How to Prevent Asthma

Introduction: What is Asthma?

All types of asthmas are induced by airway inflammation that causes narrowing of the airways and inhibits lung function. Asthma symptoms include wheezing, coughing, breathlessness, and chest tightness. Occasionally, symptoms can develop into severe asthma or asthma attacks, and immediate medical attention is required. 

Although symptoms are relatively consistent across the different forms of asthma, several types exist. The two primary definitions of the condition are atopic and non-atopic asthma. First, atopic asthma often comes in the form of childhood asthma and is triggered by allergies. In this case, asthmatic patients experience airway inflammation as a result of the release of histamines by mast cells. Many times, severe allergic asthma is also accompanied by hay fever (allergic rhinitis) or eczema (atopic dermatitis) in children. Second, non-atopic asthma symptoms can be induced by many factors and its onset is not well understood. Adults experiencing non-allergic asthma may be triggered by exercise, weather conditions, stress, and infections. 

Signs and symptoms 

Asthma is the swelling of airways, usually caused by allergens or other irritants, that ultimately leads to narrowing and difficulty breathing. Asthma affects nearly 262 million people worldwide and was accountable for approximately 500,000 deaths in 2019. In adults, symptoms of asthma are more common among people assigned female at birth (AFAB)  than people assigned male at birth (AMAB)

Contrastingly, asthma is a leading chronic disease among all children, particularly in boys. Urbanisation is often linked with the increasing rates of asthma, where air pollutants caused by industrial activity trigger many sufferers’ symptoms. The symptoms associated with airway narrowing include cough, wheeziness, shortness of breath, and chest tightness. These discomforts can be made worse by exercise, stress, infections, or triggering allergens. 

An asthma attack occurs when symptoms suddenly increase in severity and breathing becomes especially difficult. These attacks often require emergency medical treatment for access to an inhaler. Prolonged symptoms may cause adverse outcomes in other areas of life including consistent weariness, stress, anxiety, depression, and persistent lung infections.

Can you reverse this disease? 

Although the condition is incurable, many children outgrow serious attacks, and symptoms are manageable with proper treatment. Furthermore, avoiding your triggers is key to keeping breathing problems at bay. 

For those with atopic asthma, triggers are often allergens such as pollen, dust, mould, and other aeroallergens. Conversely, non-atopic (non-allergenic/intrinsic) asthma does not depend on an allergenic trigger, and its causes are largely unknown. It is postulated that the development of non-atopic asthma may be a result of increased stress, viral infections, medication side effects, and potentially more. That being said, non-atopic asthma is usually more chronic and less sporadic than atopic forms, and is more common among adults, people AFAB specifically. Although the causes of non-allergenic asthma remain ambiguous, it is treatable. Several non-atopic asthma treatments include antibiotics to fight infection, oral steroids, omalizumab, dupilumab, and other doctor recommendations.

Lifestyle factors:

The following lifestyle factors have the greatest impact on increasing your risk of this chronic health condition/disease. We will also look at what you can do to reduce your risk from today.

Nutrition 

Unfortunately, there is no diet-related cure for asthma of any type. However, the following steps may help mitigate symptoms and improve general health. 

First, eating to reduce weight in the case of obesity may help to improve nonatopic asthmatic symptoms. As discussed earlier, obesity is a risk factor for developing intrinsic asthma, and therefore decreasing body mass may eliminate chronic asthma incidence. 

Additionally, eating fruits and veggies full of antioxidants will likely reduce inflammation. Although these foods will not impact acute inflammation caused by allergic asthma triggers, they may reduce general inflammation associated with chronic asthma conditions or infection. 

Furthermore, consuming vitamin D has been shown to improve asthma-associated issues. Although the mechanism is not clear, vitamin D has been linked to a decreased incidence of asthma attacks and exacerbated symptoms. Furthermore, the supplement is also known to boost lung function and help the body fight off viral infections that might otherwise trigger breathing problems. 

Finally, reducing sulphite intake may also help improve asthma symptoms. Often found in wine, beer, shrimp, and dried fruits, sulfites cause wheezing and other asthma-like experiences in some people. Understanding your triggers and taking precautions is the best way to avoid asthma-inducing products. 

Physical activity 

For many people with asthma, especially those that have been diagnosed with nonatopic asthma, vigorous exercise can induce asthma symptoms. This response occurs because breathing often becomes more rapid during physical activity, forcing cold air in and out of the lungs quickly, therefore irritating airways. 

The best way to avoid triggering symptoms through exercise is to know your own limits. Build your body up towards more vigorous activities, or try yoga, pilates, or other less intense forms of body movement. Finally, discuss options with your GP; it may be possible that a reliever inhaler, used during the acute onset of asthmatic symptoms, could improve exercise-induced asthma. 

Although physical activity can exacerbate asthmatic conditions in some patients, the opposite also holds true. A lack of physical activity leading to obesity can also cause chronic asthma. As discussed earlier, being overweight can encourage the cellular inflammatory response that causes airway irritation and breathing difficulties. Although intensely vigorous exercise may further trigger asthma symptoms, getting moving in order to reduce body weight could vastly improve the condition. Trying some of the tips listed above, including practising breathwork-oriented activities and building up slowly, can help improve obesity-related asthma. 

Obesity 

As previously discussed, obesity is a serious risk factor for developing asthma, although the reason is unclear as to why. It is hypothesised that obesity causes low-grade inflammation throughout the body that can become exacerbated by other nonatopic triggers such as exercise, stress, and infection. 

Losing weight may improve feelings of breathlessness, and encourage you to do the things you enjoy. Furthermore, you have the potential to reduce other health problems associated with obesity including cardiovascular disease, diabetes risk, and others. Here is another great resource for beginning the process of losing weight, and staying motivated.

Smoking 

Smoking can cause asthma in both smokers and people exposed to second-hand smoke. For smokers, the chemicals in cigarettes irritate airways and produce symptoms much like those experienced during an asthma attack. Furthermore, smoking can lead to medication insensitivity, meaning that the treatments used to control asthmatic symptoms are often ineffective among smokers. 

Next, children who live in a home with a parent who smokes are far more likely to develop asthma than their peers. Surprisingly, these same children exposed to secondhand smoke can go on to develop nonatopic asthma as adults, even if disease free in childhood. 

Finally, death as a result of asthmatic complications is far higher in smokers than in the general group of asthma patients, likely due to medication insensitivity or reduced lung function. Apart from asthma, smoking can also lead to other respiratory diseases such as Chronic Obstructive Pulmonary Disease (COPD), lung cancer, and others. Of course, smoking is addictive and not an easy thing to stop. Here is a resource for getting started and staying motivated. 

Alcohol 

Various alcohols contain histamines and sulfites, both of which can serve as asthmatic triggers for some patients. Reactions to alcohol can vary widely, where some may find there other asthma triggers are exacerbated by alcohol consumption, others actually have reactions to drinking alone. 

That being said, the drinks most likely to induce asthmatic symptoms are wine, beer, and ciders. These types of alcohol contain more histamines and sulfites than spirits as a consequence of the natural brewing process. The best way to reduce reactions as a result of drinking is to avoid drinking altogether, or stick to the products you know don’t cause issues. Purchasing low-sulfite wine is also an option, and keeping a reliever inhaler nearby in the case of an unexpected acute attack is important. 

Sleep 

Sleep is a key component of the body’s ability to function, and regular sleep cycles can be seriously disturbed by asthma symptoms. Nocturnal asthma is a form of asthma where symptoms are most persistent during the night. Sufferers of nocturnal asthma may lose sleep due to breathing difficulties that limit the overall quality of life. This type of asthma problem is especially serious among non-allergic asthmatics who find that anxiety triggers their symptoms. 

Lack of sleep can exacerbate stress, creating a feedback loop where the symptoms causing sleep loss become more severe. Reducing stress-inducing activities can help improve asthmatic issues, and increase sleep quality. Try physically scheduling time for yourself into your day, or practising breathing exercises typical of yoga or tai-chi. Here is another great resource for those who experience anxiety-induced asthma. 

Mental health 

One of the primary emotional triggers for sufferers of nonatopic asthma is anxiety. Feeling anxious and stressed, whether it’s about work, life changes, or other events, can induce airway inflammation that causes most asthmatic symptoms. Furthermore, much like sleep, anxiety and asthma can exist in a feedback loop, where the symptoms of one heighten those of the other in a vicious cycle. That being said, stress is far more likely to induce asthma symptoms when the condition is not under control in the first place. 

Therefore, if the correct steps are taken, attacks caused by anxiety can be avoided. These steps include, first, sticking to an asthma treatment routine, whether that is a daily inhaler use or other treatments. Second, speak to your doctor or GP about exacerbated symptoms and keep them in the loop about potential triggers. Finally, cut down on additional stressors. This process can include eating healthier, exercising more often, or finding a hobby to utilise as a stress outlet. Here is a great source for anxiety-related asthma, and how to manage it. 

Wellness 

Keeping your emotional health balanced is necessary for your physical health. Self-care is important for overall good health. Here are a few simple tips for keeping well and avoiding triggers that may encourage exacerbated symptoms including stress, smoking, and alcohol.  

o   Forming healthy habits – dedicate one hour a day to doing something you enjoy such as reading, cooking, or making art. Eventually, the habit will form, and the hour will become a structured part of your routine. 

o   Setting boundaries – don’t be afraid to say no. Setting limits with your time, whether for work, family, or friends, is a great way to build self-confidence and remove stress from being spread too thin. 

o   Get better sleep – a full night’s sleep improves physical and mental wellbeing, here is a great resource for improving sleep habits.

Conclusion on lifestyle factors

To conclude, asthma is a complex condition that is affected and exacerbated by multiple factors. Ultimately, getting to know your own body and triggers is key to keeping the disease from negatively affecting your life. The majority of the risk factors listed above, including physical activity, nutrition, obesity, smoking, alcohol, and sleep, are completely within your control, and can be harnessed to reduce asthma’s impact on your health. 

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Kristen Bowles

Masters of Science - MSc Epidemiology Student, London School of Hygiene and Tropical Medicine, England
Kristen graduated as Summa Cum Laude and is now pursuing Masters of Epidemiology in LSHTM.
Experienced in cultural anthropology from the University of St. Andrews, and hopes to continue working in Europe with a special focus on medical mistrust and how these social factors influence health data, equity, and disease spread.

Klarity is a citizen-centric health data management platform that enables citizens to securely access, control and share their own health data. Klarity Health Library aims to provide clear and evidence-based health and wellness related informative articles.