The news this week is reporting a recent large-scale study (Ellwood et al.,2012) linking junk-food and childhood asthma and eczema.  Over the past four decades, the prevalence of asthma and eczema has markedly increased in Westernized countries and countries transitioning to this lifestyle. It has been hypothesized that these increases are a consequence of changing environmental and/or behavioural factors. The  modification of dietary habits (ie, decreased intake of fruits/vegetables and increased intake of “Westernized” processed/junk foods) and a decrease in sun exposure have led to decreased intake of antioxidant vitamins, beneficial fatty acids and circulating levels of vitamin D but higher saturated and trans-fats, sodium, carbohydrates and sugar levels and these changes have been proposed to explain the rise in such allergies (Ellwood et al., 2012; Varraso, 2012).

See below for a discussion of natural approaches to asthma symptoms:

Asthma is an increasingly common condition, with life-threatening consequences. Conventional treatment includes anti-inflammatory drugs such as corticosteroids and bronchodilators such as salbutamol. The herbal world also offers herbs which have beneficial anti-inflammatory and bronchodilating effects in asthma as well as many other benefits. Recent studies of interest in the natural management of asthma include:

Herbs:

  • A combination containing 150mg boswellic acid from frankincense (Boswellia serrata), 50mg liquorice extract (Glycyrrhiza glabra) and 15mg curcumin from turmeric (Curcuma longa) taken 3 times a day was shown to have ‘a pronounced effect in the management of bronchial asthma’. (Houssen et al., 2010). Frankincense has antiinflammatory properties through inhibition of the enzyme 5-lipoxygenase which is involved in synthesis of inflammatory chemicals called leukotrienes and turmeric in addition to inhibiting 5-lipoxygenase also inhibits the enzyme cyclo-oxygenase 2 which is involved in production of inflammatory prostaglandins. Liquorice has antiinflammatory properties which may be partly due to inhibition of the enzyme 11-beta hydroxysteroid dehydrogenase which inactivates the steroid hormone cortisol, the body’s natural antiinflammatory chemical. Asthma medication typically involves use of steroid drugs.
  • Gingko biloba inhibits an inflammatory chemical called platelet activating factor (PAF) which is involved in airway constriction and inflammation in asthma and an extract was shown to reduce inflammatory markers in asthma patients (Tang et al., 2007)
  • A trial using ginger (Zingiber officinalis) tincture (equivalent of 0.5g/day) was effective in reducing asthmatic symptoms, including nocturnal coughing attacks and dyspnoeic attacks, and usage of spray medication was reduced (Rouhi et al., 2006). In general , ginger is used for its anti-inflammatory effects and initial studies also suggest that it may also more directly prevent damaging long-term changes in the airways (Kuo et al., 2010)

Diet and Supplements:

  • Low serum vitamin D may be associated with asthmatic response to the common mould Aspergillus (Kreindler et al., 2010)
  • Vitamin C supplementation was shown to reduce the need for corticosteroids in asthma patients (Fogarty et al., 2006) and
    other antioxidants such as beta-carotene (precursor to vitamin A) have also been shown to be beneficial. Children with asthma have been shown to have increased ‘oxidative state’ suggesting the use of antioxidants is beneficial (Bakkenheim et al., 2011)
  • Although asthma has been associated with low selenium levels, recent studies do not support supplementation; brazil nuts
    have particularly high levels of naturally occuring selenium.
  • Omega-3 fatty acids (e.g. fish / flax oils) have been associated in trials with improvement in asthma symptoms (e.g. Covar et
    al.,
    2010)
  • A recent meta-analysis of trials supported use of vitamins A, D, and E; zinc; fruits and vegetables in prevention of asthma
    (Nurmatov et al., 2010)
  • Conjugated linoleic acids (CLA) are a family of natural fatty acids found primarily in beef and dairy products. These molecules have a variety of biological properties which suggest potential benefit in asthma, including effects on
    energy regulation, lipid metabolism, inflammation and immune function (Macredmond and Dorscheid, 2011).

Chemical associated with development of
asthma:

  • Phthalates in flexible plastics such as food wrappings has been found in recent studies to be associated with development of
    asthma and allergies in children (55% increased risk) and adults by altering the immune response. Phthalates in the food in contact with the plastic increases with time in contact, increased fat content and microwaving (Jaakkola and Knight, 2008).
  • The use of paracetamol in the first year of life may be linked to increased risk of asthma in children according to a study of
    more than 205,000 children aged between 6 and 7 years old (Beasley et al. 2008)

References

Bakkeheim E, Mowinckel P, Carlsen KH, Burney P, Lødrup Carlsen KC. (2011) ‘Altered oxidative state in schoolchildren with asthma and allergic rhinitis’. Pediatr Allergy Immunol. 22(2):178-85.

Beasley R, Clayton T, Crane J, von Mutius E, Lai CK, Montefort S, Stewart A; ISAAC Phase Three Study Group. (2008)
‘Association between paracetamol use in infancy and childhood, and risk of asthma, rhinoconjunctivitis, and eczema in children aged 6-7 years: analysis from Phase Three of the ISAAC programme’. Lancet. 372(9643):1039-48.

Covar R, Gleason M, Macomber B, Stewart L, Szefler P, Engelhardt K, Murphy J, Liu A, Wood S, DeMichele S, Gelfand EW,
Szefler SJ. (2010) ‘Impact of a novel nutritional formula on asthma control and biomarkers of allergic airway inflammation in children’. Clin Exp Allergy. 40(8):1163-74

Ellwood P, Asher I, García-Marcos L, Williams H, Keil U, Robertson C, Nagel G, the ISAAC Phase III Study Group (2012) ‘Do fast foods cause asthma, rhinoconjunctivitis and eczema? Global findings from the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three’ Thorax doi:10.1136/thoraxjnl–202285

Fogarty A, Lewis SA, Scrivener SL, Antoniak M, Pacey S, Pringle M, Britton J. (2006) ‘Corticosteroid sparing effects of vitamin C and magnesium in asthma: a randomised trial’. RespirMed.100(1):174-9.

Houssen ME, Ragab A, Mesbah A, El-Samanoudy AZ, Othman G, Moustafa AF, Badria FA. (2010) ‘Natural anti-inflammatory products and leukotriene inhibitors as complementary therapy for bronchial asthma’. Clin Biochem. 43(10-11):887-90.

Jaakkola JJ, Knight TL. (2008) ‘The role of exposure to phthalates from polyvinyl chloride products in the development of asthma and allergies: a systematic review and meta-analysis’. Environ Health Perspect. 116(7):845-53. Review.

Kuo PL, Hsu YL, Huang MS, Tsai MJ, Ko YC. (2011) ‘Ginger suppresses phthalate esters-induced airway remodeling’. J Agric Food Chem. PMID:21370925 [Epub ahead of print]

Kreindler JL, Steele C, Nguyen N, Chan YR, Pilewski JM, Alcorn JF, Vyas YM, Aujla SJ, Finelli P, Blanchard M, Zeigler
SF, Logar A, Hartigan E, Kurs-Lasky M, Rockette H, Ray A, Kolls JK. (2010) ‘Vitamin D3 attenuates Th2 responses to Aspergillus fumigatus mounted by CD4+ T cells from cystic fibrosis patients with allergic bronchopulmonary aspergillosis’. J Clin Invest.120(9):3242-54.

Macredmond R, Dorscheid DR. 2011Conjugated linoleic acid (CLA): is it time to supplement asthma therapy? Pulm Pharmacol Ther. 24(5):540-8. doi: 10.1016/j.pupt.2011.03.005. Epub 2011 Apr 21.

Nurmatov U, Devereux G, Sheikh A (.2010) ‘Nutrients and foods for the primary prevention of asthma and allergy: Systematic review and meta-analysis’. J Allergy Clin Immunol. [Epub ahead of print] PMID:21185068

Rouhi H, Ganji F, Nasri H. 2006 PAKISTAN J. NUTR.; 5 (4) 373-376

Tang Y, Xu Y, Xiong S, Ni W, Chen S, Gao B, Ye T, Cao Y, Du C. (2007) ‘The effect of Ginkgo Biloba extract on the expression of PKCalpha in the inflammatory cells and the level of IL-5 in induced sputum of asthmatic patients’ J Huazhong Univ Sci Technolog Med Sci. 27(4):375-80.

Varraso R. (2012) Nutrition and asthma. Curr Allergy Asthma Rep. 12(3):201-10. doi: 10.1007/s11882-012-0253-8.