Shift Work in Intensive Care

dietary factors and the severity of EIB. There is accumulating evidence that dietary modification has the potential to reduce the severity and incidence of asthma and EIB.2 It has repeatedly been shown that a low-sodium diet reduces postexercise airway narrowing2,3 and moderates airway inflammation3 in asthmatic subjects with EIB. It has also been shown that a 3-week fish oil diet, rich in omega-3 polyunsaturated fatty acids has a protective effect in suppressing EIB.4,5 In addition, antioxidant supplementation has also been shown to improve EIB to subclinical levels in significant numbers of individuals with EIB.2 The dietary factors mentioned above did not normalize postexercise pulmonary function in individuals with EIB. However, on average these dietary interventions did improve pulmonary function to below the clinical threshold of a 10% fall in postexercise FEV1, which is commonly used for diagnosis of EIB. This level of improvement is not unlike that attained with many pharmacologic treatments, which also do not necessarily normalize pulmonary function in EIB patients but do improve pulmonary function to subclinical levels. Thus, the potential for enhancing the quality of life for those individuals with EIB by dietary modification or supplementation is high. These findings point toward the prophylactic and acute therapeutic effects of selected dietary factors, which seem to be attainable by simple rearrangement of nutritional components, in patients with inflammatory diseases such as asthma and EIB.2 It is also possible that any beneficial effect of diet on asthma and EIB is mediated through the combined effect of a variety of nutrients, rather than through any single nutrient.