dietary antioxidants and asthma in adults.
abstract: 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< or =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 micromol/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.
authors.affiliation: Department of Public Health and Primary Care, Institute of Public Health, Cambridge, UK.
authors.forename: B D
authors.initials: BD
authors.lastname: Patel
authors.forename: A A
authors.initials: AA
authors.lastname: Welch
authors.forename: S A
authors.initials: SA
authors.lastname: Bingham
authors.forename: R N
authors.initials: RN
authors.lastname: Luben
authors.forename: N E
authors.initials: NE
authors.lastname: Day
authors.forename: K-T
authors.initials: KT
authors.lastname: Khaw
authors.forename: D A
authors.initials: DA
authors.lastname: Lomas
authors.forename: N J
authors.initials: NJ
authors.lastname: Wareham
mesh_terms: D000368:Aged; D000975:Antioxidants / Q000008:administration & dosage*; D001205:Ascorbic Acid / Q000097:blood; D001249:Asthma / Q000097:blood / Q000209:etiology*; D016022:Case-Control Studies; D015331:Cohort Studies; D004032:Diet / Q000592:standards*; D002149:Energy Intake; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D000975:Antioxidants; D001205:Ascorbic Acid