Speaker's Highlight

• Don Sin University of British Columbia, St. Paul Hospital (Canada)
  Kenneth R. Chapman Toronto General Hospital Research Institute (Canada)
• Parameswaran Nair McMaster University (Canada)
  Carolyn Calfee UCSF (U.S.A.)
• Gregory P. Downey University of Colorado School of Medicine (U.S.A.)
  David A. Schwartz University of Colorado School of Medicine (U.S.A.)
• Neil Schluger Tuberculosis Control Branch, California Department of Public Health (U.S.A.)
  Nick Kim Critical Care & Sleep Medicine, University of California San Diego (U.S.A.)
• Nicola Hananiah Baylor College of Medicine (U.S.A.)
  Jae-Joon Yim Seoul National University College of Medicine (Republic of Korea)
• Koichiro Asano Tokai University School of Medicine (Japan)
  Diahn-Warng Perng Taipei Veterans General Hospital (Taiwan)
• Konstantinos Kostikas University of Ioannina (Greece)
  Karin Klooster University Medical Center Groningen (Kingdom of the Netherlands)

• Eating Patterns And The Pace Of Lung Function Decline

  The effect of dietary patterns on lung function decline is becoming an important question in respiratory medicine. Lung capacity naturally changes with age, yet the rate of decline differs between people. Smoking, air pollution, physical activity, infections, body weight and chronic conditions all play a role, while food quality may influence several of these pathways at once.

  For Australians, the issue is relevant across city and regional settings. A Mediterranean-style eating pattern can be adapted to local produce, supermarket prices and familiar meals, rather than treated as a rigid overseas prescription. The aim is to support respiratory health through sustainable habits that also protect cardiovascular and metabolic wellbeing.

  How Food May Influence Respiratory Health

  Fruit, vegetables, legumes, wholegrains, nuts, seeds and oily fish provide fibre, antioxidants, minerals and beneficial fats. These nutrients may help regulate oxidative stress and low-grade inflammation, processes that can affect airway tissues and lung ageing. Fibre is also fermented by gut bacteria into short-chain fatty acids, which may influence immune activity throughout the body.

  A diet high in processed meats, refined carbohydrates, sugary drinks and heavily packaged foods can have the opposite profile. It may contribute to obesity, insulin resistance and systemic inflammation, all of which can make breathing more difficult or worsen the effects of existing lung disease. The association is complex, and food cannot reverse established emphysema or replace prescribed treatment.

  What The Research Can And Cannot Show

  Population studies often find better spirometry results among people who eat more plants and fish and fewer ultra-processed foods. Measures such as forced expiratory volume in one second, or FEV1, and forced vital capacity may be higher in these groups. Some studies also associate greater fibre intake with a slower fall in respiratory performance over time.

  These findings do not prove that one food directly prevents lung function loss. People with healthier diets may also exercise more, smoke less, sleep better and have greater access to healthcare. Researchers therefore need to account for age, socioeconomic conditions, occupational exposures and smoking history. Clinical advice should present dietary patterns as one part of prevention and long-term disease management.

  The Value Of A Mediterranean-Style Pattern

  A Mediterranean-style pattern emphasises vegetables, fruit, beans, lentils, wholegrain breads and cereals, extra-virgin olive oil, nuts and regular fish. Poultry, eggs and yoghurt can fit in moderate amounts, while red meat, processed meat and discretionary foods are used less often. This combination supplies fibre and unsaturated fats without requiring unusual ingredients.

  In Australia, the pattern can include Tasmanian salmon, sardines, Victorian lentils, Queensland mangoes, seasonal leafy greens and wholegrain sourdough. It also works with familiar meals such as vegetable-based pasta, bean stews, grilled fish with salad or a breakfast of oats, fruit and yoghurt. The Australian Dietary Guidelines provide a practical foundation, especially when meals need to suit family routines and local availability.

  Foods Worth Prioritising

  Plant foods are useful because they increase dietary variety and help replace foods with less favourable nutritional profiles. A gradual target might be to add a vegetable to lunch, include legumes several times a week and choose wholegrain cereal or bread more often. Frozen vegetables and tinned beans can be affordable alternatives when fresh produce is costly or inconvenient.

  Oily fish provides omega-3 fats, while nuts and seeds add protein, magnesium and unsaturated fat. For people managing chronic obstructive pulmonary disease, asthma or another respiratory condition, an accredited practising dietitian can adjust portions and textures around appetite, fatigue, reflux, diabetes or unintended weight loss. Nutritional needs differ greatly between a person carrying excess weight and someone struggling to maintain muscle.

  Practical Markers For An Australian Plate

  A useful way to assess eating habits is to look for patterns across a week rather than judge a single meal. Shopping at a weekend farmers’ market in Adelaide or Melbourne may help some households, while others will rely on Coles, Woolworths, Aldi, community food services or local greengrocers. Price, distance and cooking facilities matter, particularly in rural and remote areas.

  Helpful features to build into regular meals include:

  • Two or more types of vegetables at the main meal
  • Legumes, tofu or fish replacing some processed meat
  • Wholegrain rice, oats, pasta or bread
  • Water as the usual drink

  Small substitutions can be more realistic than a complete dietary overhaul. At a barbecue in Perth or Sydney, grilled fish, corn, salad and bean-based sides can sit alongside traditional foods. In colder Canberra or Hobart weather, vegetable soups and lentil casseroles offer economical ways to increase fibre and fluids.

  When planning a respiratory-friendly shopping list, consider:

  • Seasonal produce to reduce cost
  • Unsalted tinned beans and fish
  • Plain yoghurt, nuts and seeds
  • Fewer packaged snacks and sugary drinks

  Diet, Infection And Long-Term Lung Care

  Adequate protein, energy and micronutrients support immune function, which matters because respiratory infections can cause significant setbacks for people with vulnerable lungs. Diet alone does not prevent pneumonia, and vaccination, hand hygiene, smoking cessation and timely medical assessment remain essential. Information about updated pneumonia guidance can help place dietary care within broader infection management.

  Hydration and sufficient food intake may also support recovery after illness, especially for older adults. However, persistent breathlessness, fever, chest pain, confusion or a worsening cough requires medical attention rather than dietary experimentation. People taking corticosteroids, diuretics or other medicines should check before using concentrated supplements, as interactions and excessive doses are possible.

  Making Dietary Change Sustainable

  Respiratory health advice works best when it respects culture, budget and capacity. A person with limited mobility may need simple meals, delivered groceries or help from family and community services. Someone working long shifts in Brisbane, driving long distances in regional New South Wales or managing seasonal work in the Riverina may need portable options such as fruit, unsalted nuts, wholegrain sandwiches and yoghurt.

  Smoking cessation remains one of the strongest ways to protect lung function, and dietary change should support rather than distract from it. Regular movement, pulmonary rehabilitation, vaccination and routine reviews are also important. A pattern rich in plants, fish and wholegrains may help create a healthier inflammatory and metabolic environment, but it is most effective when combined with established respiratory care.

  What matters most is the overall pattern: more minimally processed plant foods, enough protein and healthy fats, fewer heavily processed choices, and advice tailored to the person’s medical needs. Food is one contributor to the speed of lung ageing, while smoking avoidance, infection prevention and appropriate treatment remain central to preserving breathing capacity.

  Richard Russell Nuffield Department of Clinical Medicine, University of Oxford (United Kingdom)
• Mona Bafadhel King’s College London (United Kingdom)
  David Jackson Guy’s and St Thomas’ Hospital, King’s College London (United Kingdom)
• James Chalmers University of Dundee (United Kingdom)
  David Price University of Aberdeen (United Kingdom)