Vitamin C may alleviate exercise-induced bronchoconstriction: a meta-analysis
Harri Hemilä
+ Author Affiliations
Abstract
Objective To determine whether vitamin C administration
influences exercise-induced bronchoconstriction (EIB).
Design Systematic review and meta-analysis.
Methods MEDLINE and Scopus were searched for
placebo-controlled trials on vitamin C and EIB. The primary measures of vitamin
C effect used in this study were: (1) the arithmetic difference and (2) the
relative effect in the postexercise forced expiratory volume in 1 s (FEV1)
decline between the vitamin C and placebo periods. The relative effect of
vitamin C administration on FEV1 was analysed by using linear modelling for two
studies that reported full or partial individual-level data. The arithmetic
differences and the relative effects were pooled by the inverse variance
method. A secondary measure of the vitamin C effect was the difference in the
proportion of participants suffering from EIB on the vitamin C and placebo
days.
Results 3 placebo-controlled trials that studied the effect
of vitamin C on EIB were identified. In all, they had 40 participants. The
pooled effect estimate indicated a reduction of 8.4 percentage points (95% CI
4.6 to 12) in the postexercise FEV1 decline when vitamin C was administered
before exercise. The pooled relative effect estimate indicated a 48% reduction
(95% CI 33% to 64%) in the postexercise FEV1 decline when vitamin C was
administered before exercise. One study needed imputations to include it in the
meta-analyses, but it also reported that vitamin C decreased the proportion of
participants who suffered from EIB by 50 percentage points (95% CI 23 to 68);
this comparison did not need data imputations.
Conclusions Given the safety and low cost of vitamin C, and
the positive findings for vitamin C administration in the three EIB studies, it
seems reasonable for physically active people to test vitamin C when they have
respiratory symptoms such as cough associated with exercise. Further research
on the effects of vitamin C on EIB is warranted.
BMJ Open 2013;3:e002416 doi:10.1136/bmjopen-2012-002416
Respiratory medicine
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