None listed
Conditions
Brief summary
This study will investigate the mechanisms by which nutrient surplus heightens inflammatory responses and interferes with pharmacological management of asthma. Our previous work demonstrates that in asthma, consumption of a high energy mixed meal activates innate immune responses in the airways, with increased TLR4 expression and airway neutrophilia. The specific nutrient responsible for this effect is uncertain; therefore, we will assess the independent effects of saturated fat, omega-6 fat and carbohydrate. We have also observed that a high energy mixed meal leads to impaired bronchodilator responses; therefore, the effect of each of these nutrients on bronchodilator response will also be investigated. Understanding this process is vital, and highly relevant to asthma management, as effective bronchodilator response is essential for achieving good asthma control and providing bronchodilation during acute exacerbations of asthma.
Interventions
Participants will attend four visits. At each visit, participants will consume a study meal at 0 hours and a study meal or water at 2 hours. The order in which these meals will be consumed will be randomly allocated. There will be a washout period of at least 1 week between visits. The four study groups are as follows: 1. Control Group 0 hours - 200g plain mashed potato (720kJ, 0.2g fat, 40g carbohydrate) 2 hours - 250mL plain water (0kJ) 2. Carbohydrate Group 0 hours - 200g plain mashed potato (720kJ, 0.2g fat, 40g carbohydrate) 2 hours - Participants can choose their preference of either: marshmallows (138g) (1918kJ, 0g fat, 109g carbohydrate) OR white jelly beans (114g) (1858kJ, <1g fat, 109g carbohydrate) OR marshmallows (69g) and white jelly beans (57g) (1888kJ, <1g fat, 109g carbohydrate). 3. Saturated Fat Group: 0 hours - 200g mashed potato (720kJ, 0.2g fat, 40g carbohydrate) mixed with 75g double cream and 14g unsalted butter (1940kJ, 50g fat, 3.4g carbohydrate) 2 hours - 250mL plain water (0kJ) 4. Omega-6 Fat Group: 0 hours - 200g mashed potato (720kJ, 0.2g fat, 40g carbohydrate) mixed with 50g sunflower oil (1850kJ, 50g fat, 0g carbohydrate 2 hours - 250mL plain water (0kJ) Participants will be asked to consume each meal within a 15 minute timeframe. On arrival, participants will undergo exhaled nitric oxide (eNO) measurement, blood pressure/pulse wave velocity measurement, and a fasting venous blood sample will be collected. Baseline lung function will be measured. A hypertonic saline challenge/sputum induction will be performed for a standardised 15.5 minutes nebuliser time. All participants will be administered with a short acting B2-agonist (salbutamol 200ug, inhaled via a spacer) either when they exhibit airway hyperresponsiveness during the saline challenge (>=15% drop in FEV1) or after the completion of 15.5 minutes nebuliser time. The participant will then consume the allocated study meal. At 2 hours, a venous blood sample will be collected and lung function measured. Immediately following these measurements, the allocated study meal or water will be consumed. At 3 hours, a venous blood sample and spirometry will be performed. At 4 hours, participants will again undergo exhaled nitric oxide (eNO) measurement, blood pressure/pulse wave velocity measurement, and a venous blood sample will be collected. Lung functionwill be measured. A hypertonic saline sputum induction will be performed for a standardised 15.5 mins nebuliser time. Participants will be administered with a short acting B2-agonist (salbutamol 200ug, inhaled via a spacer) if they exhibit a >=15% drop in FEV1 during the sputum induction, or if at the completion of 15.5 minutes nebuliser time their FEV1 is >=10% below baseline, or at the patients request. At visit 1 a skin prick allergy test will be completed, and height and weight measured. Standardised questionnaires will be completed at: * Visit 1 only: Asthma history, medications, GINA pattern, Juniper asthma quality of life questionnaire. * All visits: Asthma stability, Juniper asthma control quesitonnaire, 24-hour food recall diary.
Sponsors
Study design
Eligibility
Inclusion criteria
Non-smokers, stable asthma. Asthma will be defined by clinical history and airway hyperresponsiveness to hypertonic saline (4.5%) greater than 15% from baseline
Exclusion criteria
Current smoker, BMI > 35, pregnant or breastfeeding, high blood pressure or cholesterol, history of coronary heart disease, diabetes or currently taking lipid lowering drugs or oral corticosteroids.