Introduction-Prevalence of Respiratory diseases in the world

Introduction-Prevalence of Respiratory diseases in the world

Respiratory illnesses inflict a substantial health burden in the world today. Many of these illnesses are the major causes of deaths and severe ailments today[1].For instance, approximately 66 million have been diagnosed with mild to severe chronic obstructive pulmonary disease (COPD), where nearly three million deaths are reported every year globally^[2] .Asthma, on the other hand, is the most chronic disease in the world with over 300 million people suffering from the disease, besides approximately 14% of children globally are affected by this disease, and the prevalence is growing[3]

.Over the years now, acute lower respiratory tract infections have progressed into leading causes of death and disability in people. Even though quantifying the burden is difficult, these diseases cause 4 million deaths among children under the age of 5[4].Even so, respiratory tract infections later develop into chronic illnesses in later stages of children’s lives.

According to the Global Burden of Disease Study[5] .Over 11 million people got infected by tuberculosis (TB) in 2015, out of which 1.4 million died from the illness. The pandemic of respiratory diseases is vast, and the numbers continue growing each day, what is more, distressing is the substantial suffering these illnesses cause. This submission identifies that respiratory diseases increase the acidity levels and lowers the alkalinity levels of blood. It also discusses the medical nutrition therapy of some of the respiratory illnesses. The conclusion sums it all.

Effect of Respiratory diseases on Arterial Blood Gases (ABGs)

Oxygen and carbon dioxide are the Arterial blood gases in the body. Their levels are measured through the Arterial Blood Gases test, which measures the level of oxygen in the blood and whether carbon dioxide is adequately removed in the blood[6].Besides, this test also measures the acidity of the blood. The results are used to evaluate respiratory diseases and the functioning of the body’s vital organs such as the kidney.

The respiratory system normally consists of the lungs that inhale oxygen and exhale carbon dioxide. Oxygen passes from the lungs into the blood system while carbon dioxide passes from the blood to the lungs[7]. Nevertheless, sometimes the lungs in the system are not able to exhale carbon dioxide sufficiently, and this can be due to a slow respiratory rate or a decline in the air movement caused by respiratory illnesses⁶. For instance, Asthma brings breathing difficulties, which can make physical activities challenging to undertake. On the other hand, chronic obstructive pulmonary disease (COPD) – a group of gradually developing lung diseases destroys air sacs present in the lungs interfering with the outward flow of air. Also, pneumonia causes an inflammatory effect on the air sacs in the lungs, commonly known as alveoli, filling them with pus, which brings breathing difficulties⁶.

Because the lungs are unable to remove enough carbon dioxide from the blood, the resultant effect is a high level of carbon dioxide in the body which decreases the blood pH and other body fluids making them too acidic[8]. Typically the body can balance the ions responsible for acidity levels in the body, whereby the adequate levels are between 7.35 and 7.45. If the acidity falls below 7.25, then the body results in respiratory failure, a condition also known as respiratory acidosis⁶. Besides, respiratory acidosis is determined by the following blood gases.

Hydrogen ions – normal level of hydrogen ions in the blood range of 7.38 to 7.42[9]; the acidity or alkalinity levels of the blood are associated with high CO2 amounts in the body.

The partial pressure of oxygen – this involves the levels of oxygen gas dissolved during the ABGS test; values less than 75 to 100 mm hg indicate that the CO2 levels in the blood are high, and the blood pH is acidic.

The partial pressure of CO2- this is the CO2 levels in the blood system; if the levels are above the normal range, i.e., 32 to 42 mm hg, then the blood is considered acidic. The partial pressure of CO2 below the average values indicates that the blood is alkaline⁶.

Therefore, respiratory illnesses affect the Arterial Blood Gases ABGs in the body resulting in fluctuations of the ions controlling the acidity and alkalinity of the blood. Any variation (below or above the normal range) in the blood has severe effects on the body’s metabolism. Besides, the consequences can also lead to organ failure, such as kidney^9.

Medical Nutrition Therapy (MNT)

Nutritional considerations for respiratory illnesses should aim at repairing the lungs to enable it to function effectively. The following are some considerations for each of the respiratory diseases identified below.

Asthma

Altering fatty acids intake- nutritional components such as omega-6 fatty acids mostly present in animal products and vegetable oils usually increase the risk for asthma[10]. On the other hand, omega -3 acids also are linked to anti-inflammatory effects[11].

Avoiding dairy products – feeding on dairy products doesn’t cause Asthma, but in the case of a person with dairy allergies, it might trigger asthma symptoms.

Alcohol- consumption of alcohol causes an influx of acids in the body hence prolonging the symptoms of asthma¹⁰.

Avoiding fruits and vegetables that have high oxidants- fruits and vegetables with the least amount of oxidants lower the acidity levels in the body as compared with fruits and vegetables with high oxidants¹¹.

COPD

Carbohydrates- Limiting intake of simple carbohydrates such as table sugar, candy, and standard soft drinks[12]. Secondly, it is advisable to eat a lot of fiber (20 to 30) grams from products such as bread and pasta.

Proteins- good sources of proteins such as fish, poultry, cheese, nuts, and eggs will help in maintaining strong respiratory muscles.

Fats- it is advisable to limit foods that contain saturated fat such as butter, skin meat, and fried foods, among others.

Drinking plenty of water also keeps the body hydrated and also helps in maintaining a thin layer of mucus for easier removal.

-Pulmonary fibrosis

Nutritional considerations for pulmonary fibrosis include[13]

Eating a diet with low components of sodium, sugars and trans fats

Getting protein and calories from lean meats, fish bean, and low-fat dairy products.

Avoiding acidic foods, including coffee and tomatoes; these foods will reduce the acid reflux in the body.

Eating smaller though frequent meals to avoid getting full and creating breathing problems

Drinking a lot of water to keep the body dehydrated

Generally, the nutritional consideration for this illness is to maintain the right weight. For instance, being overweight will create more pressure on the lungs resulting in breathing problems. Conversely, being underweight means less energy and weakened muscles that won’t help in breathing properly¹³.

Lung cancer

Eating more legumes and less of red meat- a meta-analysis done by Yang et al. found that individuals who consume red meat have 35% risk of developing lung cancer[14]  As compared to individuals who do not. Besides, consuming legumes, especially ones with soy, reduces the risk of lung cancer[15].

Consuming a lot of fruits and vegetables- these foods are rich in protective benefits including carotenoids which are contrasted with vitamin A available in animal products[16]. Besides, fruits and vegetables contain vitamin C, sulfur elements in vegetables such as cauliflower and cabbage, among other nutrients which are essential in preventing cell damage.

Reducing alcohol intake – alcohol consumption increases the risk of developing lung cancer[17]. High intake of alcohol reflects a link with smoking or carcinogenic effect of alcohol metabolite and the capability of activating carcinogens by increasing cytochrome p450¹⁷.

Bacterial infections – Pneumonia and tuberculosis

Vitamins and minerals have a substantial benefit in treating bacterial infections such as pneumonia and TB; the two nutrients enhance lymphocyte proliferation responses[18]. Besides, vitamins C and E are effective in improving immune responses in human bodies. Also, vitamins A and zinc enhance the efficacy of drugs administered for bacterial infections¹⁸.

Conclusion

Respiratory acidosis is a condition caused by underlying diseases majorly respiratory infections such as Asthma, TB, Pneumonia, and lung cancer. These conditions affect the quality of human life and might even lead to severe conditions, including death, if not properly managed. Therefore, proper nutrition could be an excellent solution for managing these conditions.

References

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[2] World Health Organization. Global surveillance, prevention and control of chronic respiratory diseases. 2007.

[3] Massachusetts Department of Public Health. Asthma Prevention and Control Program.(April 2009). Burden of Asthma in Massachusetts. 2009.

[4] World Health Organization. Global status report on noncommunicable diseases. 2010. ht tp. whqlibdoc. who. int/publications/2011/9789240686458_eng. pdf (accessed 29 Oct 2013). 2011.

[5] GBD 2016 Lower Respiratory Infections Collaborators. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory infections in 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet. Infectious diseases. 2018 Nov;18(11):1191.

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[7] Hogan BL, Tata PR. Cellular organization and biology of the respiratory system. Nature. 2018;560:377-81.

[8] Tipping R, Nicoll A. Mechanisms of hypoxaemia and the interpretation of arterial blood gases. Surgery (Oxford). 2018 Dec 1;36(12):675-81.

[9] González SB, Menga G, Raimondi GA, Tighiouart H, Adrogué HJ, Madias NE. Secondary response to chronic respiratory acidosis in humans: a prospective study. Kidney international reports. 2018 Sep 1;3(5):1163-70.

[10] Egan KB, Ettinger AS, Bracken MB. Childhood body mass index and subsequent physician-diagnosed Asthma: a systematic review and meta-analysis of prospective cohort studies. BMC pediatrics. 2013 Dec 1;13(1):121.

[11] Wendell SG, Baffi C, Holguin F. Fatty acids, inflammation, and Asthma. Journal of allergy and clinical immunology. 2014 May 1;133(5):1255-64.

[12] Kohzuki M, Ebihara S. Taste sensi-tivity and nutrition in COPD rehabili-tation. Pulm Res Respir Med Open J. 2016;3(1):e1-2.

[13] Tynan C, Hasse JM. Current nutrition practices in adult lung transplantation. Nutrition in clinical practice. 2004 Dec;19(6):587-96.

[14] Yang WS, Wong MY, Vogtmann E, Tang RQ, Xie L, Yang YS, Wu QJ, Zhang W, Xiang YB. Meat consumption and risk of lung cancer: evidence from observational studies. Annals of Oncology. 2012 Dec 1;23(12):3163-70.

[15] Yang WS, Va P, Wong MY, Zhang HL, Xiang YB. Soy intake is associated with lower lung cancer risk: results from a meta-analysis of epidemiologic studies. The American journal of clinical nutrition. 2011 Dec 1;94(6):1575-83.

[16] Yu N, Su X, Wang Z, Dai B, Kang J. Association of dietary vitamin A and β-carotene intake with the risk of lung cancer: A meta-analysis of 19 publications. Nutrients. 2015 Nov;7(11):9309-24.

[17] Bagnardi V, Rota M, Botteri E, Tramacere I, Islami F, Fedirko V, Scotti L, Jenab M, Turati F, Pasquali E, Pelucchi C. Alcohol consumption and site-specific cancer risk: a comprehensive dose–response meta-analysis. British journal of cancer. 2015 Feb;112(3):580-93.

[18] Gupta KB, Gupta R, Atreja A, Verma M, Vishvkarma S. Tuberculosis and nutrition. Lung India: official organ of Indian Chest Society. 2009 Jan;26(1):9.