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.

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) They also need to vastly reduce their omega-6 fat intake.  Note that the Omega 3 fatty acid EPA is more effective than DHA in controlling asthma and inflammation, so make sure your fish oil is high in that important factor.  http://www.vitasearch.com/get-clp-summary/37960

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. http://www.vitasearch.com/get-clp-summary/37053

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.  http://www.medicalnewstoday.com/index.php?newsid=8689

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.

Since Cod Liver Oil is so helpful for Ear Infections,  it might also be beneficial for asthma sufferers.  http://my.webmd.com/content/article/49/39662.htm

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,

• Only 64% of US women even attempted to breastfeed their babies

• At 6 months, only a mere 29% were  still breast-feeding
• Rates were especially low among poor women, and among African Americans (only 19% still breast-feeding at 6 months)

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. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12077091&dopt=Abstract

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 - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12077091&dopt=Abstract 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)

Find the recommended supplements here

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A Report on the connection between Family Stress and Childhood asthma - http://www.eurekalert.org/pub_releases/2001-07/aaft-fsa070201.php

A kit to deal with the possibility of mold in your house as a contributing factor in ill health. - http://www.realmilk.com/where.html

Information about raw milk products