From Plate to Airways: Dietary Influences on Asthma in South Asian Populations

Main Article Content

Swathi Anphalagan
Shurabi Anphalagan
Swetha Suthananthan
Vinthiya Sriharan
Nirosshan Thiruchelvam

Abstract

Asthma is a common chronic respiratory disease with disproportionately high and rising burden among South Asian populations in South Asia and in diaspora communities such as Canada. While Western dietary patterns have been widely studied in relation to asthma risk and control, the potential influence of traditional and modern South Asian dietary patterns as modifiable factors remains underexplored. The purpose of this commentary is to highlight the potential role of South Asian dietary patterns as culturally relevant and modifiable factors in asthma prevention and management. Traditional South Asian diets, characterized by high intake of fruits, vegetables, legumes, whole grains and spices with anti-inflammatory properties, may reduce airway inflammation and oxidative stress. In contrast, modernization through increased consumption of refined grains, added sugars, saturated fats and processed foods may contribute to increased asthma risk or poor disease control. Understanding these dietary influences can support more culturally relevant asthma management approaches in South Asian Communities by emphasizing protective dietary changes.

Article Details

Anphalagan, S., Anphalagan, S., Suthananthan, S., Sriharan, V., & Thiruchelvam, N. (2026). From Plate to Airways: Dietary Influences on Asthma in South Asian Populations. Journal of Pulmonology and Respiratory Research, 21–25. https://doi.org/10.29328/journal.jprr.1001079
Short Communications

Copyright (c) 2026 Swathi A, et al.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

1. Ismaila AS, Sayani AP, Marin M, Su Z. Clinical, economic, and humanistic burden of asthma in Canada: a systematic review. BMC Pulm Med. 2013 Dec 5;13:70. Available from: https://dx.doi.org/10.1186/1471-2466-13-70.

2. Bishwajit G. Nutrition transition in South Asia: the emergence of non-communicable chronic diseases. F1000Res. 2015 Nov 24;4:8. Available from: https://dx.doi.org/10.12688/f1000research.5732.2.

3. Wang Z, Li Y, Gao Y, Fu Y, Lin J, Lei X, et al. Global, regional, and national burden of asthma and its attributable risk factors from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019. Respir Res [Internet]. 2023 Jun 23 [cited 2026 Feb 13];24(1):169. Available from: https://dx.doi.org/10.1186/s12931-023-02475-6.

4. Hammad H, Lambrecht BN. The basic immunology of asthma. Cell. 2021 Mar 18;184(6):1469–85. Available from: https://dx.doi.org/10.1016/j.cell.2021.02.016.

5. Oh J, Kim S, Yim Y, Kim MS, Hay SI, GBD 2023 Global Chronic Respiratory Disease and Covid Collaborators, et al. Global, regional, and national burden of chronic respiratory diseases and impact of the COVID-19 pandemic, 1990-2023: a Global Burden of Disease study. Nat Med. 2026 Jan;32(1):197–223. Available from: https://dx.doi.org/10.1038/s41591-025-04077-9.

6. Bishwajit G, Tang S, Yaya S, Feng Z. Burden of asthma, dyspnea, and chronic cough in South Asia. Int J Chron Obstruct Pulmon Dis. 2017 Apr;12:1093–9. Available from: https://dx.doi.org/10.2147/COPD.S133148.

7. Zhang L, Jiang H, Yang G, Zhang J, Yuan S, Chen J, et al. Global, regional and national burden of asthma from 1990 to 2021: a systematic analysis for the Global Burden of Disease Study 2021. BMJ Open Respir Res [Internet]. 2025 Jul [cited 2026 Feb 13];12(1):e003144. Available from: https://dx.doi.org/10.1136/bmjresp-2024-003144.

8. Stanojevic S, Shah BR, Anand SS, Sears MR, Su J, Subbarao P. The burden of asthma among South Asian and Chinese populations residing in Ontario. Can Respir J [Internet]. 2014 [cited 2026 Feb 13];21(6):346–50. Available from: https://dx.doi.org/10.1155/2014/160476.

9. Benchimol EI, Manuel DG, To T, Mack DR, Nguyen GC, Gommerman JL, et al. Asthma, type 1 and type 2 diabetes mellitus, and inflammatory bowel disease amongst South Asian immigrants to Canada and their children: a population-based cohort study. PLoS One. 2015 Apr 7;10(4):e0123599. Available from: https://dx.doi.org/10.1371/journal.pone.0123599.

10. Lakhanpaul M, Bird D, Manikam L, Culley L, Perkins G, Hudson N, et al. A systematic review of explanatory factors of barriers and facilitators to improving asthma management in South Asian children. BMC Public Health [Internet]. 2014 Apr 27 [cited 2026 Feb 13];14:403. Available from: https://dx.doi.org/10.1186/1471-2458-14-403.

11. Garcia-Larsen V, Del Giacco SR, Moreira A, Bonini M, Charles D, Reeves T, et al. Asthma and dietary intake: an overview of systematic reviews. Allergy [Internet]. 2016 [cited 2026 Feb 13];71(4):433–42. Available from: https://dx.doi.org/10.1111/all.12800.

12. Alwarith J, Kahleova H, Crosby L, Brooks A, Brandon L, Levin SM, et al. The role of nutrition in asthma prevention and treatment. Nutr Rev [Internet]. 2020 [cited 2026 Feb 13];78(11):928–38. Available from: https://dx.doi.org/10.1093/nutrit/nuaa005.

13. Sahiner UM, Birben E, Erzurum S, Sackesen C, Kalayci O. Oxidative stress in asthma. World Allergy Org J [Internet]. 2011 Oct [cited 2026 Feb 13];4(10):151–8. Available from: https://dx.doi.org/10.1097/WOX.0b013e318232389e

14. Scott HA, Gibson PG, Garg ML, Pretto JJ, Morgan PJ, Callister R, et al. Dietary restriction and exercise improve airway inflammation and clinical outcomes in overweight and obese asthma: a randomized trial. Clin Exp Allergy. 2012 Dec 24;43(1):36–49. Available from: https://dx.doi.org/10.1111/cea.12004.

15. Zhang H, Zhang X, Yang H, Yang H, Zhang T, Chen L, et al. Dietary carbohydrate types, genetic predisposition, and risk of adult-onset asthma: a longitudinal cohort study. Int J Biol Macromol [Internet]. 2024 Jan 28 [cited 2026 Feb 13];261:129824. Available from: https://dx.doi.org/10.1016/j.ijbiomac.2024.129824.

16. Wood LG. Diet, obesity, and asthma. Ann Am Thorac Soc [Internet]. 2017 Nov [cited 2026 Feb 13];14(Suppl 5):S332–8. Available from: https://dx.doi.org/10.1513/AnnalsATS.201702-124AW.

17. Li Z, Rava M, Bédard A, Dumas O, Garcia-Aymerich J, Leynaert B, et al. Cured meat intake is associated with worsening asthma symptoms. Thorax. 2016 Dec 20;72(3):206–12. Available from: https://dx.doi.org/10.1136/thoraxjnl-2016-208375

18. Wang JG, Liu B, Kroll F, Hanson C, Vicencio A, Coca S, et al. Increased advanced glycation end product and meat consumption is associated with childhood wheeze: analysis of the National Health and Nutrition Examination Survey. Thorax. 2021 Feb 16;76(3):292–4. Available from: https://dx.doi.org/10.1136/thoraxjnl-2020-216109.

19. Scott S, Patwardhan S, Ruel M, Chakrabarti S, Neupane S, Manohar S, et al. What adults in rural South Asia eat and when they eat it: evidence from Bangladesh, India, and Nepal. J Nutr [Internet]. 2025 May 23 [cited 2026 Feb 13];155(7):2406–15. Available from: https://dx.doi.org/10.1016/j.tjnut.2025.05.014.

20. Misra R, Balagopal P, Raj S, Patel TG. Vegetarian diet and cardiometabolic risk among Asian Indians in the United States. J Diabetes Res [Internet]. 2018 Feb 18 [cited 2026 Feb 13];2018:1675369. Available from: https://dx.doi.org/10.1155/2018/1675369

21. Richardson S, Marshall J, Rendeiro C. Dietary patterns and physical activity in young South Asians and white Europeans and their potential implications for cardiovascular risk. Sci Rep [Internet]. 2025 Apr 15 [cited 2026 Feb 13];15(1):8412. Available from: https://dx.doi.org/10.1038/s41598-025-97605-z.

22. Roberts G, Almqvist C, Boyle R, et al. Developments in the mechanisms of allergy in 2018 through the eyes of Clinical and Experimental Allergy, Part I. Clin Exp Allergy. 2019;49(12):1541–1549. https://doi.org/10.1111/cea.13532

23. Usmani K, Jain SK, Yadav S. Mechanism of action of certain medicinal plants for the treatment of asthma. Journal of Ethnopharmacology [Internet]. 2023;317:116828. Available from: https://www.sciencedirect.com/science/article/pii/S0378874123006967

24. Carey O, Cookson J, Britton J, Tattersfield AE. The effect of lifestyle on wheeze, atopy, and bronchial hyperreactivity in Asian and white children. Am J Respir Crit Care Med. 1996 Aug;154(2 Pt 1):537–40. Available from: https://dx.doi.org/10.1164/ajrccm.154.2.8756835.

25. Khusun H. Compressed modernization and nutrition transition: implications for diet quality and disease prevalence in Southeast Asia. Global perspective on the relationship between dietary habits and health [Internet]. London: IntechOpen; 2025 [cited 2026 Feb 13]. Available from: https://dx.doi.org/10.5772/intechopen.1010887.

26. Jessa R, Murphy RA, Khan NA, Tang TS. Comparing dietary intake and cardiovascular risk factors in Vancouver’s South Asian community. Nutrients. 2025 Jun 10;17(12):1967. Available from: https://dx.doi.org/10.3390/nu17121967.

27. Bao Y, Zeng J, Wang L, et al. Dietary intake of different carbohydrate types and asthma risk: a systematic review and meta-analysis. Nutr J [Internet]. 2025 [cited 2026 Oct 7];24:179. Available from: https://dx.doi.org/10.1186/s12937-025-01233-2.

28. Williamson A, Martineau AR, Sheikh A, Jolliffe D, Griffiths CJ. Vitamin D for the management of asthma. Cochrane Database Syst Rev [Internet]. 2023 [cited 2026 Oct 7];(2):CD011511. Available from: https://dx.doi.org/10.1002/14651858.CD011511.pub3.

29. Darling AL. Vitamin D deficiency in western dwelling South Asian populations: an unrecognised epidemic. Proc Nutr Soc [Internet]. 2020 Aug [cited 2026 Feb 13];79(3):259–71. Available from: https://dx.doi.org/10.1017/S0029665120000063.

30. Medici TC, Schmid AZ, Häcki M, Vetter W. Are asthmatics salt-sensitive? Chest. 1993 Oct;104(4):1138–43. Available from: https://dx.doi.org/10.1378/chest.104.4.1138.

31. Saad AY. Effect of artificial food additives on lung health: an overview. Medicina [Internet]. 2025 Apr [cited 2026 Feb 13];61(4):684. Available from: https://dx.doi.org/10.3390/medicina61040684.

32. Jansen L, van Kleef E, Van Loo EJ. The use of food swaps to encourage healthier online food choices: a randomized controlled trial. Int J Behav Nutr Phys Act [Internet]. 2021 Dec [cited 2026 Feb 13];18(1):156. Available from: https://dx.doi.org/10.1186/s12966-021-01222-8.

33. Grummon AH, Lee CJY, Robinson TN, Rimm EB, Rose D. Simple dietary substitutions can reduce carbon footprints and improve dietary quality across diverse segments of the US population. Nat Food [Internet]. 2023 Oct 26 [cited 2026 Feb 13];4(11):966–77. Available from: https://dx.doi.org/10.1038/s43016-023-00864-0.