New Treatments for Asthma: Change Your Lifestyle
While the diagnosis of asthma has not changed significantly, the treatment has (and should). Asthma affects 25 million people (including 7 million children) in the U.S. The incidence of asthma has increased in the last few decades, and while the exact reason for this is unclear, evidence suggests a link between nutrition/diet, weight, air pollution and allergies. The treatment for asthma is not just taking medications!
Think of the new asthma treatments as “lifestyle” changes.
- Antioxidants: While no diet will eliminate or cure asthma, evidence suggests those who embrace diets high in Vitamin C and E, beta-carotene, flavonoids, magnesium, selenium, and omega-3 fatty acids have lower rates of asthma. Foods high in carotenoids include carrots, watermelon, mango and tomatoes. Children who grew up eating a “Mediterranean Diet” high in nuts and fruits (grapes, tomatoes, apples) had less asthma symptoms. Studies show a low Vitamin D level has been linked to asthma attacks and low lung function. Vitamin D supplements may improve asthma control. A high fat meal (over 48 grams) can lead to more lung inflammation and less recovery of low lung function with albuterol.
- Obesity is associated with severe asthma (requiring ER visits) and decreased lung function. Inhaled steroid medications don’t work as well in patients with body mass index (BMI) over 25. How much weight do you need to lose to help improve asthma? Only 5 to 10%, and aim for a BMI less than 25.
- Acid reflux is associated with asthma symptoms. Heartburn is more likely if a person eats too much, too fast, or too late at night.
Exercise: Although exercise can sometimes be a trigger of asthma, this is no excuse to be a couch potato. Exercise has been shown to improve quality of life in persons with asthma with more symptom-free days, better oxygen consumption, and less inflammation. How much exercise is enough? At least 30 minutes twice a week. Exercise can also be helpful with weight control.
Stress control: Individuals with asthma who have anxiety and depression are at increased risk of asthma attacks. A disorder called vocal cord dysfunction triggered by anxiety can complicate asthma but not respond to asthma medications. Interventions may include counseling, breathing relaxation techniques, and sometimes anti-anxiety medications.
Allergen control: 90% of children with asthma have allergies and these allergies can trigger asthma. In adults, about 50% of patients with asthma have allergies. By treating your allergies, the asthma can improve.
Air pollution. Air pollutants that include small particles can trigger asthma. Sources include cigarette smoking, wood smoke (campfires, wildfires, poorly ventilated indoor stoves), diesel exhaust, soot and ash. Strong chemicals and fumes are also triggers.
Vaccines: viruses such as influenza, RSV, and the common cold virus called Rhinovirus can trigger asthma. The flu vaccine is recommended for all individuals over 6 months old, but especially for those with asthma according to the CDC.
Medications: They are still important!
- Quick relief: albuterol is still the most common inhaler in use today to help relieve symptoms of asthma and prevent exercise-induced asthma when used 15 minutes before exercise. Whether it is by a nebulizer or inhaler, keep it on hand. The newer devices have dose counters and are easier to use.
- Daily controller: this group includes the inhaled corticosteroids deemed the most effective treatment for asthma. When combined with long-acting bronchodilators, the combination is even better for those with moderate to severe asthma. The newest combination medications are taken only once a day. Medications like Singular® block an inflammatory pathway without being a steroid medication and are taken as a pill once a day. Spiriva, an inhaled medication long known to be used for COPD (chronic lung disease from smoking), was recently approved for treating asthma.
- Biologicals: The injectable medication Xolair® has been available since 2003 and blocks the allergic antibody IgE. Mepolizumab marketed as Nucala® and approved in 2015 is monthly injection that works by blocking the protein interleukin-5 to prevent buildups of white blood cells called eosinophils in the lungs that can trigger asthma.
Individuals with asthma have choices. While there is no cure for asthma, the available treatment options and lifestyle changes can help control asthma so individuals can lead healthy, productive lives. By controlling asthma, it will not control you!
At Family Allergy & Asthma Care of Montana, we look at asthma differently and look forward to improving the quality of life of all of our patients.