 This landmark study, a manipulating antioxidant intake in asthma, found that just a few extra servings of fruits and veggies a day can powerfully reduce asthma exacerbation rates. If it's the antioxidant doing it, why can't we instead just take some antioxidant pills? Because they don't seem to work. Studies using antioxidant supplements on respiratory or allergic diseases have mostly shown no beneficial effects. This discrepancy between studies relating to fruit and vegetable intake, compared with those using antioxidant supplements, may indicate the importance of the whole food rather than individual components. For example, in the Harvard Nurses Health study, women who got the most vitamin E from diet appeared to be at half the risk for asthma, which may help explain why nut consumption is associated with significantly lower rates of wheezing, but vitamin E supplements did not appear to help. Men who eat a lot of apples appear to have superior lung function, same with kids who eat fresh fruit every day, as measured by FEV1, which is basically how much air you can forcibly blow out in one second. The more fruit, salad, and green vegetables kids ate, the greater their lung function appeared. Why no data points for more than once daily consumption of salad and veggies? Because so few kids made the cut. They were cautious about concluding which nutrient might be responsible. Yes, there's vitamin C in all three, but there's lots of other antioxidants, for example, so-called vitamin P. Polyphenol phytonutrients found in grapes, and flax seeds, and beans, berries, broccoli, and apples, citrus, herbs, tea, soy. Turns out they can directly bind allergenic proteins and render them hypoallergenic to slip under our body's radar. And if that first line of defense fails, they can inhibit the activation of the allergic response and prevent the ensuing inflammation, and so may not only work for prevention, but for treatment as well. Mostly available evidence is weak, though, in terms of using supplements containing isolated phytonutrients to treat allergic diseases. You could just give people fruits and vegetables to eat, but then you can't do a double-blind study to see if they work better than placebo. So researchers decided to try to use pills containing plant food extracts. It's kind of a middle ground, better than isolated plant chemicals, but not as complete as whole foods, but you can stick them in a capsule for experimental purposes so you can pair them to sugar pill placebo capsules. The first trial involved giving people extracts of apple skins. I've talked about the big problem they have in Japan with seed or allergy, so apple extract pills were given every day for a few months, starting right before pollen season started. The results were pretty disappointing, maybe a little less sneezing, but didn't seem to help their stuffy noses or itchy eyes. What about a tomato extract? Randomized double-blind placebo-controlled 8-week trial for perennial allergic rhinitis. This time not for seasonal pollen, but for year-round allergies to things like dust mites. There's lots of drugs out there, but you may have to take them every day year-round, so how about some tomato pills instead? Significant improvement of total nasal symptoms scores, combined sneezing, running nose, and nasal obstruction were all observed after oral administration of tomato extract for 8 weeks with no apparent adverse effects. Would whole tomatoes work even better? If only researchers would design an experiment directly comparing phytonutrient supplements to actual fruits and vegetables, head-to-head against asthma, but such a study had never been done until now. Same amazing study that compared the seven fruit and vegetable a day diet to three fruits and vegetables, then commenced a parallel, randomized controlled supplementation trial with capsules of tomato extract, which boasts the power of five tomatoes and one little pill. And the study subjects were given three pills a day. So who did better? The group that ate seven servings of actual fruits and vegetables a day, or the group that ate three servings a day, but also took 15 supposed serving equivalents in pill form. The pills didn't help at all. Improvements in lung function and asthma control were evident only after increased fruit and vegetable intake, which suggests that the whole food interventions are most effective. Most of the supplements in increased fruit and vegetable intake were effective methods for increasing carotenoid concentrations in the bloodstream, but who cares? The clinical improvements, the getting better from disease, was evident only as a result of an increased produce intake, not pill intake. The results provide further evidence that whole food approaches should be used to achieve maximum efficacy of antioxidant interventions. And if this is what just a few more plants can do, what might a whole diet composed of plants accomplish? I'll cover that next.