Introduction;

• Respiratory diseases places a significant burden on healthcare system throughout the world.

• Asthma and chronic obstructive pulmonary diseases (COPD) ten leading chronic problems associated with protection in activity.

• In a healthy individual the respiratory system receives oxygen for cellular metabolism and expires waste products.

• Metabolic fuels - carbohydrate, protein and lipid metabolized, using Oxygen and  producing carbon dioxide.

• The type of fuel an individual receives can affect physiological conditions and  interfere with normal respiration.

       Pulmonary function test:

• Pulmonary function test are used to detect lung diseases or to monitor the progression of disease.

• In pulse oximetry light waves measure the oxygenation of arterial blood:

• The finger or air line is the most common site for using the pulse oximeter.

• The most common pulmonary function test is done with the machine called spirometer:

• During spirometry, the patients breast into a tube attached to the machine which calculates the amount of air the lungs can hold and the rate the air can be enabled and exhaled.

• The result of test are compared with those of healthy individuals of similar height and age and of the same gender.

• Gas diffusion : my herbal Oxygen and other gases pass through the lungs air sacs and are absorbed by the blood.

• A reduced diff using capacity colde indicate pulmonary diseases.

• Evolution of arterial blood gases (ABG s) determine the pH, oxygen content and carbon dioxide content of the blood and can also be used to measure pulmonary function

• Oxygen saturation the amount of oxygen carried by the red blood cells (94-100%)

      Nutrition and pulmonary health:

     Malnutrition (EPM)

• Malnutrition associated with poor intake appear to have an impact on the strength and endurance of respiratory muscles, particularly the diaphragm and may also cause reduction in lungs parenchyma )respiratory bronchioles ,alveoli and capillaries)

• With continued malnutrition, increased incidence of pulmonary infection may also occurs, as a result of depressed 😔 immune function.

     Antioxidants:

• There are evidence correlating the role of dietary antioxidants such as vitamin c, vitamin E, B-carotene and selenium with healthy lung function.

• Antioxidant play an important role in protecting the lungs from accidental injury as the result of inflammatory process caused by the inhalation of cigarette smoking and other pollutants.

• Of all the carotenoids studded, lutein/zeaxanthin have the strongest relationship to pulmonary function.

• Cigarette smoking is associated with reduced level of antioxidants such as serum ascorbate- tocopherol, carotene and selenium.

• Respiratory disease often includes a variety of symptoms that may affect the dietary intake, including the early satiety, anorexia, weight loss, cough and dyspnea during eating.

• As the disease progresses ,these symptoms may have a marked impact on nutritional status.

      Asthma:

• Asthma is the chronic inflammatory disorder of the airway involving many cells and cellular elements, such as mast cells, eosinophils, T lymphocytes, macrophage, epithelial and neutrophils cells.

• Inflammation is primarily immunoglobulin E (lgE) mediated.

• Inflammation causes recurrent episodes of wheezing, breathlessness, chest tightness and coughing, particularly at night or in the early morning.

• Associated with airflow obstruction that is open reversible either spontaneously or with treatments.

     Epidemiology:

Asthma 3rd leading cause of hospitalization and chloric illness among the children under 15 years of the age.

    Etiology:

  Two types

   1) Allergic asthma:

• The most common and is triggered predominantly by inhaled indoor allergens such as dust mite allergen, pet dander, pollen and mold.

    2)Nonallergic asthma:

• Caused by other factors, such as anxiety, stress, exercise, cold air, dry air hyperventilation, smoke, viruses.

• Patient with asthma are at greater risk for life- threatening allergic reactions to foods.

• Persistent asthma has been associated with elevated igE to egg and wheat, through food allergies are rarely a cause of asthma.

• There is an association between obesity and asthma

• Direct effects of obesity on the mechanical functioning of the lungs,

• Changes in the immune system or an inflammatory response related to obesity hormonal influences.

• The interrelationship between the genes responsible for asthma and obesity.

     Pathophysiology:

• When asthma occurs bronchi and bronchioles respond to stimuli by contraction of smooth muscles (bronchoconstriction).

• The mucosa is inflamed and edematous, with an increased production of mucus.

• This result in a partial or totally obstructed airway.

    Clinical manifestation:

• The initial symptoms the patient may experience include cough, dyspnea, and a tight feeling in chest.

• Signs may include wheezing, increase respiratory rate ,and labored breathing.

• Increased heart rate (tachycardia) and hypoxia may also be.

    Nutrition therapy for asthma:

Produce a bestie specially in children's

• It is most important to recommend a nutritionally adequate diet for individuals suffering from asthma

• For overweight individuals, weight loss may result in reversibility of asthma

• Breastfeeding decreases the chances for development and episodes of asthma in children.

• Leukotrienes  are chemical mediators (synthesized for arachidonic acid) produced by the body that contribute to development of a asthma.

• These modulate the inflammatory response resulting in tissue edema mucus secretion.

As medication leukotrienes inhibitors that ;

• interfere with the actual synthesis of Leukotrienes.

• Leukotriene antagonists that block their action at the receptor level.

   Dietary modification for Leukotrienes:

• Human inflammatory cells contain high amounts of the Omega- 6 fatty acids, arachidonic Acid, and low amount of Omega-3 fatty acids.

• Because both Omega-6 and Omega-3 fatty acids are metabolized by a common pathway and excess of Omega-3 fatty acids interferes with the metabolism of Omega-6 fatty acids and reduce the incorporation into tissue lipids.

• Supplementation of Omega-3 fatty acids vitamin c ,and zinc either singly or in combination significantly improves asthma control and pulmonary function tests.

• Manganese and vitamin c is associated with adult asthma.

• Of all the antioxidant vitamins, the data linking vitamin c with asthma appears the strongest.

• Vitamin c may modify oxidative issues from inhaled for infectious agents and reduce cellular information.

How does diet effect asthma?

Can malnutrition cause asthma?

Are respiratory disease related to nutrition?

How does the poor  nutrition effect the reparatory system ?

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Nutrition therapy for Atherosclerosis