Effectiveness of an antioxidant-rich diet on childhood asthma outcomes: A randomized controlled trial

Abstract Background 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 d...

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Main Authors: Theerapan Songnuy, Putrada Ninla-aesong, Piyada Thairach, Janjira Thok-Ngaen
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Nutrition
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Online Access:https://doi.org/10.1186/s40795-025-01078-2
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author Theerapan Songnuy
Putrada Ninla-aesong
Piyada Thairach
Janjira Thok-Ngaen
author_facet Theerapan Songnuy
Putrada Ninla-aesong
Piyada Thairach
Janjira Thok-Ngaen
author_sort Theerapan Songnuy
collection DOAJ
description Abstract Background 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. Methods 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. Results 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. Conclusions 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. Trial Registration 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).
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spelling doaj-art-e1f7ba0771fd4dbc8a4cb1d266e40b712025-08-20T02:11:22ZengBMCBMC Nutrition2055-09282025-05-0111111210.1186/s40795-025-01078-2Effectiveness of an antioxidant-rich diet on childhood asthma outcomes: A randomized controlled trialTheerapan Songnuy0Putrada Ninla-aesong1Piyada Thairach2Janjira Thok-Ngaen3King Mongkut’s Institute of Technology Ladkrabang, Faculty of MedicineDepartment of Medical Sciences, Walailak University, School of MedicineDivision of Pediatrics, Sichon HospitalDivision of Pediatrics, Pak Panang HospitalAbstract Background 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. Methods 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. Results 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. Conclusions 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. Trial Registration 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).https://doi.org/10.1186/s40795-025-01078-2Childhood AsthmaClinical OutcomesEffectivenessLycopene-rich dietPulmonary Function Test
spellingShingle Theerapan Songnuy
Putrada Ninla-aesong
Piyada Thairach
Janjira Thok-Ngaen
Effectiveness of an antioxidant-rich diet on childhood asthma outcomes: A randomized controlled trial
BMC Nutrition
Childhood Asthma
Clinical Outcomes
Effectiveness
Lycopene-rich diet
Pulmonary Function Test
title Effectiveness of an antioxidant-rich diet on childhood asthma outcomes: A randomized controlled trial
title_full Effectiveness of an antioxidant-rich diet on childhood asthma outcomes: A randomized controlled trial
title_fullStr Effectiveness of an antioxidant-rich diet on childhood asthma outcomes: A randomized controlled trial
title_full_unstemmed Effectiveness of an antioxidant-rich diet on childhood asthma outcomes: A randomized controlled trial
title_short Effectiveness of an antioxidant-rich diet on childhood asthma outcomes: A randomized controlled trial
title_sort effectiveness of an antioxidant rich diet on childhood asthma outcomes a randomized controlled trial
topic Childhood Asthma
Clinical Outcomes
Effectiveness
Lycopene-rich diet
Pulmonary Function Test
url https://doi.org/10.1186/s40795-025-01078-2
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