The University of Newcastle, Australia

Better eating, better breathing

Turning familiar anecdotes into effective antidotes, Professor Lisa Wood's nutritional biochemistry research is proving there are crucial links between what we eat and how we breathe.

Lisa Wood

Professor Lisa Wood has developed something of a research niche. The enterprising educator and investigator studies both nutrition and inflammation, creatively combining the two to provide evidenced based dietary advice on respiratory disease management.

"I didn't have a particular interest in respiratory when I started," she recalls.

"Exploring nutritional approaches to disease management was a direction I took when I saw an unmet need."

Evolving this specialist area for the past 15 years, however, Lisa has made a number of significant discoveries. Together with her team at the Hunter Medical Research Institute (HMRI), the leader of the Nutrition Research group in the Priority Research Centre for Asthma and Respiratory Diseases examines the mechanisms by which dietary factors, including antioxidants, fatty acids, obesity and soluble fibre, affect the biochemical and physiological outcomes of respiratory disease. Principally demonstrating that short-term nutritional manipulation can modify blood lipid profiles, airway inflammation, asthma control, lung function and responses to asthma medications, such as Ventolin, she's also put science behind some 'very strong' perceptions and hearsay.

"People seem to know food is important in the management of asthma and other respiratory diseases even though there is so little data available," she claims.

"It's a curious thing."

The ambitious academic is similarly aiming to highlight 'great' community interest in this scope of research.

"What we do is incredibly translatable and applied," Lisa concedes.

"This is because people are trying to manage their asthma by changing their diet and as such, they need to be provided with specific guidelines."

Diet detective

Lisa began her research career with a PhD in Nutrition and Dietetics in 2001. Collaborating with the University of Newcastle and Westmead Children's Hospital during the four-year project, she studied the relationship between antioxidants and oxidative stress in young cystic fibrosis patients.

"People with this disease have a very different eating pattern. They are recommended a high-fat/high-energy diet because they don't absorb food properly," the nutritional biochemist explains.

"Eating lots of calorie-rich foods means they'll get enough energy to grow."

Lisa's investigation explored the effect of high fat diets in these patients and also identified a link between lung health and antioxidant levels in the body.

"Increasing antioxidant levels was found to be associated with improved lung function in patients with cystic fibrosis," she divulges.

Continuing this work on antioxidants with the HMRI's Respiratory Research Group from 2002-2006, the National Health and Medical Research Council Australian Training Research Fellow looked to translate some of her PhD research to another airways disease – asthma.

"It has a very different pathology to cystic fibrosis," she asserts.

"But it was again about using nutritional approaches to combat inflammation."

Moving to whole food interventions this time around, Lisa delivered antioxidants to asthma patients in the form of fruit and vegetables. The 'high' fruit and vegetable diet group consumed two serves of fruit and five serves of vegetables per day to meet current dietary guidelines, while the 'low' fruit and vegetable diet group consumed one serve of fruit and two serves of vegetables per day, which is the usual intake for Australian adults.

"We compared what people should be eating with what they are actually eating," she says.

"In a three-month period we found that those in the 'low' group had more than twice the risk of having an asthma attack than those in the 'high' group."

"So consuming lots of fruits and vegetables, which are high in antioxidants and soluble fibre, is important in controlling and reducing intermittent asthma flare-ups."

Hoping this research is as translatable as it is applied, Lisa is now in the process of undertaking a similar study with children.

"Asthma is more prevalent in young people so we're really hoping we can use the dietary approach to reduce their risk of picking up a viral infection or having it move on to an exacerbation," she reveals.

"The other great thing about a high fruit and vegetable diet is that it has multiple health benefits."

"It's an appealing strategy."

Foods that harm and foods that heal

Lisa extended her studies to investigate the roles of fatty acids and obesity in respiratory disease after procuring the prestigious University of Newcastle Brawn Fellowship in 2007. Seeking to examine the effects of different types of dietary fats on different types of bronchodilators, the interdisciplinary researcher demonstrated for the first time that nutritional factors could modulate airway inflammation and pharmacological responses.

"Bronchodilators are drugs that widen the bronchi. An example is Ventolin which is taken by inhalation to alleviate asthma symptoms," she clarifies.

"The key observation underpinning this project is that when people eat lots of fatty foods, it reduces the efficacy of their Ventolin."

"Bronchodilators are the first thing people go to when they're experiencing an asthma flare-up, so it's important we understand why they don't work as well when high-fat foods are consumed."

"It has major implications for the health and safety of asthmatics who are experiencing a potentially life-threatening asthma episode."

Currently working with bariatric surgeons at Lake Macquarie and Lingard Private Hospitals to explore the role of adipose tissue macrophages in obese asthma, Lisa is adding yet another dimension to her research. Fat samples collected during bariatric surgery are brought back to the labs at HMRI, to understand how this tissue could be driving airway inflammation.

"When someone is obese, they develop fat around their organs," the Associate Editor of Respirology explains.

"But it doesn't just sit there doing nothing – the fat actively releases chemicals into the bloodstream."

"Those chemicals then reach different organs and damage them, and this is why obesity is related to so many other diseases."

Hypothesising the same thing happens in asthma, Lisa is after scientific proof that chemicals in the bloodstream also reach the lungs and stop them working efficiently.

"Once you know what the tissue is actually doing you can get creative in how you prevent its effects," she reveals.

"Having this understanding opens up the way to develop new therapies."

Simultaneously running a clinical trial to examine the effects of soluble fibre on the gut microbiome and immune responses in asthma, Lisa is addressing airway inflammation from multiple angles.

"No one has ever done an intervention to see if fibre supplements affect the airways in humans," she says.

"It's only been done in animals, with exciting results."

"Now we are extending the investigation to humans."

Engaging the next generation

Combining this research expertise with more than a decade's worth of teaching experience, Lisa also teaches undergraduate students and supervises a team of PhD students at the University of Newcastle. Chiefly focusing on the biochemical and nutritional aspects of human health, both roles have a strong synergy with her multidisciplinary research endeavours.

"I'm very lucky that I get to teach what I am researching," she admits.

"It gives me an opportunity to talk to students with similar interests and feed them into the research groups at the HMRI and University's Priority Research Centre for Asthma and Respiratory Diseases."

"Most of the members of my team actually come through the undergraduate programs."

A 'very proud' leader both in and out of the laboratory, Lisa has nothing short of praise when it comes to commenting further on her colleagues' collective work ethic.

"Data from five of our recent publications was included in last year's National Asthma Council 'Australian Asthma Handbook', which was very rewarding," she says.

"We're finally starting to provide definitive advice after all these years of research."

A complete picture

Lisa's research hope for the not-so-distant future is two-pronged – provide a comprehensive plan on how people should approach their diet when they have a disease involving airway inflammation, and secure more funding opportunities for work that is of increasing interest to the general public.

"They're the ultimate goals," she declares.

"Any research that crosses disciplines can be difficult to fund because it doesn't fit into any one category – but to me, that's the research that is most worthwhile."