 In the international study of asthma analogies in childhood of over a million kids, a consistent inverse relationship, meaning protective relationship, was seen between prevalence rates of asthma, allergies, and eczema in the intake of plants, starch, grains, and vegetables. If these findings can be generalized, and if the average daily consumption of these foods increased, researchers speculated over a decade ago an important decrease in symptoms prevalence may be achieved. No need to speculate anymore, though. Plants were finally put to the test. Researchers had proposed that by eating less and less fruits and vegetables, this would increase the susceptibility of the population as a whole to potentially harmful inhaled substances by reducing the antioxidant defenses within our lungs. That makes sense. The thin lining of fluid that forms the interface between our lung lining and the external environment is our first line of defense against oxidative damage, which plays an important role in asthma, contributing to airway constriction, contraction, mucus, hypersensitivity. Antioxidants protect against oxidative stress, though, so our lung lining contains a range of antioxidants our body makes itself, as well as those obtained from our diet, particularly from fruits and vegetables. In fact, we can even quantify the level of oxidative stress in people by measuring the level of oxidation products in their exhaled breath, which drops as they start eating more fruits and vegetables, then drops further when they combine more plants with less animal foods. So do these, to those with asthma, really have lower levels of antioxidants than people without asthma? Compared to healthy controls, subjects with asthma had lower whole blood levels of total carotenoids, and each of the individual plant phytonutrients they measured, cryptosanthin, lycopene, lutein, alpha-carotene, and beta-carotene, compared to healthy controls. So the accumulating evidence does suggest that diets has an influence on modulating the response of the lung to inhaled allergens and irritants. But wait a second, I mean it's possible that the reduced carotenoid levels in asthma are a result of increased utilization in the presence of excess free radicals. So it's like a chicken or the egg phenomenon, or a cholesterol-free vernacular, which came first, the peer of the pod. We know antioxidant-rich diets have been associated with reduced asthma prevalence, however direct evidence that altering intake of antioxidant-rich foods actually affects asthma was lacking, until now. There's two ways to test the effects of fruits and vegetables on asthma. Add fruits and vegetables to people's diets and see if their asthma improves, or, like they did here, take asthmatics and remove fruits and vegetables from their diets and see if they get worse. This was the first research group to see if altering the intake of antioxidant-rich foods directly affects asthma outcomes. Placing subjects with asthma on a low antioxidant diet for just a matter of days led to a significant worsening of lung function and asthma control. This finding is highly significant for subjects with asthma, as it indicates that omitting antioxidant-rich foods from the diet for even a short time frame will have a detrimental effect on asthma symptoms. Interestingly, ironically, the low antioxidant diet consumed by the subjects, where they were restricted to one serving of fruit and only up to two servings of vegetables per day, is typical of Western diets. In other words, the low antioxidant diet they used to worsen people's asthma, to cripple their lung function, was just like the standard American diet. As about half the population usually consumes a diet with an intake of fruit and vegetables equivalent to the study diet or less, it appears likely that this dietary pattern, which must be considered suboptimal for lung health, may be having a significant impact on asthma management, indicating the potential for typical Western dietary patterns to contribute to the worsening of lung function and asthma control within just days. Cutting down, fruit and vegetable intake can impair lung function, but does adding fruits and vegetables actually help with asthma? That was the second phase of the study. Asthmatics on the standard American diet in this study had about 40% chance of relapsing into an asthma exacerbation within three months, but put them on seven servings of fruits and vegetables instead of three, and you can cut their exacerbation rate in half down to 20%, just with a few fruits and vegetables.