Flu, RSV and COVID-19 are especially tough on those with impaired lung function
By David Dunaief, M.D.
Our experiences over the past several years with COVID-19 have increased our awareness of how chronic ailments can make us more vulnerable to the consequences of acute diseases circulating in our communities.
For those with chronic obstructive lung diseases such as chronic obstructive pulmonary disease (COPD) and asthma, as well as those who smoke and vape, the consequences of the flu, RSV and COVID-19 are especially severe.
The good news is that we can do a lot to improve our lung function by exercising, eating a plant-based diet with a focus on fruits and vegetables, expanding lung capacity with an incentive spirometer, and quitting smoking and vaping, which damage the lungs (1). Studies suggest that everyone will benefit from these simple techniques, not only people with compromised lungs.
Do antioxidants improve asthma?
In a randomized controlled trial, results show that, after 14 days, asthma patients who ate a high-antioxidant diet had greater lung function than those who ate a low-antioxidant diet (2). They also had lower inflammation at 14 weeks. Inflammation was measured using a c-reactive protein (CRP) biomarker. Participants in the low-antioxidant group were over two-times more likely to have an asthma exacerbation.
The good news is that there was only a small difference in behavior between the high- and low-antioxidant groups. The high-antioxidant group had a modest five servings of vegetables and two servings of fruit daily, while the low-antioxidant group ate no more than two servings of vegetables and one serving of fruit daily. Using carotenoid supplementation in place of antioxidant foods did not affect inflammation. The authors concluded that an increase in carotenoids from diet has a clinically significant impact on asthma in a very short period.
Can increasing fiber lower COPD risk?
Several studies demonstrate that higher consumption of fiber from plants decreases the risk of COPD in smokers and ex-smokers.
In one study of men, results showed that higher fiber intake was associated with significant 48 percent reductions in COPD incidence in smokers and 38 percent incidence reductions in ex-smokers (3). The high-fiber group ate at least 36.8 grams per day, compared to the low-fiber group, which ate less than 23.7 grams per day. Fiber sources were fruits, vegetables and whole grain, essentially a whole foods plant-based diet. The “high-fiber” group was still below the American Dietetic Association’s recommended intake of 14 grams per 1,000 calories each day.
In another study, this time with women, participants who consumed at least 2.5 serving of fruit per day, compared to those who consumed less than 0.8 servings per day, experienced a highly significant 37 percent decreased risk of COPD (4).
The highlighted fruits shown to reduce COPD risk in both men and women included apples, bananas, and pears.
What devices can help improve lung function?
An incentive spirometer is a device that helps expand the lungs when you inhale through a tube and cause a ball (or multiple balls) to rise in a tube. This inhalation opens the alveoli and may help you breathe better.
Incentive spirometry has been used for patients with pneumonia, those who have had chest or abdominal surgery and those with asthma or COPD, but it has also been useful for healthy participants (5). A small study showed that those who trained with an incentive spirometer for two weeks increased their lung function and respiratory motion. Participants were 10 non-smoking healthy adults who were instructed to take five sets of five deep breaths twice a day, totaling 50 deep breaths per day. Incentive spirometers are inexpensive and easily accessible.
In another small, two-month study of 27 patients with COPD, the incentive spirometer improved blood gasses, such as partial pressure carbon dioxide and oxygen, in COPD patients with exacerbation (6). The authors concluded that it may improve quality of life for COPD patients.
How does exercise help improve lung function?
Exercise can have a direct impact on lung function. In a study involving healthy women aged 65 years and older, results showed that 20 minutes of high-intensity exercise three times a day improved FEV1 and FVC, both indicators of lung function, in just 12 weeks (7). Participants began with a 15-minute warm-up, then 20 minutes of high-intensity exercise on a treadmill, followed by 15 minutes of cool-down with stretching.
Note that you don’t need special equipment to do aerobic exercise. You can walk up steps or steep hills in your neighborhood, do jumping jacks, or even dance around your living room. Whatever you choose, you want to increase your heart rate and expand your lungs. If this is new for you, consult a physician and start slowly. You’ll find that your stamina improves quickly when you do it consistently.
We all should be working to strengthen our lungs. This three-pronged approach of lifestyle modifications — diet, exercise and incentive spirometer — can help.
(1) Public Health Rep. 2011 Mar-Apr; 126(2): 158-159. (2) Am J Clin Nutr. 2012 Sep;96(3):534-43. (3) Epidemiology Mar 2018;29(2):254-260. (4) Int J Epidemiol Dec 1 2018;47(6);1897-1909. (5) Ann Rehabil Med. Jun 2015;39(3):360-365. (6) Respirology. Jun 2005;10(3):349-53. (7) J Phys Ther Sci. Aug 2017;29(8):1454-1457.
Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.