Pilot randomised trial of a healthy eating behavioural intervention in uncontrolled asthma.
Rigorous research on the benefit of healthy eating patterns for asthma control is lacking.We randomised 90 adults with objectively confirmed uncontrolled asthma and a low-quality diet (Dietary Approaches to Stop Hypertension (DASH) scores <6 out of 9) to a 6-month DASH behavioural intervention (n=46) or usual-care control (n=44). Intention-to-treat analyses used repeated-measures mixed models.Participants were middle-aged, 67% female and multiethnic. Compared with controls, intervention participants improved on DASH scores (mean change (95% CI) 0.6 (0, 1.1) versus -0.3 (-0.8, 0.2); difference 0.8 (0.2, 1.5)) and the primary outcome, Asthma Control Questionnaire scores (-0.2 (-0.5, 0) versus 0 (-0.3, 0.3); difference -0.2 (-0.5, 0.1)) at 6 months. The mean group differences in changes in Mini Asthma Quality of Life Questionnaire overall and subdomain scores consistently favoured the intervention over the control group: overall 0.4 (95% CI 0, 0.8), symptoms 0.5 (0, 0.9), environment 0.4 (-0.1, 1.0), emotions 0.4 (-0.2, 0.9) and activities 0.3 (0, 0.7). These differences were modest, but potentially clinical significant.The DASH behavioural intervention improved diet quality with promising clinical benefits for better asthma control and functional status among adults with uncontrolled asthma. A full-scale efficacy trial is warranted.
Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA Dept of Medicine, Stanford University School of Medicine, Stanford, CA, USA Dept of Health Policy and Administration, University of Illinois at Chicago School of Public Health, Chicago, IL, USA maj2015@uic.edu.
Jun
J
Ma
Dept of Allergy, Asthma, and Immunology, The Permanente Medical Group, San Francisco Medical Center, San Francisco, CA, USA.
Peg
P
Strub
Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA.
Nan
N
Lv
Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA.
Lan
L
Xiao
Dept of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Carlos A
CA
Camargo
Pulmonary & Critical Care Medicine, Oregon Health & Science University, Portland, OR, USA.
A Sonia
AS
Buist
Dept of Health Research & Policy, Stanford University School of Medicine, Stanford, CA, USA.
Philip W
PW
Lavori
Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA Dept of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Sandra R
SR
Wilson
Dept of Paediatric Allergy and Immunology, Stanford University, Stanford, CA, USA.
Kari C
KC
Nadeau
Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA Dept of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Lisa G
LG
Rosas
D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000178:diet therapy* / Q000188:drug therapy / Q000503:physiopathology; D001521:Behavior Therapy / Q000379:methods*; D018752:Diet, Fat-Restricted / Q000379:methods*; D004039:Diet, Sodium-Restricted / Q000379:methods*; D004043:Dietary Fiber; D018450:Disease Progression; D005260:Female; D005541:Forced Expiratory Volume; D005638:Fruit; D006801:Humans; D057194:Intention to Treat Analysis; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014675:Vegetables; D014797:Vital Capacity
D018927:Anti-Asthmatic Agents; D004043:Dietary Fiber