***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective . The rapidly increasing prevalence of asthma in developed countries suggests an environmental cause . The benefits of Mediterranean diet ( MD ) in cardiovascular disease have been tentatively attributed to its anti-inflammatory properties . Asthma is an inflammatory disease and MD is associated with reduced asthma risk in epidemiological studies , but there are no reported interventional studies of MD in asthma . Methods . In this 12-week open-label r and omized trial , 38 adults with symptomatic asthma were allocated to high-intervention ( HI ) , low-intervention ( LI ) , and control groups . The first two groups were encouraged to adopt an MD and received multiple consultation sessions with a nutritionist , written advice , and vouchers for the purchase of appropriate foods .  Food frequency question naires , asthma control question naires , asthma-related quality of life question naires ( AQLQs ) , and spirometry  were completed at the beginning and at the end of the study . Results : The MDt score increased in the HI group ( p < .001 ) , indicating successful alteration of dietary behavior . Statistically , nonsignificant improvements were seen in spirometry and several AQLQ subdomains in the two intervention groups . No changes were seen in the asthma control or in inflammatory markers . Conclusions : The trial intervention has successfully altered the dietary behavior among adults with asthma . Small but consistent improvements were seen in quality of life and spirometry among the intervention group . The use of the MD to treat asthma is feasible and warrants evaluation in a larger study , powered to examine clinical endpoints Background : Many foods are associated with chronic obstructive pulmonary disease ( COPD ) symptoms or lung function . Because foods are consumed together and nutrients may interact , dietary patterns are an alternative way of characterising diet . A study was undertaken to assess the relation between dietary patterns and  newly diagnosed COPD in men . Methods : Data were collected from a large prospect i ve cohort of US men ( Health Professionals Follow-up Study ) . Using principal component analysis , two dietary patterns were identified : a prudent pattern ( high intake of fruits , vegetables , fish and whole grain products ) and a Western pattern ( high intake of refined grains , cured and red meats , desserts and French fries ) . Dietary patterns were categorised into quintiles and Cox proportional hazards models were adjusted for age , smoking , pack-years , (pack-years)2 , race/ethnicity , physician visits , US region , body mass index , physical activity , multivitamin use and energy intake . Results : Between 1986 and 1998 , 111 self-reported cases of newly diagnosed COPD were identified among 42 917 men . The prudent pattern was inversely associated with the risk of newly diagnosed COPD ( RR for highest vs lowest quintile 0.50 ( 95 % CI 0.25 to 0.98 ) , p for trend = 0.02 ) , and the Western pattern was positively associated with the risk of newly diagnosed COPD ( RR for highest vs lowest quintile 4.56 ( 95 % CI 1.95 to 10.69 ) , p for trend < 0.001 ) . Conclusions : In men , a diet rich in fruits , vegetables and fish may reduce the risk of COPD whereas a diet rich in refined grains , cured and red meats , desserts and French fries may increase the risk of COPD Introduction Air pollutant exposure has been associated with an increase in inflammatory markers and a decline in lung function  in asthmatic children . Several studies suggest that dietary intake of fruits and vegetables might modify the adverse effect of air pollutants . Methods A total of 158 asthmatic children recruited at the Children 's Hospital of Mexico and 50 non-asthmatic children were followed for 22 weeks . Pulmonary function was measured and nasal lavage collected and analyzed every 2 weeks . Dietary intake was evaluated using a 108-item food frequency question naire and a fruit and vegetable index ( FVI ) and a Mediterranean diet index ( MDI ) were constructed . The impact of these indices on lung function and interleukin-8 ( IL-8 ) and their interaction with air pollutants were determined using mixed regression models with r and om intercept and r and om slope . Results FVI was inversely related to IL-8 levels in nasal lavage ( p < 0.02 ) with a significant inverse trend ( test for trend p < 0.001 ) , MDI was positively related to lung function ( p < 0.05 ) , and children in the highest category of MDI had a higher FEV1 ( test for trend p < 0.12 ) and FVC ( test for trend p < 0.06 ) than children in the lowest category . A significant interaction was observed between FVI and ozone for FEV1 and FVC as was with MDI and ozone for FVC . No effect of diet was observed among healthy children . Conclusion Our results suggest that fruit and vegetable intake and close adherence to the Mediterranean diet have a beneficial effect on inflammatory response and lung function in asthmatic children living in Mexico City This pilot study aims to provide effect size confidence intervals , clinical trial and intervention feasibility data , and procedural material s for a full-scale r and omized controlled trial that will determine the efficacy of Dietary Approaches to Stop Hypertension ( DASH ) as adjunct therapy to st and ard care for adults with uncontrolled asthma . The DASH diet encompasses foods ( e.g. , fresh fruit , vegetables , and nuts ) and antioxidant nutrients ( e.g. , vitamins A , C , E , and zinc ) with potential benefits for persons with asthma , but it is unknown whether the whole diet is beneficial . Participants ( n = 90 ) will be r and omized to receive usual care alone or combined with a DASH intervention  consisting of 8 group and 3 individual sessions during the first 3 months , followed by at least monthly phone consultations for another 3 months . Follow-up assessment s will occur at 3 and 6 months . The primary outcome measure is the 7-item Juniper Asthma Control Question naire , a vali date d composite measure of daytime and nocturnal symptoms , activity limitations , rescue medication use , and percentage predicted forced expiratory volume in 1 second . We will explore changes in inflammatory markers important to asthma pathophysiology ( e.g. , fractional exhaled nitric oxide ) and their potential to mediate the intervention effect on disease control . We will also conduct pre-specified subgroup analyses by genotype ( e.g. , polymorphisms on the glutathione S transferase gene ) and phenotype ( e.g. , atopy , obesity ) . By evaluating a dietary pattern approach to improving asthma control , this study could advance the evidence base for refining clinical guidelines and public health recommendations regarding the role of dietary modifications in asthma management Overall diet in early childhood may affect the development of respiratory symptoms . This study examined whether childhood dietary patterns are associated with  respiratory symptoms in Dutch pre-school children , and whether this association could be explained by energy intake . A prospect i ve cohort study was performed in 2,173 children aged ≤4 yrs . Data on asthma-related symptoms were obtained by questions from the age-adapted version of the " International Study of Asthma and Allergies in Childhood " question naires . Data on respiratory tract infections , defined as episodes of physician attended fever with respiratory symptoms , was obtained by question naire . Principal components analysis was used to develop dietary patterns at 14 months of age . Compared with low adherence , high adherence to the “ Western ” dietary pattern was significantly associated with frequent wheeze at 3 yrs of age ( relative risk ( RR ) 1.39 , 95 % CI 1.02–1.89 ) and frequent shortness of breath ( RR 1.44 , 95 % CI 1.03–2.01 ) and respiratory tract infections ( RR 1.54 , 95 % CI 1.08–2.19 ) at 4 yrs of age . However , this association was partially explained by energy intake . A “ Western ” diet may increase the risk of frequent respiratory symptoms at 3 and 4 yrs of age . In some measure , this association was explained by energy intake BACKGROUND The rise in asthma prevalence over the last few decades may be a result of changes in prenatal or early-life environment , including maternal diet during pregnancy . Previous studies have found associations between individual foods or nutrients consumed during pregnancy and  asthma or wheeze in children , but these may be confounded by overall dietary pattern . OBJECTIVE To determine whether overall maternal dietary pattern during pregnancy is associated with  recurrent wheeze in children . METHODS A total of 1376 mother-infant pairs from Project Viva , a longitudinal prebirth cohort , who had responses for food frequency question naires in the first and second trimester and outcome data at 3 years of age were included .  Multivariable logistic regression was used to look at associations between dietary pattern and the primary outcome of recurrent wheeze at 3 years . Overall  dietary  pattern was examined by using  Mediterranean diet score , Alternate Healthy Eating Index modified for pregnancy ( AHEI-P ) , and principal components analysis to look at Western and Prudent diets . RESULTS None of these dietary patterns was associated with the primary outcome of recurrent wheeze in children in either the crude or the multivariable model ( multivariable model , odds ratio per 1-point increase in Mediterranean diet , 0.98 [ 95 % CI , 0.89 - 1.08 ] ; AHEI-P , 1.07 [ 0.87 - 1.30 ] ; Prudent , 1.02 [ 0.83 - 1.26 ] ; Western , 0.98 [ 0.81 - 1.19 ] ) . CONCLUSION Overall dietary pattern during pregnancy is not associated with recurrent wheeze in this cohort . Maternal intake of individual nutrients may be more important determinants of offspring wheeze-associated illness than is dietary pattern BACKGROUND The independent effect of individual foods on the risk of respiratory disease is difficult to establish because intakes of specific foods are generally strongly correlated . To date , few studies have examined the relation between dietary food patterns and forced expiratory volume in 1 s ( FEV(1 ) ) or respiratory symptoms . OBJECTIVE The objective was to investigate the relation between dietary patterns and FEV(1 ) , FEV(1 ) decline , and respiratory health in a general population sample . DESIGN Data were collected from the cross-sectional study in 12,648 adults from the Netherl and s [ MORGEN-EPIC ( Monitoring Project on Risk Factors and Chronic Diseases in the Netherl and s-European Prospect i ve Investigation into Cancer and Nutrition ) ] . Principal components analysis was used to derive dietary patterns , and multivariate regression analyses were conducted to investigate these patterns with FEV(1 ) or respiratory health . We also investigated these dietary patterns in relation to lung function decline over 5 y in a sub population . RESULTS A more traditional diet ( high intake of meat and potatoes and lower intake of soy and cereal ) was associated with a lower FEV(1 ) ( fifth compared with first quintile : -94.4 mL ; 95 % CI : -123.4 , -65.5 mL ; P for trend < 0.001 ) and a higher prevalence of chronic obstructive pulmonary disease . An increased trend through quintiles was seen with a cosmopolitan diet ( higher intakes of vegetables , fish , and chicken ) for asthma and wheeze . CONCLUSIONS The results suggest that a traditional diet has adverse effects on lung function and chronic obstructive pulmonary disease and that a more cosmopolitan diet was associated with increased risk of wheeze and asthma . However , none of the dietary patterns appear to be related to lung function decline BACKGROUND Although many foods and nutrients are associated with lung function or symptoms of chronic obstructive pulmonary disease ( COPD ) , the relation between overall diet and newly diagnosed COPD is not known . OBJECTIVE We assessed the relation between  dietary patterns  and  newly diagnosed COPD in women . DESIGN Data were collected from a large prospect i ve cohort of US women ( Nurses ' Health Study ) . Between 1984 and 2000 , 754 self-reported confirmed cases of newly diagnosed COPD were identified among 72 043 women . With the use of principal component analysis , 2 dietary patterns were identified : a prudent pattern ( fruit , vegetables , fish , whole-grain products ) and a Western pattern ( refined grains , cured and red meats , desserts , French fries ) . Patterns were categorized into quintiles , and the risk of COPD was compared between quintiles ( lowest as reference ) with the use of Cox proportional hazard models . RESULTS After adjustments for 14 potential confounders , the prudent pattern was negatively associated with risk of newly diagnosed COPD [ relative risk ( RR ) for highest compared with lowest quintile : 0.75 ; 95 % CI : 0.58 , 0.98 ; P for trend = 0.02 ] whereas the Western pattern was positively associated with risk of COPD ( RR for highest compared with lowest quintile : 1.31 ; 95 % CI : 0.94 , 1.82 ; P for trend = 0.02 ) . In contrast with findings for COPD , dietary patterns were not associated with the risk of adult-onset asthma . CONCLUSION In women , a negative association 
    Output:
    
Conclusion The evidence suggests no association of dietary patterns with asthma prevalence in adults or of maternal diet with child asthma or wheeze .