The Science Behind Asthma

Wheezing, coughing and shortness of breath, symptoms that are all too common for people with Asthma. In medicine, today it’s too easy to hand over a blue asthma inhaler and hope that the symptoms will lessen, when in fact so much more can be done to help.

There are nutrition, lifestyle and supplement tips that can help you beat the wheeze.

What is Asthma?

Asthma is a disease that effects the workings of the lungs. There are two main kinds described are bronchial and exercise induced asthma, these have different causes. It’s thought that over 8 million people, that is 12% of the UK population have been diagnosed with Asthma at some point their lives [1,2]. Asthma can start in the early years of life or develop as we age. Typically, those that are diagnosed as children grow out of their symptoms [2].

Bronchial Asthma is very serious and can cause spasms within the bronchioles. Bronchioles are branch-like structures that lead to the lungs. During spasms, the smooth muscle found it its wall sporadically contracts and relaxes which causes gasping for breath as the person feels as if they cannot breath. Oxygen is not getting into the lungs and carbon dioxide is not being expelled. This hyper-sensitivity can be an allergen, dust particles, excitability, anxiety or exercise (exercise induced asthma), however this is far less common [1,3].

One of the main clinical symptoms of asthma is inflammation of the bronchiole lining. Inflammation causes swelling which leads to a smaller lumen for air to travel through, this generates feelings of a tight chest. The protein used to prevent inflammation here is called surfactant protein D or SD-P this has been found to be faulty in people with Asthma.

What are the Symptoms of Asthma?

Typical symptoms of Asthma include the following:

• Wheezing
• Crackling chest
• Tight Chest
• Coughing
• Rapid Heartbeat, met by Rapid Breathing
• Poor tolerance for even moderate exercise
• Blue lips
• Frequent and opportunistic upper respiratory infections [1,3].

The typical steps of an attack go as follows:

1. Stimulus for reaction, this can be allergenic (dust or nuts) or non-allergenic (exercise).
2. Immunoglobulin E (IgE) are activated. Immunoglobulins are part of the immune system that protects us from foreign invaders. IgE in particular is responsible for the inflammatory immune response.
3. Bronchoconstriction and Spasm. Both restrict air flow, lumen size and induce shortness of breath, increasing breathing and heart rate.
4. Mast Cells release Histamine and other reactive chemicals. Mast Cells are a type of white blood cell that produce and release Histamine, the same chemical released during Hayfever.
5. Histamine travels around the body and induces Bronchial edema (fluid to the lung), stimulates the mucosa cells leading to running noses and eyes. It also causes constriction of the smooth muscle found in the bronchioles, leading to Bronchoconstriction and Bronchospasm. The wheezing, crackling and tight chest symptoms are often caused by this phase.
6. Airway Obstruction, and symptomatic shows of Asthma.

Causes of Asthma?

The main cause of Asthma is a faulty gene, which means that if one parent has Asthma there is a significantly higher risk of Asthma in any offspring. A specific gene was located in 2013 that found a link between mutation and childhood asthma, that is the 17Q2-21 gene[1].

Lesser known causes include obesity and poor diets. Obesity increases your body’s hypersensitivity to chemicals and foreign particles that can be non-harmful. This leads to increased inflammatory response. Additionally, there is more adipose stores that around the vital organs that puts more pressure on the lungs, increasing the need for surfactant to prevent collapse. Poor diets that contain very little antioxidants (Vitamin C and E) have also been shown to increase risk of asthmatic attacks [1].

Those most at risk of Asthma are shown below:

• Those with asthma in their family history in their first-generation relatives.
• Those with Allergy/Hypersensitivity related conditions in their family, i.e. Eczema, Food Allergens, Hayfever etc
• Overweight/Obese
• Born Prematurely or with a below average birth weight.
• Having frequent infections as a child
• Exposure to second hand smoke as an infant or child. [1,3]

Nutrition and Supplement Tips to Improve Asthma

As previously mentioned Antioxidants are thought to have an important role in the development and symptoms of the disease. One 2012 study found that there is a strong association to the use of antioxidants Vitamin C, E, beta-carotene and phenolic compounds and the severity of Asthma. Antioxidants seek to reduce the number of reactive free radicals in the body thus reducing oxidative stress and likelihood of inflammation in the bronchioles [4]

Vitamin D has boosted its press of recent months due to its claims of preventing everything from osteoporosis, to bowel cancer and finally Asthma. A 2013 study by Gergen et-al found that low levels of serum Vitamin D3 led to worsened symptoms of Asthma. This was confirmed in 2016 when the Guardian released that Vitamin D supplements are thought to half the risk of serious asthma attacks[5].

Omega 3 fatty acids are thought to aid white blood cell production and stimulate the chemicals that these produce. Also, it modulates inflammation of cell lining, this could reduce the speed in which an asthmatic attack could occur. Although Omega 6 oils should be avoided as these are thought to worsen symptoms.

Lastly, despite lack of specific Asthma related evidence for the following, Magnesium is thought to control smooth muscle and thus reduce spasms by stimulating the relax phase. Copper and Zinc, are cofactors to many antioxidant enzymatic reactions. The main enzyme used against free radicals and oxidation is the SOD enyzmes (superoxide dismutase). Both Copper and Zinc are cofactors to its action. The diet may be rich in antioxidants but Copper and Zinc are also required for efficient action.

Lifestyle tips to reduce Symptomatic Asthma

• Always keep an inhaler close by as these are the quickest way of lessening serious attacks
• Document specific triggers so you can best avoid them.
• Concentrate on your diet and health
• Practice breathing exercise to control your breathing
• Some people try complementary therapies such as acupuncture and hypnosis.