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The disease (fill in the blank) is on the rise. Almost every chronic
problem seems to be on the rise these days, and
asthma
is no
exception! Sadly, no one seems to be immune: the young, the old, the
athlete, the student, even the previously healthy: the terrifying
inability to fill one's lungs with the breath of life suddenly becomes a
major challenge. In 2005, the Centers for Disease Control found that 1
in 6 high school students is affected. What is to blame?
There are many causes. Obviously, one
consideration in asthma has to be the rise in air pollution and second hand
cigarette smoke. Bakers, manicurists, hairdressers and house painters,
those who work in construction and auto body shops, food processors and
janitors, frequently fall victim to asthma. Another villain is
allergy,
and anyone suffering
from asthma would be well advised to determine whether this is a factor;
the most common allergens for asthma sufferers are dairy products, eggs,
chocolate, wheat, corn, citrus fruits, peanuts and fish. High levels of
mold can be very problematic. Medscape published a really interesting
synopsis of diet and asthma in September 2000: studies from Italy,
Britain and Finland were mentioned in which the effect of diet on asthma
is unmistakable. The main outcome is that fruits and vegetables -
particularly apples - are extremely beneficial.
An Australian study
found that excessive polyunsaturated fat was harmful, while lowering sodium (see remarks
later) was helpful, reducing the risk of asthma by a factor of 30.
(Thorax
2002;57:94)
Also, finally, after many studies over
the years confirming the link, the connection between stress and asthma
is being explored. See RESOURCES at
right.
Asthma is caused by
inflammation of
the airways
, which causes swelling.
Asthma control
is very dependent on a proper fatty acid profile.
Asthma sufferers need omega-3 fats in their
diet in the form of fish oil.
(See
RESOURCES at right)
They also need to vastly reduce their omega-6 fat intake.
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Fatty acid balance determines one's degree of
inflammation: if the delta 5 desaturase enzymes are turned off by
insulin activity, inflammatory cell messengers will be produced from
Omega 6 fatty acids, and
anti-inflammatory ones in the Omega 3 pathway inhibited.
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Virtually
eliminating all high omega-6 fats will seem counter-intuitive to many
interested in health, as some common omega-6 foods seem healthy. For
instance, all seeds and nuts should be avoided (except walnuts and
flaxseeds, which have substantial amounts of omega-3 fats. However, though
omega-3 from fish oil is still preferred for its high levels of EPA and DHA). Nearly all other seeds and nuts have significant quantities of
omega-6 fats and should be eliminated from the diet (even if they are
organic), including:
-
Almonds
-
Pecans
-
Cashews
-
Peanuts
-
Sunflower
seeds
-
Pumpkin
seeds
-
Sesame seeds
For asthmatics,
it is always beneficial to know the omega-6 content of the foods you
consume, and to eliminate those that are high in this fatty acid.
Fish Intake and Risk of Adult Asthma -
this study also suggests
that consumption of fish in childhood is protective.
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Asthma and the Mediterranean
Diet
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The importance of diet overall has come to
the fore again in
this study
, which suggests that breathing problems in kids are
improved by 80% if they follow a Mediterranean type diet. See my
article on a
Healthy Diet
here.
Studies published in 2004 make a connection between
eating
oily fish during pregnancy, and lower rates of asthma.
This would
confirm a protective effect from EPA and DHA. Fish STICKS,
on the other hand, fried in Omega 6 oils, had a negative effect, causing
MORE asthma in the children.
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Research now links
ear infections in childhood with asthma,
which is no surprise at all. The lungs are also filled
with narrow tubes
lined with mucus membrane!
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The most common allergens for ear problems are indisputably
milk, wheat, eggs, corn and soy
.
Chocolate, citrus, peanuts, sugar and yeast
can also be implicated. Infants who are not breast fed commonly receive formulas containing the first 5 foods; and even some children who are breastfed, but have solids introduced early, are not able to digest them because at this stage in their lives, their digestive systems are really only designed by nature to handle the proteins present in mother's milk: the introduction of unexpectedly large protein molecules into the immature digestive system leads to their entering the bloodstream unaltered, stimulating the body's defenses to attack them as unfriendly invaders and leading not only to allergies, but often to something called
leaky gut syndrome,
which can compromise health in other serious ways.
The death rate from asthma for African-Americans
is four to six times that of whites. Among African American
children, the number of cases was 20 times higher in 1997 than in
1970. There is no doubt in my mind that there is a link here
between milk and wheat intolerances and ear infections, and
subsequently asthma, particularly when you bear in mind that a
substantial percentage of African Americans are blood type O.
Read Dr. D'Adamo's blood type theories here.
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Since Cod Liver Oil is so
helpful for
Ear Infections, it might also be beneficial for asthma
sufferers.
It also appears possible that
susceptibility to asthma goes back to the very beginning, to the
question of
breastfeeding
. Even in the year 2000, when
breastfeeding began subtly to increase,
which makes the following report very
interesting:
WESTPORT, CT (Reuters Health) Nov 20 - Results of a
study of more than 5000
Brazilian schoolchildren indicate that many breastfed children are less
likely than
others to have asthma or wheezing disorders.
Reporting in the October issue of the Journal of Asthma, Dr. Isabelle
Romieu, of
the Instituto Nacional de Salud Publica, Morelos, Mexico, and
colleagues
elsewhere note that they sought to examine the association between
breastfeeding
and chronic respiratory disorders in children.
The researchers examined questionnaires completed by 5182 Brazilian
schoolchildren (ages 7 to 14) and their parents. Of these, 4.6% reported
medically
diagnosed asthma and 11.9% reported current wheezing.
A total of 90% of the children had been breastfed, and after adjusting
for
confounders, the researchers found that children who had not been
breastfed were
1.51 times more likely to have an asthma diagnosis, 1.29 times more
likely to
experience current wheeze and 1.51 times more likely to have wheeze
after exercise than those who had been breastfed for at least six
months.
However, this protective effect was observed "only among children with
no family
history of asthma," and, say the investigators, "we did not observe a
dose-response
relationship with duration of breastfeeding."
The researchers call for further studies, but the low prevalence of
asthma and
wheezing seen in the studied population, they conclude, "may be partly
related to
the high level of breastfeeding." (J Asthma
2000;37:575-583. )
It now also appears (from a 2000 study in London's
Imperial College of Medicine, reported in the October issue of the
Journal of Asthma) that mechanical interventions at birth, such as
caesareans and vacuum extraction, or even the use of forceps, can raise
the adjusted odds ratio by as much as 2.14!
Babies that are fed so
called "good" bacteria
while they are being weaned may be less
likely to develop the allergy-related skin condition eczema, and I
speculate, any other allergy related condition.
Previous research has found
that
children with food allergies
are more likely to have a
"disturbed balance between beneficial and potentially harmful bacteria
in the large intestine.
In fact, both of
these first groups benefit from the addition of probiotics. An article
in
Gut
(
July
2002;51:51-55)
says definitively that "a
healthy balance of gut microorganisms is essential for the normal
development of the immune system. The establishment of such a balance in
infancy is thought to nudge the immune system away from allergic
reactions to harmless substances in the environment.
In the current
investigation, the team of researchers evaluated 21 breast-fed infants
who were previously diagnosed with eczema and therefore had a heightened
risk of allergies. Infants were weaned to whey formula that either did
or did not contain good bacteria, and stool samples were tested for the
presence of good and bad bacteria. Those who did not get the good
bacteria-laden formula were more likely to have higher concentrations of
"bad" bacteria. What's more, the presence of these bad bacteria appeared
to be related to immune system responses and the extent of eczema."
Very interesting also is research connecting asthma to
obesity
in children, with a French study showing that the risk of
asthma is 30% greater among obese adolescents, higher for girls than
boys. In light of these findings, the researcher decided to study the
eating habits of French adolescents and discovered another connection to
youths who skip the occasional meal or hide to eat. Dr. Annesi-Maesano
added: "it is interesting to note that there are fewer asthmatics among
young people who regularly enjoy their food." Further support for the
obesity connection comes in a study from the Dept. of Pediatrics in
N.Y.S.U, New York (quoted in Nutrition Science News, p 206 Apr.
99 Vol.4 #4) which found that 31% of asthmatic children were very obese,
as compared to 12% of non-asthmatic children
Yellow dye #5 (tartrazine
) is a suspected trigger, thought
to cause asthma attacks in as many as 100,000 Americans, and
aspartame
is under suspicion. Several studies have suggested that
high sodium intake may be linked to bronchial asthma, and conversely
that limiting sodium may lead to improvement. There are some studies
that suggest also a link between
trans fatty acids (hydrogenated
fats)
and asthma.
Sulfites in foods
are triggers for asthma,
and those with asthma need to be aware that some of the inhalers
recommended to help their spasms, actually contain sulfites.
The increase in asthma may also have a
simple root - the eating of less fresh fruits and vegetables,
particularly by children: a study from the Sackler School of Medicine,
Tel Aviv found that
64 mg of beta-carotene daily relieved symptoms of
exercise induced asthma
in 53% of patients.
Another "simple" connection is very
interesting to me, since I have spent many years decrying the obsessive
attention to "germs" in the American culture: and that is the suggestion
that eliminating minor challenges to the immune system renders it
ineffective when it finally encounters a major attack. From this it
follows that supporting the immune system will be of great benefit for
the asthma sufferer.
Addendum in 2002
-the above was written circa 1999 - it's great
to be right!! A new British study (
Archives
of Disease in Childhood
June 2002;87:26-29)
says exactly this:
that children
with the highest degree of personal hygiene -- those who washed their
faces and hands more than five times per day, cleaned before meals, and
bathed more than two times each day -- were the most likely to develop
eczema and wheezing between the ages of 30 and 42 months ....As the
level of hygiene increased, so did the risk of developing eczema or
wheezing ... The link between hygiene and allergies is in step with the
so-called "hygiene hypothesis" -- the theory that a lower exposure to
germs affects the immune system's development in such a way that it is
more prone to allergic reactions.
Two possible causative factors not
commonly considered are
water
- chlorine may cause an asthma reaction in
susceptible individuals - and
gas stoves
: a by-product called nitrogen
dioxide may trigger asthma and other respiratory problems.
Even more alarming is the connection a
French Doctor has established between
certain drugs and injury to the
respiratory system
, high on the list being many aspirin derivatives,
ACE inhibitors, beta blockers, anti-depressants, contraceptives, and
NSAIDS. Is that everyone???
New research (Ann. Allergy Asthma
Immunol 2000;85:495-500.) shows that besides adversely affecting
women's risk for
osteoporosis
, using corticosteroid inhalers also
results in decreased bone mineral density. The researchers looked at 56
women, using from 88mcg to 2000 mcg per day of common inhalants, and
found that 60.7% of them showed decreased BMD in the hips or spine.
This figure increased the longer the corticosteroids were used.
Another possible factor in asthma is inefficient
digestion: an experimental study of 160 asthmatic children determined
that they had low levels of
stomach acid
:
when Betaine Hydrochloride was supplemented, immediate improvements in
appetite, weight ,sleep and frequency of asthma attacks was noted.
Asthma attacks
became shorter in duration, and when offending allergens were also
removed, there was virtual freedom from attacks. ( It would be possible
to hypothesize here a possible connection between the frequent taking of
antacids and developing asthma as an adult - - but no studies have been
done along those lines, so this is pure speculation! It is alarming,
though, to see that there is now an anti-acid available specially for
kids.—the exact opposite of what they need!) Dr. Jonathan Wrights states
that underproduction of Hydrochloric Acid & pepsin to be a factor in 80%
of children with asthma. Using HCL to address the problem is best
supervised by a health professional,
Swedish Bitters
is perhaps a
safer alternative if you wish to try on your own to see if this is part
of your child's problem.
Another correlation, perhaps not
totally unexpected in light of Dr. Wright’s findings, is between
gastro esophageal reflux disease
and asthma: studies have suggested
that the reflux of acid into the esophagus can actually trigger a nerve
impulse that constricts the airways in the lungs, perhaps as a defense
mechanism against swallowing the acid the wrong way. This often results
in the prescribing of more or higher dose medications, which in turn
worsen the frequency of GERD occurrences, and we're off on a classic
vicious circle
Asthmatics appear to have 50% lower
than normal concentrations of
Vitamin C
in their blood, and the
EPA is now reporting that low Vitamin C values are directly linked with
a higher rate of asthma, bronchitis and wheezing. This would fit well
with new research from a Dr. Camporoto, of Southampton General Hospital,
UK, which shows that a general approach to boosting the immune system
can be beneficial for people suffering from rhinitis and bronchial
weaknesses that often progress to asthma ( December 2000 issue of
the American Journal of Respiratory and Critical Care Medicine.) A
1997 study by Cohen et al. (Arch. Pediat. Adolesc.151: 367-70) showed
that large doses of Vitamin C can protect against exercise induced
asthma. 20 subjects aged between 7 and 28 were supplemented with 2 grams
of Vitamin C or placebo before engaging in 7 minutes of exercise on a
treadmill. Asthmatic attacks were prevented in 45% of the subjects and
lessened in another 10%. Five of the subjects went on using Vitamin C
500 mg daily for two weeks, and the protective effect was continued.
B6
is also deficient in asthmatics, sometimes metabolically but
sometimes because some of the inhalants & medications prescribed for
asthmatics deplete B6. I would definitely supplement B6 along with a
good all round B Complex.
Magnesium
is a very important nutrient
for asthmatics, since it is a smooth muscle relaxant and reduces
histamine response. It is interesting to note that
absorption of
both B6 and Magnesium is adversely affected by low HCL levels.
Some research suggests a correlation
between low Vitamin D levels and intractable asthma.
It's many other benefits would make it a definite recommendation.
High amounts of Vitamin C are helpful, but both
magnesium and Vit. C therapy should be used with caution if kidney
problems are present.
Pycnogenol
and Ginkgo Biloba are sometimes helpful, since they both increase
micro-circulation and thereby lessen the inflammatory response while
strengthening capillaries. An Ayurvedic herb called Coleus Forskohlii
has been helpful for asthmatics, since it is a proven smooth muscle
relaxant. Fish Liver Oil is also an anti-inflammatory - be cautious if
allergic to fish!
The first important step for asthmatics is to
eliminate the identified triggers from their lives: airborne irritants,
allergens, high salt intake, hydrogenated fats, sulfites in foods. The
diet should be improved by an emphasis on fresh raw foods, complex
carbohydrates high in fiber, limiting sugar and animal products.
A body cleansing program
should be followed, and many asthmatics find bromelain, butyrates and a
good digestive enzyme helpful.
An Israeli Doctor investigated to see whether
Lycopene
might be helpful in exercise induced asthma: Dr. Ben-Amotz
designed a double-blind, crossover study with 20 patients. They were
randomly given either placebo, or 30mg of Lycopene, and the Doctor
found that 55% of those given the supplement experienced a significant
level of protection - he speculated that this result is due to the
antioxidant activity of the tomato based substance. The study was
published in Allergy 2000;55:1184-1189.
A U.S. patent has been awarded for the beneficial
effects of
MSM
on allergic asthma attacks - the sulfur factor at work
again! The patent holder, Robert Herschler states that "subjects find a
direct correlation between systemic concentrations of MSM and resistance
to allergens". (VitRet Mar 99:56)
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