Asthma Overview

Asthma is a long-term disorder that causes the airways of the lungs to swell and narrow, therefore increasing mucus production.1 In the UK, there are around 5.4 million asthma patients, with one in every 12 adults and one in every 11 children being affected.2 Coughing, whistling sounds (wheezing) as you exhale, and shortness of breath are common symptoms that might be a minor inconvenience for some people, and  life-threatening for others. 

All ages are affected, but it usually starts in childhood. People with asthma may experience symptoms that are triggered or worsened by certain things, which is called 'asthma triggers.' When symptoms worsen, it is called an asthma attack.3 Everyone with asthma has their own personal set of triggers and symptoms, leading to various types of asthma, such as allergic asthma, occupational asthma, exercise-induced asthma, severe asthma, and seasonal asthma, etc. 

Causes

It is impossible to pinpoint the exact cause of asthma. However, it is generally caused by a severe immune system response to chemicals in the lungs. There are some common risk factors that make asthma more likely.4

  • Having allergies-related conditions, such as eczema or hay fever.
  • Having a family history of asthma or atopic conditions.
  • Having had lung infections
  • Smoking or long-term exposure to tobacco
  • Being born prematurely (before 37 weeks), or with a low birth weight
  • Exposure to substances: wood dust, latex, flour, grain dust, etc.

Signs and Symptoms

Asthma can be diagnosed if one or more of the following symptoms are present, they  continue to return and worsen at night, or occur when the sufferer  reacts to a trigger (such as exercise, weather, or an allergy).3

  • Wheezing (a whistling sound when breathing)
  • Breathlessness
  • A tight chest
  • Coughing 

Asthma symptoms can occur more frequently if your asthma is more severe or if you are exposed to allergens. Asthma attacks, or exacerbations, can occur when symptoms intensify and may cause long-term damage to the airways in the lungs if not well controlled. Some signs of a severe asthma attack include:4

  • Fast heartbeat
  • Drowsiness, confusion, exhaustion, or dizziness
  • Blue lips or fingers
  • fainting

Can you reverse this disease? 

There is currently no cure, but there are simple treatments to keep  symptoms under control so that they do not interfere with your daily routine. Keeping track of your symptoms and adjusting your therapy as appropriate is essential because asthma can change over time. Long-term treatment is common to include a daily controller and an additional inhaler for short-term relief or to prevent symptoms.2

Lifestyle Factors

The following lifestyle factors have the greatest impact on increasing your risk of developing asthma or worsening symptoms.  We will also look at what you can do to reduce your risk today. 

Overweight/Obesity

Being overweight or obese can increase the chances of developing asthma or worsening asthma symptoms, however,  there is no complete clear answer to how this occurs.3 This could be due to changes in the immune system in obese people, excess weight around the chest and belly that constricts the lungs, or obesity that triggers the development of high cholesterol and diabetes, all of which can contribute to breathing problems. 

A study published in the Pediatrics Journal in 2018 found that overweight and obese children had an 8 to 17 percent increased chance of developing asthma, while obese teens had a 26 to 38 percent increased risk of asthma.5 Therefore, you should ensure that your overall weight and body mass index (BMI) are within normal ranges. 

However, even if these values are within normal ranges, having a large waist circumference puts you at risk. A healthy BMI is between 18.5-24.9, and waist measurement should be less than 80 cm for women, and 94 cm for men2. Weight loss is undoubtedly a recommended component of any asthma treatment approach. A study published in the Journal of Asthma in 2018 concluded that obese people with asthma who reduced weight had better breathing performance and quality of life, especially if they lost more than 5% of their weight.6

Nutrition

Eating a healthy and well-balanced diet is a fantastic way to keep your weight under control. Regardless of your weight it is still important to make healthier food choices, as certain foods are linked to reducing the risk of asthma. 

Fruits and vegetables are high in antioxidants, such as beta carotene, vitamins C and E, which can help minimise lung swelling and irritation caused by cell-damaging molecules called free radicals.7 There is also evidence that those who consume more vitamin C and E, beta-carotene, flavonoids, magnesium, selenium, and omega-3 fatty acids have reduced asthma rates. However, the direct link between diet and asthma still remains inconclusive; many researchers believe that our increasing consumption of processed foods increases our chances of acquiring asthma.8

Physical Activity 

Although exercise is an asthma trigger for some people, you should not avoid it. While a healthy diet is essential to maintain a healthy weight, regular physical activity is the next critical step. According to government guidelines, adults should engage in moderate-intensity physical activity (walking quickly, cycling, swimming) for at least 150 minutes per week. Breaking it down into 30 minutes a day, five days a week maybe more manageable. At least 75 minutes of vigorous activity (running, HIIT workouts, cycling fast or up hills) per week is recommended, and this could be broken down into 15-minute sessions, five days a week.4 If you don't know how to get started, here are some tips:

  • Finding something you like is important, as you will need to stick to it. 
  • Start small: becoming physically active should be a gradual process if you are not already doing it. For example, you could walk to the office, take the stairs, or walk your dog. Start with a short workout and gradually increase the duration and intensity of your workouts each week.
  • Pick a goal: Set a goal, such as cycling for a month or being active every week for 30 minutes. Be specific and realistic.

Smoking 

Tobacco use and second-hand smoke inhalation stimulate and complicate asthma treatment because smoke irritates the airways, making them inflamed, constricted, and clogged with sticky mucus.9 E-cigarette smoking and exposure to second-hand smoke can also be associated with asthma symptoms, as several research articles have suggested  that nicotine and flavourings contained in e-cigarette smoking can harm your lungs.2 

Other serious health conditions have also been linked to smoking, including heart disease, emphysema, and various cancers of the lungs, body, lymphatic system (including the breast), prostate, and digestive tract. Therefore, quitting smoking is good for overall health and well-being. If you find it difficult to quit smoking by yourself, the NHS provides stop smoking services available in local pharmacies.

Alcohol  

Alcohol is one of the triggers for asthma, as it contains substances called histamines and sulfites, which some people are sensitive to.2 Alcohol is also high in calories and can cause weight gain. According to current government recommendations, you should not drink more than 14 units (six glasses of wine) of alcohol per week, and those units should be spread over a period of three to four days. In addition to increasing the risk of obesity, binge drinking one or two days a week can have a significant impact on your overall health, such as developing certain types of cancer.10 

Sleep  

A new article in ACAAI reveals that too little sleep, and sometimes too much sleep can negatively affect adults with asthma.11 In addition, lack of sleep makes it difficult to lose weight because it increases your desire for high-calorie, high-carbohydrate foods. Stress hormones are released into the body when you get too little sleep, telling your body to store fat. With asthma, it might be difficult to get a good night's sleep. Try to exercise on a regular basis to overcome the difficulty of sleeping and staying asleep. A calming nighttime routine, avoiding large meals and alcohol an hour before bedtime, and keeping your bedroom dark and cool, are just a few of the recommendations.12 

Mental Health 

Some mental health problems, such as anxiety and depression, may also trigger asthma; however, the severity varies in individuals. One of the best things we can do to reduce anxiety is to confront negative ideas. You can alleviate your discomfort by using breathing and relaxation techniques. If you suffer from anxiety, depression, or panic attacks, seek a mental health specialist.

Takeaway

Many of the risk factors that can cause asthma can be controlled. It may be useful to think of it as a drive to make adjustments that will help minimise your risk. Eating the right foods and engaging in lifestyle habits that maintain a healthy weight will increase your chances of preventing asthma.

Diagnostic testing 

At Klarity, we use the latest technology when it comes to diagnostic testing. Our home blood tests give you information about your health and personalised recommendations. Find out which test you should take. Your medical history, physical exam, and diagnostic test results all contribute to the diagnosis of asthma. An asthma diagnosis is based primarily on the results of the following tests.

  • FeNO test – a machine that measures the level of nitric oxide in your breath 
  • Peak flow test – a handheld device that measures how fast you can breathe out
  • Spirometry – a machine that measures how fast you can breathe out and how much air you can hold in your lungs

After being diagnosed with asthma, you may be subjected to a chest X-ray or allergy tests to see whether an allergy is causing your symptoms.4

References

  1. Asthma [Internet]. Mayo Clinic. [cited 2021 Nov 8]. Available from: https://www.mayoclinic.org/diseases-conditions/asthma/symptoms-causes/syc-20369653
  2. Asthma UK [Internet]. Asthma UK. [cited 2021 Nov 8]. Available from: https://www.asthma.org.uk/ 
  3. Asthma [Internet]. [cited 2021 Nov 8]. Available from: https://www.nhlbi.nih.gov/health-topics/asthma  
  4. Asthma [Internet]. nhs.uk. [cited 2021 Nov 8]. Available from: https://www.nhs.uk/conditions/asthma/ 
  5. Lang JE, Bunnell HT, Hossain MJ, Wysocki T, Lima JJ, Finkel TH, et al. Being Overweight or Obese and the Development of Asthma. Paediatrics [Internet]. 2018 Dec;142(6). Available from: http://dx.doi.org/10.1542/peds.2018-2119 
  6. Özbey Ü, Balaban S, Sözener ZÇ, Uçar A, Mungan D, Mısırlıgil Z. The effects of diet-induced weight loss on asthma control and quality of life in obese adults with asthma: a randomized controlled trial. J Asthma [Internet]. 2020 Jun;57(6):618–26. Available from: http://dx.doi.org/10.1080/02770903.2019.1590594 
  7. Asthma diet: Does what you eat make a difference? [Internet]. Mayo Clinic. 2022 [cited 2021 Nov 8]. Available from: https://www.mayoclinic.org/diseases-conditions/asthma/expert-answers/asthma-diet/faq-20058105 
  8. Asthma and diet [Internet]. WebMD. [cited 2021 Nov 8]. Available from: https://www.webmd.com/asthma/guide/asthma-diet-what-you-should-know 
  9. Smoking and asthma [Internet]. [cited  2021 Nov 8]. Available from: https://kidshealth.org/en/teens/smoking-asthma.html
  10. Comprehensive cancer information [Internet]. National Cancer Institute. 1980 [cited 2021 Nov 8]. Available from: https://www.cancer.gov/ 
  11. Too little sleep can mean more asthma attacks in adults [Internet]. ACAAI Public Website. 2020 [cited 2021 Nov 8]. Available from: https://acaai.org/news/too-little-sleep-can-mean-more-asthma-attacks-in-adults/ 
  12. CDC. Healthy weight [Internet]. Centres for Disease Control and Prevention. 2021 [cited 2021 Nov 8]. Available from: https://www.cdc.gov/diabetes/managing/healthy-weight.html 

Yuting Jiang

Master of Science in Pharmacy - UCL (University College London)
Dynamic Master of Pharmacy student driven by a passion for providing high-quality patient care. Engaged in rigorous programmes of professional development, refining a myriad of skills, including data, analytical, and numerical. Gained excellent multi-lingual communication skills used to great effect in developing strong, multidisciplinary relationships and in the confident presentation of research findings both verbally and in writing.

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