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VOLUME 65 , ISSUE 2 ( April-June, 2023 ) > List of Articles


Diets and Chronic Lung Diseases: A Narrative Review

Archana Malik, Suprova Chakraborty, Saroj Kumar Tripathy, Reshma Yadav, Manoranjan Sahoo, Sarthak Das

Keywords : Body mass index, Chronic lung diseases, Diet, Malnutrition, Tuberculosis, Vitamin D

Citation Information : Malik A, Chakraborty S, Tripathy SK, Yadav R, Sahoo M, Das S. Diets and Chronic Lung Diseases: A Narrative Review. Indian J Chest Dis Allied Sci 2023; 65 (2):109-113.

DOI: 10.5005/jp-journals-11007-0080

License: CC BY-NC 4.0

Published Online: 01-11-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Chronic respiratory diseases like chronic obstructive pulmonary disease (COPD), tuberculosis, obstructive sleep apnea (OSA), and asthma contribute significantly to the mortality of the human population. Many advances exist in treating chronic lung disease, but clinicians and researchers must address dietary intervention better. Malnutrition has a bidirectional link with tuberculosis (TB). Calorie-rich and protein-rich diets are to be advised to the TB patient. Cachexia is detrimental as well as obesity increases the risk of cardiovascular mortality. So optimal weight management is very much crucial in COPD management. A vitamin D-rich diet rich in fiber and polyunsaturated fatty acid (PUFA) is to be included in the diet of COPD patients. Oily, salt food is to be avoided by asthma patients. Junk and oily food increase the risk of asthma exacerbation. Milk consumption does not affect asthma symptoms to be included in an asthma patient's diet. Weight reduction will improve the apnea-hypopnea index in OSA patients. Low carbohydrate food is to be advised for OSA patients. India is culturally diverse. So diet chart will be provided to all chronic lung disease patients based on individual, social, and cultural needs.

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  1. Chen Y. Interpretation of global strategy for the diagnosis, treatment, management and prevention of chronic obstructive pulmonary disease. Chinese General Practice 2022;25(11):1294–1304. DOI: 10.12114/j.issn.1007-9572.2022.01.302.
  2. Central TB Division. INDIA TB REPORT 2022 coming together to end TB altogether. Minist Heal Fam Welf 2022;1–263. Available from:
  3. WHO. Tuberculosis Report. Vol. XLIX, Baltimore Health News. 2020. Available at:
  4. Sinha P, Davis J, Saag L, et al. Undernutrition and tuberculosis: Public health implications. J Infect Dis 2019;219(9):1356–1363. DOI: 10.1093/infdis/jiy675.
  5. Feleke BE, Feleke TE, Biadglegne F. Nutritional status of tuberculosis patients, a comparative cross-sectional study. BMC Pulm Med 2019;19(1):1–9. DOI: 10.1186/s12890-019-0953-0.
  6. WHO. Guideline: Nutritional care and support for patients with tuberculosis. World Health Organization 2017;107. Available from: Document - Nutritional Care %26 Support for TB patients in India.pdf.
  7. Podell BK, Aibana O, Huang CC, et al. The impact of vitamin a deficiency on tuberculosis progression. Clin Infect Dis 2022;75(12):2178–2185. DOI:
  8. Wagnew F, Alene KA, Eshetie S, et al. Effects of zinc and vitamin A supplementation on prognostic markers and treatment outcomes of adults with pulmonary tuberculosis: A systematic review and meta-analysis. BMJ Glob Heal 2022;7(9):e008625. DOI: 10.1136/bmjgh-2022-008625.
  9. Ali W, Ahmad I, Srivastava V, et al. Serum zinc levels and its association with vitamin A levels among tuberculosis patients. J Nat Sci Biol Med 2014;5(1):130–134. DOI: 10.4103/0976-9668.127310.
  10. Choi R, Kim HT, Lim Y, et al. Serum concentrations of trace elements in patients with tuberculosis and its association with treatment outcome. Nutrients 2015;7(7):5969–5981. DOI: 10.3390/nu7075263.
  11. Kearns MD, Tangpricha V. The role of vitamin D in tuberculosis. J Clin Transl Endocrinol 2014;1(4):167–169. DOI:
  12. Elsafi SSMS, Nour BM, Abakar AD, et al. Vitamin D level and it is association with the severity of pulmonary tuberculosis in patients attended to Kosti teaching hospital, Sudan. AIMS Microbiol 2020;6(1):64–74. DOI: 10.3934/microbiol.2020004.
  13. Bryce E, Gurung S, Tong H, et al. Population attributable fractions for risk factors for spontaneous preterm births in 81 low- and middle-income countries: A systematic analysis. J Glob Health 2022;12:04013. DOI: 10.7189/jogh.12.04013.
  14. Handa A, Dhooria S, Sehgal IS, et al. Primary cavitary sarcoidosis: A case report, systematic review, and proposal of new diagnostic criteria. Lung India 2018;35(1):41–46. DOI: 10.4103/lungindia.lungindia_225_17.
  15. Montes de Oca M, Tálamo C, Perez-Padilla R, et al. Chronic obstructive pulmonary disease and body mass index in five Latin America cities: The PLATINO study. Respir Med 2008;102(5):642–650. DOI: 10.1016/j.rmed.2007.12.025.
  16. Zhu J, Luo Y, Wang X, et al. Body mass index and mortality of chronic obstructive pulmonary disease: A meta-analysis. Chinese J Evidence-Based Med 2019;19(7):811–817. DOI: 10.1371/journal.pone.0043892.
  17. Hanson C, Rutten EP, Wouters EFM, et al. Influence of diet and obesity on COPD development and outcomes. Int J Chron Obstruct Pulmon Dis 2014;9:723–733. DOI: 10.2147/COPD.S50111.
  18. Keogh E, Mark Williams E. Managing malnutrition in COPD: A review. Respir Med 2021;176:106248. DOI:
  19. Langen RCJ, Gosker HR, Remels AHV, et al. Triggers and mechanisms of skeletal muscle wasting in chronic obstructive pulmonary disease. Int J Biochem Cell Biol 2013;45(10):2245–2256. DOI:
  20. Hallin R, Koivisto-Hursti UK, Lindberg E, et al. Nutritional status, dietary energy intake and the risk of exacerbations in patients with chronic obstructive pulmonary disease (COPD). Respir Med 2006;100(3):561–567. DOI: 10.1016/j.rmed.2005.05.020.
  21. McDonald MLN, Wouters EFM, Rutten E, et al. It's more than low BMI: Prevalence of cachexia and associated mortality in COPD. Respir Res 2019;20(1):100. DOI:
  22. Khan DM, Ullah A, Randhawa FA, et al. Role of Vitamin D in reducing acute exacerbations in COPD. Pak J Med Sci 2017;33(3):610–614. DOI: 10.12669/pjms.333.12397.
  23. Jolliffe DA, Greenberg L, Hooper RL, et al. Vitamin D to prevent exacerbations of COPD: Systematic review and meta-analysis of individual participant data from randomised controlled trials. Thorax 2019;74(4):337–345. DOI: 10.1136/thoraxjnl-2018-212092.
  24. Ritu G, Gupta A. Vitamin D deficiency in India: Prevalence, causalities and interventions. Nutrients 2014;6(2):729–775. DOI: 10.3390/nu6020729.
  25. Szmidt MK, Kaluza J, Harris HR, et al. Long-term dietary fiber intake and risk of chronic obstructive pulmonary disease: A prospective cohort study of women. Eur J Nutr 2020;59(5):1869–1879. DOI:
  26. Fonseca Wald ELA, van den Borst B, Gosker HR, Schols AMWJ. Dietary fibre and fatty acids in chronic obstructive pulmonary disease risk and progression: A systematic review. Respirology 2014;19(2):176–184. DOI: 10.1111/resp.12229.
  27. Broekhuizen R, Wouters EFM, Creutzberg EC, et al. Polyunsaturated fatty acids improve exercise capacity in chronic obstructive pulmonary disease. Thorax 2005;60(5):376–382. DOI: 10.1136/thx.2004.030858.
  28. Gibeon D, Batuwita K, Osmond M, et al. Obesity-associated severe asthma represents a distinct clinical phenotype analysis of the british thoracic society difficult asthma registry patient cohort according to bmi. Chest 2013;143(2):406–414. DOI:
  29. Peters U, Dixon AE, Forno E. Obesity and asthma. J Allergy Clin Immunol 2018;141(4):1169–1179. DOI: 10.1016/j.jaci.2018.02.004.
  30. Al-sharif FM, El-kader SMA, Neamatallah ZA, et al. Figure (1): Subjects screening and recruitment CONSORT diagram. 2020;20(2):897–902. Available at:
  31. Sharma V, Ricketts HC, McCombie L, et al. A Total diet replacement weight management program for difficult-to-treat asthma associated with obesity. Chest 2023;163(5):1026–1037. DOI:
  32. Wood LG, Garg ML, Smart JM, et al. Manipulating antioxidant intake in asthma: A randomized controlled trial1-3. Am J Clin Nutr 2012;96(3):534–543. DOI: 10.3945/ajcn.111.032623.
  33. Carey OJ, Cookson JB, Britton J, et al. The effect of lifestyle on wheeze, atopy, and bronchial hyperreactivity in Asian and white children. Am J Respir Crit Care Med 1996;154(2 pt 1):537–540. DOI: 10.1164/ajrccm.154.2.8756835.
  34. Varraso R, Kauffmann F, Leynaert B, et al. Dietary patterns and asthma in the E3N study. Eur Respir J 2009;33(1):33–41. DOI: 10.1183/09031936.00130807.
  35. Saadeh D, Salameh P, Baldi I, et al. Diet and allergic diseases among population aged 0 to 18 years: Myth or reality? Nutrients 2013;5(9):3399–3423. DOI: 10.3390/nu5093399.
  36. Hosseini B, Berthon BS, Wark P, et al. Effects of fruit and vegetable consumption on risk of asthma, wheezing and immune responses: A systematic review and meta-analysis. Nutrients 2017;9(4):341. DOI: 10.3390/nu9040341.
  37. Sveiven SN, Bookman R, Ma J, et al. Milk consumption and respiratory function in asthma patients: Nhanes analysis 2007–2012. Nutrients 2021;13(4):1182. DOI: 10.3390/nu13041182.
  38. Skaaby T, Kilpeläinen TO, Mahendran Y, et al. Europe PMC Funders Group Association of milk intake with hay fever, asthma, and lung function: A mendelian randomization analysis. Eur J Epidemiol 2023;37(7):713–722. DOI: 10.1007/s10654-021-00826-5.
  39. Guilleminault L, Williams EJ, Scott HA, et al. Diet and asthma: Is it time to adapt our message? Nutrients 2017;9(11):1227. DOI: 10.3390/nu9111227.
  40. Beckhaus AA, Garcia-Marcos L, Forno E, et al. Maternal nutrition during pregnancy and risk of asthma, wheeze, and atopic diseases during childhood: A systematic review and meta-analysis. Allergy Eur J Allergy Clin Immunol 2015;70(12):1588–1604. DOI: 10.1111/all. 12729.
  41. Wang M, Liu M, Wang C, et al. Association between vitamin D status and asthma control: A meta-analysis of randomized trials. Respir Med 2019;150:85–94. DOI: 2019.02.016.
  42. Peppard PE, Young T, Barnet JH, et al. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol 2013;177(9): 1006–1014. DOI: 10.1093/aje/kws342.
  43. Romero-Corral A, Caples SM, Lopez-Jimenez F, et al. Interactions between obesity and obstructive sleep apnea: Implications for treatment. Chest 2010;137(3):711–719. DOI: 10.1378/chest.09- 0360.
  44. Tuomilehto H, Gylling H, Peltonen M, et al. Sustained improvement in mild obstructive sleep apnea after a dietand physical activity-based lifestyle intervention: Postinterventional follow-up. Am J Clin Nutr 2010;92(4):688–696. DOI: 10.3945/ajcn.2010.29485.
  45. Thomasouli MA, Brady EM, Davies MJ, et al. The impact of diet and lifestyle management strategies for obstructive sleep apnoea in adults: A systematic review and meta-analysis of randomised controlled trials. Sleep Breath 2013;17(3):925–935. DOI: 10.1007/s11325-013-0806-7.
  46. Bueno NB, De Melo ISV, De Oliveira SL, et al. Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: A meta-analysis of Randomised controlled trials. Br J Nutr 2013;110(7): 1178–1187. DOI: 10.1017/S0007114513000548.
  47. Dobrosielski DA, Papandreou C, Patil SP, et al. Diet and exercise in the management of obstructive sleep apnoea and cardiovascular disease risk. Eur Respir Rev 2017;26(144):160110. DOI:
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