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BLOG: April 2007

Asthma symptoms spinning out of control

Recent statistics show that only one in five asthmatic children in the U.S. has their asthma symptoms under "good control". Nearly 3% of Americans are affected by this breath-robbing disease, children under ten more commonly than other age groups. The article (Associated Press) goes on that asthma causes 2 million emergency room visits, half a million hospitalizations and over 4,000 deaths a year. And the rate is rising.

On the other hand, children on the Mediterranean island Crete barely need any asthma related medical assistance. What makes the difference?

New federal guidelines expected this summer see the solution in "focusing" on more frequent, low-level symptoms, which should result in more effective medicating. Typically, there is no mention of the possibility to address the actual causes, or support body's own asthma-fighting ability.

While no one disputes that minimizing exposure to confirmed and possible asthma triggers is the main priority, this is where the official medical approach already falls short from addressing the problem. It is limited mainly to some of airborne allergens like smoke, mold, dander or dust mite particles and, in general, external factors like cold, physical activity and stress (even that is rather halfhearted, since doctors routinely do not systematically examine asthma sufferers for these possible particular sensitivities, nor do they have developed efficient methods for detecting them).

Consequently, the usual follow-up to asthma diagnosis is a symptom-suppressing medication followed with a set of general guidelines.

What is routinely overlooked and ignored when addressing asthma symptoms are underlying health conditions, environmental factors and nutritional deficiencies, often time a major asthma factor.

Food allergies (most often to eggs, fish, shellfish, nuts, milk, chocolate, wheat and citrus fruit), as well as  low gastric acid, intestinal dysbiosis (Candida), leaky gut and compromised tryptophan metabolism are among conditions that predispose people to asthma. Some offending foods tend to cause immediate response (i.e. asthma symptoms and/or attack), while others tend to cause delayed reaction7.

Other asthma triggers are similarly divided in this respect, showing again that asthma is a complex disease, most often with multiple causes, contributing factors and mechanisms of action.

Low level of antioxidants, especially vitamin C, exposes lungs to more tissue damage by oxidation, which directly contributes to asthma vulnerability. Infusion of magnesium can stop an acute asthma attack; its deficiency can make it happen. Vitamin B12 has also shown preventive capability, especially for sulfite-induced asthma symptoms7. Vitamin B6 is usually beneficial when compromised tryptophan metabolism is a factor (but not in those using steroids for symptom control).

An asthma aggravating factor is also the elevated level of pro-inflammatory prostaglandins (2-series prostaglandins) and leukotriens, hormone-like substances produced by the body from arachidonic acid, unsaturated fatty acid found in meat, eggs and dairy. Arachidonic acid is also the end product of metabolism of Omega-6 polyunsaturated fatty acids, particularly in the absence of Omega-3 fatty acids (which compete for the enzyme needed for conversion to arachidonic acid).

Thus diet low in foods of animal origin is generally beneficial for asthma sufferers, and so is moderation in consumption of oils high in Omega-6, with no Omega-3 fatty acids (safflower, sunflower, corn).

Just as much important is avoiding triggers like aspirin and other nonsteroidal anti-inflammatory drugs (NAID) - to which those with nasal polyps are frequently sensitive - as well as some common food additives (dyes, benzoates, sulfites). Both, NAID and food additive yellow dye #5 (tartrazine) stimulate production of inflammatory leukotriens that can cause or worsen asthma symptoms in sensitive individuals. The latter also inhibits vitamin B6 use, thus aggravating asthma symptoms through at least two different mechanisms.

Bronchial reactivity - and so the frequency and severity of asthma attacks - increases with salt intake, probably due to reduced water availability in the lungs.

Chemical environmental sensitivities, such as those to formaldehyde, also can be the major factor in triggering asthma attacks. Chlorinated tap water can also be an aggravating factor, particularly during hot shower, when chlorine inhalation is combined with skin absorption.

The above is still only a partial list of the possible factors directly related to asthma attacks. Considering how seldom, if ever, these factors are a part of systematic asthma therapy, it comes as no surprise that in the cited study nearly half of the children had persistent symptoms despite being prescribed preventive medications.

In fact, it has been shown over and over again, that over-reliance on drugs alone actually leads to more problems. It is only logical, since the underlying causes are not addressed, and condition is likely to worsen. One day your medication simply doesn't help anymore, and you rely on how fast you can get to the emergency room.

My mother wasn't lucky enough. Her asthma was "treated" with progressively stronger medications, to end up with periodic corticosteroid injections, just to keep her symptoms "under control". Yet all it took was a preservative vapor (potassium-metabisulphite) that found its way into her lungs as she was seasoning vegetables for the winter. The inhalator wouldn't help. Nothing did. She died in the car, as my father was rushing her to a hospital.

The bottom line is that identifying and avoiding asthma triggers, combined with correcting health conditions, environmental intolerances and nutritional deficiencies predisposing for asthma symptoms, should be in the forefront of asthma treatments. Medications should be used only for temporary, emergency or infrequent assistance. Unfortunately, the official view of medical profession is still turned upside down.

The good news is that times are changing, slowly but surely. A recent UK/Greece/Spain joint study was designed to find out why is incidence of asthma much lower for children in rural areas of Crete, compared to ~10% asthma incidence among children in the U.K. (BBC).

The study conclusion is that children on Crete are resistant to asthma mainly due to their better, nutrient rich diet, particularly in antioxidants and magnesium (although not mentioned in the article, less polluted environment is certainly a factor, since it lowers demands for nutrients the body needs for detox). About 80% of the children ate fresh fruit, and over two-thirds of them ate fresh vegetables, at least twice a day.

However, higher intake of margarine alone - known for its high trans-fatty acid contents, inhibiting synthesis of beneficial, anti-inflammatory 3-series prostaglandins - doubled the chances of asthma and allergic rhinitis.

An interesting finding is that skin allergies, relatively common on Crete, seldom are accompanied with respiratory symptoms. Apparently, it is not the allergic sensitivity itself causing asthma symptoms, rather oxidative damage to the lungs, causing inflammation, combined with insufficient nutrient level to control the immune and neuro-muscular function. 

The importance of nutrition in avoiding asthma - and other diseases - extends to the very beginning of everyone's life: mother's diet while expecting. Researchers from Netherlands and Scotland have recently found out that eating apples alone significantly reduces chances that newborn develop childhood asthma.

Why apples? They happened to be an excellent source of quercetin, a phytonutrient (flavonoid) that not only exerts potent antioxidant effect, but also suppresses production of pro-inflammatory leukotriens and histamine, thus having stabilizing influence on mast cell activity.

This indicates that oxidative/inflammatory damage to the lungs, predisposing for asthma symptoms, can take place as early as in mother's womb.

Adequate intake of vitamins A, E and D, as well as zinc also has shown beneficial effect.

Is it really that hard to put all the pieces together, and finally come up with a safe and effective set of guidelines for comprehensive, individually based, cause-oriented treatment of asthma? It isn't. But there is something in the way - a big, mighty pharmaceutical industry that wants to continue selling thousands of tons of medications for astronomical profits, and steers the official medicine in that direction. 



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