What is asthma?
Asthma is a chronic or recurrent inflammatory disease of the airways (bronchi) that carry air to and from the lungs. Asthmatics find it hard to breathe during an attack because mucosal and bronchial wall inflammation induces bronchial constriction (bronchospasm) due to mucosal oedema, mucus plugging, and smooth muscle spasm. In turn, the swelling or inflammation makes the airways more sensitive to irritations and allergic reaction.
During an asthma attack, the lung airways become narrower and less air can get into the lungs causing symptoms such as wheezing, chest tightness, shortness of breath, difficulty breathing, and a cough. Symptoms are usually worse and more frequent during the night, in the early morning, or during exercise.
Asthma can be triggered by a bronchial hyper-sensitivity reaction to environmental and dietary allergens, air pollutants, exercise, and infection. Asthma appears to be genetically determined with a high incidence of bronchial hyperactivity and other allergic disorders detectable in close blood relatives of asthmatic patients.
Asthma can affect people of all ages, but it usually becomes apparent during childhood and has a substantial impact on the community. Australia has the highest rates of clinically diagnosed asthma worldwide.
Asthma symptoms may be mild and resolve spontaneously or after minimal treatment with asthma medication. However, symptoms may continue to get worsen, which may require hospitalisation.
Asthma is a chronic or recurrent inflammatory disorder of the bronchial airways that usually begins in childhood, occurring most frequently in ‘atopic’ individuals, who readily produce IgE antibodies to common environmental antigens and allergens. Other allergic disorders such as allergic rhinitis, eczema, and irritable bowel syndrome are often present in these patients and a family history of these disorders and of ‘early onset’ asthma is common.
Commonly, asthma patients show an elevated total serum IgE level and allergy tests (skin tests and RAST) may reveal specific IgE antibodies to a variety of environmental allergens derived from organic materials, such as pollens, dustmite, cockroach, feathers, animal dander, and fungal spores. Less frequently, allergy testing shows positive reactions to ingested allergens derived from certain foods such as wheat, corn, milk, eggs, yeast, and fish, which presumably reach the bronchi via the bloodstream.
However, many patients with overt asthma do not demonstrate an allergic diathesis and many patients with frank allergic disease do not develop asthma, indicating that other non-allergic mechanisms are also involved in the development of asthma.
Asthma during pregnancy potentially can affect the foetus. Effective treatment and good control will reduce the affects. Ineffective treatment and poor control could lead to oxygen deprivation for the foetus (hypoxia), preeclampsia, growth retardation, premature birth or low birth weight.
Conventional medical treatments doctors use to treat asthma
While asthma is an incurable condition, a person who manages treatment well can live a normal and active life.
A person with asthma needs to see a doctor to find out what triggers symptoms and how to avoid asthma triggers. A doctor will prescribe medications to help manage asthma symptoms and reduce inflammation.
Over time, a person with asthma will learn to avoid triggers, and when to take medication. Effective control will enable participation in normal everyday activities.
Asthma is part of the spectrum of disorders that includes severe reactions to food allergies and both are allergic disorders. One study of food allergy fatalities found that the vast majority of patients who died from anaphylactic shock caused by food also had asthma. The bottom line is that if a person has food allergies and asthma symptoms, an awareness of how his or her asthma might affect allergies, and vice versa, is essential.
Nutritional medicine treatment for asthma
Nutritional medicine therapy for asthma focuses on changes to diet and nutritional supplementation, and aims to correct immune response and in turn airway sensitivity and reactivity. Modifications to diet in developed countries can partly explain the increase asthma incidence during the 20th Century.
Epidemiologic data demonstrates a significant association between dietary deficiencies in omega-3 fatty acids, vitamins A, E, D and C, magnesium, selenium and asthma. Determining and eliminating allergens from the environment and diet will help alleviate the severity of chronic asthma symptoms. Populations with higher intake of pro-inflammatory polyunsaturated fatty acids (omega-6 fatty acids) have a higher prevalence of asthma, eczema, and allergic rhinitis.
Potential allergens include food additives and preservatives, eggs, wheat, corn, sugar, peanuts, eggs, and dairy products. The fat cells stored in the body secrete cytokines and immune proteins that can contribute to inflammatory conditions, such as asthma. Research shows that when a person with asthma loses weight, his or her symptoms improve. Determining an ideal BMI and maintaining an appropriate weight will assist with asthma control.
Imbalances between oxidants and antioxidants are believed to play a fundamental role in the development of asthma and ongoing exacerbations. A diet rich in fresh fruits and vegetables, whole gains, nuts, and legumes will provide essential antioxidants to protect the body from the rigors of oxidation. Antioxidants preferentially react with free radicals to prevent free radicals reacting with and damaging body tissue. The oxidative stress in the 21st Century from environmental toxins is much higher than 200 years ago. Vitamins c and E, flavonoids, and polyphenols are antioxidants that defend the body against oxidative stress.
General nutritional medicine treatment steps include:
- Ensuring an adequate medication management plan is in place
- Identifying and eliminating, if possible, environmental and dietary allergens and irritants
- Supporting and enhancing digestive efficacy
- Optimising antioxidant intake including ascorbate, vitamins C and E, and bioflavonoids
- Increasing omega-3 fatty aid and reducing omega-6 fatty acids in the diet
- Improving EFA metabolism, and
- Correcting bowel dysbiosis.
Specific nutrient supplementation should include vitamins B6, B3, B5 and magnesium together with immuno-modulatory and anti-inflammatory phytochemicals, as indicated.
Vitamin C supplements can reduce the symptoms of asthma, in particular exercise-induced asthma. Preliminary research found that children with asthma had significantly less asthma symptoms on a vitamin C-enriched diet. The anti-inflammatory and antioxidant benefits of vitamin C are well established and help keep the airways open and free of mucus.
Vitamin E is known to fight the detrimental effects of air pollution. Nutritional deficiencies in vitamin E have been linked with asthma in children and young adults.
Omega-3 fatty acids reduce inflammation and symptoms associated with most types of asthma, according to several medical studies, but not aspirin-induced asthma.
Choline, also called vitamin B5, acts as a methyl donor, and may help reduce the severity and frequency of asthma attacks. Choline is found in liver, muscle meats, fish, nuts, beans, peas, spinach, wheat germ, and eggs.
Magnesium has proven brochodilating and anti-inflammatory effects and is used as an adjuvant therapy for moderate to severe asthma attack. People who have asthma often have low levels of magnesium. Intravenous magnesium can work as an emergency treatment for adult asthma attack.
Coenzyme Q10 acts as a powerful antioxidant and research shows that supplementation can reduce the dosage of corticosteroids required to control asthma. People with corticosteroid-dependent bronchial asthma have low levels of Coenzyme Q10 in their blood stream.
Lycopene and beta-carotene (vitamin A) are useful anti-oxidants found in fresh fruit and vegetables that protect against inflammation in the lungs and reduce the risk of developing asthma, including exercise-induced asthma. Lycopene is a bright red carotene found in tomatoes, red capsicum, watermelons, and papaya. Beta-carotene is found in vibrantly coloured fruit and vegetables, such as carrots, apricots, green capsicum, paw paw, sweet potatoes and other vibrantly coloured fruit and vegetable are an excellent source of beta-carotene.
Quercetin is a flavonoid antioxidant that reduces histamine release, the chemicals released during an allergic reaction. Histamines produce symptoms such as a runny nose, watery eyes, and hives. Because of its antihistamine benefits, Quercetin has been proposed as a treatment for allergic asthma.
Simply drinking more water and avoiding caffeine can increase hydration levels. Chronic dehydration is linked to broncho-constriction. While the symptoms of most asthma patients are related to a combination of airway inflammation and broncho-constriction, drinking adequate amounts of clean water will keep normal lung mucus from becoming sticky.
A person with asthma needs to have hepatic detoxification pathways and bowel mucosal permeability assessed, in order to correct any problems identified.
Recent studies report that GUT-mucosal tissue macrophage antigen presentation and CD4 T-cell cytokine production are both down-regulated by increasing intake of vitamin E, omege-3-fatty acids and probiotic supplements.
Recent studies also confirm that dietary and nutrition manipulation of essential fatty acid balance, reducing saturated and omega-6-fatty acid intake and augmenting omega-3-fatty acid intake, substantially reduces bronchial hyper-reactivity and asthma severity and occurrence.
Several clinical intervention studies utilising food avoidance or oligoantigenic diets report substantial improvement in asthma incidence and severity in approximately 70-80% of asthmatic patients. It is likely that this beneficial therapeutic effect occurs secondary to GALT-mediated cytokine production and may be augmented by concomitant supplementation with vitamin E, omega-3-fatty acids and probiotics.
Breast feeding during the first six months of life reduces the development of atopic diseases, such as asthma, in particular in children with a family history of allergic reactions. Breast milk immunoglobulin enhances TH1/TH2 reactions along the gut mucosa and help with the maturation of intestinal flora in infants.
The use of probiotics during pregnancy or early life to enhance gut flora to prevent allergic conditions has been show to have a favourable effect in children at high risk for developing allergies. According to a recent meta-analysis study of randomised, controlled trials published during the decade to 2012, “carefully selected probiotics administered during pregnancy and early infancy may have a role in the primary prevention of atopic diseases, particularly in high-risk infants”.
Asthma comes from the Greek verb aazein, which means to pant or exhale through an open mouth. Nutritional medicine treatment can reduce inflammation, speed recovery, and reduce the amount of corticosteroid medication needed to prevent attacks.