Optimising Lung Health
| Educator
12th Aug, 2020Quick read

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Optimising Lung Health


Optimising Lung Health 


Recent global events such as bushfires and SARS-CoV-2 are contributing to the potential decline of lung health with unknown long-term effects. Pre-empting and meeting the needs of these health effects are paramount for avoiding a decline in quality of life.

Research has shown that even if a single micronutrient deficiency exists, immune function can be impaired and increase susceptibility to infectious disease (1).

A selection of some of the latest research regarding dietary, nutrient and lifestyle recommendations for lung health is shown below.



Impact on the lungs

Diet (1)

  • Research has shown that poor nutritional status predisposes an individual to infection.
  • High intake of fresh fruit and vegetables appears to have a beneficial effect on lung health and their consumption are recommended on a daily basis.

Dietary fibre and prebiotics (1,2,3,4)


  • Dietary fibre is a good source of microbiota accessible carbohydrates which provide the host with energy and improves intestinal health.
  • The beneficial effects of prebiotics are thought to be mediated primarily by increased absorption of short chain fatty acids (SCFAs) from the colon microbiome, providing protection against airway inflammation in the lungs through the induction of T regulatory cells and strengthening of the gastro-intestinal associated lymphoid tissue (GALT).
  • A fibre rich diet changes not only the intestinal microbiota, but can also affect the lung microbiota, indicating influence of nutrition on lung immunity.
  • Dietary sources of prebiotics

Vitamin D  (1,5,6,7,8,9)


  • Several meta-analyses have concluded that vitamin D supplementation reduces the risk of respiratory tract infections (RTIs) in both children and adults.
  • Deficiency can increase lung permeability and reduce pulmonary barrier integrity.
  • Activation of vitamin D in the lung induces antimicrobial peptides and reduces inflammatory cytokines in response to viruses.
  • Serious deficiency is common among elderly housebound people in aged care facilities, nursing homes and long stay wards. This has been identified as an important public health problem.
  • Sources of vitamin D

Vitamin C


  • An effective antioxidant that enhances activity and function of immune cells.
  • Deficiency leads to:
    • Impaired immunity and increased susceptibility to infection.
    • Increased risk of contracting pneumonia and increased disease severity.
  • Supplementation is effective in both prevention and treatment of RTIs, reducing both incidence and duration.
  • Long-term vitamin C intake is significantly associated with improved lung function.
  • Elderly people are at higher risk of vitamin C deficiency and are more likely to have a compromised immune system.



  • Plays a role in mediating the inflammatory response and may reduce the incidence of infection in healthy elderly individuals.
  • Zinc supplementation (45mg/day) in healthy elderly individuals improves immune function and reduces the incidence of infections.
  • Zinc supplementation in children under 5 reduces the risk of pneumonia by 13%.
  • Emerging research clarifies zinc’s involvement in the onset of pulmonary diseases.
    • Abnormality in the zinc transport mechanism influences obstructive pulmonary diseases.
    • Zinc supplementation alone is not sufficient for treatment in obstructive pulmonary diseases. A therapeutic approach that takes the transport mechanisms into consideration is necessary.

Vitamin A


  • Contributes to key biological processes including epithelial differentiation and immune responses.
  • Involved in the proliferation and maintenance of epithelial cells, including those of the respiratory tract.
  • During infectious diseases, particularly RTIs, plasma retinol levels decline inducing an increased susceptibility to infection creating a “vicious circle”.

Omega-3 fatty acids (10)

  • Dietary intake of polyunsaturated fatty acids (PUFAs), primarily from a seafood rich diet, appears to play a role in lung diseases.
  • Increased intake of omega-3 fatty acids can reduce the inflammatory response by changing the contents of lipid membranes and other substrates which are in turn the substrates for eicosanoid production.

N-Acetyl cysteine (NAC)


  • In vitro and in vivo studies show that NAC protects the lungs against toxic agents by increasing pulmonary defence mechanisms through its direct antioxidant properties and its indirect role as a precursor of glutathione synthesis.
  • Treatment with NAC in humans alters the pulmonary oxidant–antioxidant imbalance.
  • Oral administration of 600 mg/day improves lung function.



  • Improve or alleviate lung disease conditions by regulating the immune system via immunomodulation of local immunity (by maintaining gut wall integrity) and systemic immunity (by enhancing non‐specific and specific arms of the immune system).
  • More effective than placebo in reducing episodes of acute upper RTIs by ~47%. Further quality trials are needed to confirm this finding.
  • LGG and Lactobacillus casei strains Shirota (LcS) and DN114001 may be beneficial in the prevention and/or treatment of bacterial and viral infections in the gastrointestinal and respiratory systems, including influenza.
  • Nutritional factors affecting the gut-lung axis



  • Physical fitness and moderate intensity exercise training have been shown to improve immune responses to vaccination and chronic low-grade inflammation.
  • Exercise improves various immune markers in several disease states.
  • Regular bouts of short-lasting (i.e. up to 45 minutes) moderate intensity exercise are “immunoenhancing” whereas repeated bouts of long-lasting (>2 hours) high intensity exercise can be “immunosuppressive”.

Sleep quality


  • Poor sleep increases susceptibility to certain infections such as the common cold and is associated with increased inflammatory markers.
  • A systematic review of previous meta-analysis has shown exercise improves selected sleep outcomes in adults.
1Dhar D, Mohanty A. Gut microbiota and Covid-19- possible link and implications. Virus Res. 2020;285:198018
2Gray LEK, O’Hely M, Ranganathan S, Sly PD, Vuillermin P. The Maternal Diet, Gut Bacteria, and Bacterial Metabolites during Pregnancy Influence Offspring Asthma. Front Immunol. 2017 Mar 31;8.
3Halnes I, Baines KJ, Berthon BS, MacDonald-Wicks LK, Gibson PG, Wood LG. Soluble Fibre Meal Challenge Reduces Airway Inflammation and Expression of GPR43 and GPR41 in Asthma. Nutrients. 2017 Jan 10;9(1).
4McAleer JP, Kolls JK. Contributions of the intestinal microbiome in lung immunity. Eur J Immunol. 2018;48(1):39–49.
5Martineau AR, Jolliffe DA, Hooper RL, Greenberg L, Aloia JF, Bergman P, et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ. 2017 Feb 15;356:i6583.
6Bergman P, Lindh ÅU, Björkhem-Bergman L, Lindh JD. Vitamin D and Respiratory Tract Infections: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. PLoS One. 2013;8(6).
7Charan J, Goyal JP, Saxena D, Yadav P. Vitamin D for prevention of respiratory tract infections: A systematic review and meta-analysis. J Pharmacol Pharmacother. 2012;3(4):300–3.
8Rejnmark L, Bislev LS, Cashman KD, Eiríksdottir G, Gaksch M, Grübler M, et al. Non-skeletal health effects of vitamin D supplementation: A systematic review on findings from meta-analyses summarizing trial data. Slominski AT, editor. PLOS ONE. 2017 Jul 7;12(7):e0180512.
9Autier P, Mullie P, Macacu A, Dragomir M, Boniol M, Coppens K, et al. Effect of vitamin D supplementation on non-skeletal disorders: a systematic review of meta-analyses and randomised trials. Lancet Diabetes Endocrinol. 2017;5(12):986–1004.
10Romieu I. Nutrition and lung health. Int J Tuberc Lung Dis. 2005;9(4):362-374.
11Shunsuke Kamei, Haruka Fujikawa, Hirofumi Nohara, Keiko Ueno-Shuto, Kasumi Maruta, Ryunosuke Nakashima, Taisei Kawakami, Chizuru Matsumoto, Yuki Sakaguchi, Tomomi Ono, Mary Ann Suico, Richard C. Boucher, Dieter C. Gruenert, Toru Takeo, Naomi Nakagata, Jian-Dong Li, Hirofumi Kai, Tsuyoshi Shuto. Zinc Deficiency via a Splice Switch in Zinc Importer ZIP2/SLC39A2 Causes Cystic Fibrosis-Associated MUC5AC Hypersecretion in Airway Epithelial Cells. EBioMedicine, 2017.
12Whyand T, Hurst JR, Beckles M, Caplin ME. Pollution and respiratory disease: can diet or supplements help? A review. Respir Res. 2018;19(1):79.
13Timoneda J, Rodríguez-Fernández L, Zaragozá R, et al. Vitamin A Deficiency and the Lung. Nutrients. 2018;10(9):1132.
14Dekhuijzen PN, van Beurden WJ. The role for N-acetylcysteine in the management of COPD. Int J Chron Obstruct Pulmon Dis. 2006;1(2):99-106.
15Hao Q, Dong BR, Wu T. Probiotics for preventing acute upper respiratory tract infections. Cochrane Database of Systematic Reviews 2015, Issue 2. Art. No.: CD006895.
16Mortaz E, Adcock IM, Folkerts G, Barnes PJ, Paul Vos A, Garssen J. Probiotics in the management of lung diseases. Mediators Inflamm. 2013;2013:751068.
17Simpson RJ, Katsanis E. The immunological case for staying active during the COVID-19 pandemic. Brain Behav Immun. 2020;87:6-7.
18Walsh NP, Gleeson M, Shephard RJ, Gleeson M, Woods JA, Bishop NC, et al. Position statement. Part one: Immune function and exercise. Exerc Immunol Rev. 2011;17:6–63.
19Shakkottai A, O'Brien LM, Nasr SZ, Chervin RD. Sleep disturbances and their impact in pediatric cystic fibrosis. Sleep Med Rev. 2018;42:100-110.
20Kelley GA, Kelley KS. Exercise and sleep: a systematic review of previous meta-analyses. J Evid Based Med. 2017;10(1):26-36.