You’ll certainly know how stressful asthma can be if you or a family member suffers from it. Watching someone close to you struggling to breathe can be very worrying. In clinical practice we see lots of clients with viral wheeze and asthma, and over the years we have found some key areas of nutrition that can help to ease things up a bit. Let me share them with you now.
What is asthma?
In the UK, it is estimated that 5.4 million people suffer with asthma, so that’s one in every 11 children and one in every 12 adults. But interestingly, children don’t get diagnosed with asthma until the age of 3. Up until this point the symptoms are simply known as ‘viral wheeze’. This is because it is usually a virus which can trigger the wheeze and the laboured breathing.
Asthma is commonly a chronic and life-long lung condition and affects the airway that carries air to and from your lungs. Asthma sufferers often have inflamed and sensitive airways, struggling with symptoms such as wheezing, feeling breathless, a tight chest as well as coughing.
If you suffer with asthma, you’ll know that sometimes it can come and go. You might have weeks when symptoms are troublesome, and then have a long period of time with no symptoms at all.
If you have been prescribed medication for your asthma then you should continue to take it as directed by your doctor, however, I also want to share with you my top tips that can help to support overall chronic and acute inflammation, which in turn may help to support lung health.
The gut connection
If you are a regular reader of my blogs, you will have seen me frequently refer to the importance of the gut microbiome and trying to achieve the right balance of bacteria in the gut to help build strong immunity.
The microbiome and the immune cells within the gut helps our immune system to naturally tag our environment (pollen, dust, animal dander etc) as well as foods (nuts, gluten, dairy, eggs etc) as “friends”; and are also able to tag infections as “foe” and fight them quickly and effectively. However, when the mucosal lining is inflamed or damaged, we can develop allergies and food intolerances; and you might find that you are unable to fight infections effectively and they can become hard to overcome or linger for a long time.
In some cases, gaps appear in the lining of the small intestine leading to intestinal permeability (also known as leaky gut). This is a common factor shared by people who suffer from atopic conditions (asthma, wheezing, eczema, hay fever and allergies). In fact, studies show that intestinal permeability is often more marked in both adults and children who have asthma.
What many people do not realise is that our lungs ALSO have their very own microbiome which is linked to the gut microbiome via the gut-lung axis. Studies show that there is important cross talk between these two organs, and that the state of our gut health and our diet can really play a role in respiratory disease.
This means that working on your gut microbiome may also help to develop a more diverse and robust lung microbiome as they are inextricably connected. This in turn should help to reduce the allergic inflammatory cytokines present in the lung tissue and may over time help to reduce the severity of any wheezing related episode.
Research shows that dietary fermentable fibre is able to change the composition of both the gut and lung microbiota. Foods that contain fermentable fibre include oats, barley, Jerusalem artichokes, chicory root, leeks, onions and bananas. Gut bugs metabolise (break down) the fibre in the foods, and this increases the amount of short-chain fatty acids (SCFAs) which in turn protect against allergic inflammation in the lungs. In this way, supporting our gut bacteria also in turn supports our lung health.
Until the gut health and gut-lung axis are in a healthier and more robust state, many asthmatic people find that they have sensitivity to certain foods which can range from food additives to sulphites in foods, such as dried fruit, wine and beer.
For children who frequently get a viral-induced wheeze, there can sometimes be a low-grade sensitivity to dairy products such as milk, yoghurt or cheese. If you have noticed that you or your little one develops symptoms such as coughing, wheezing or breathing difficulties after consuming yoghurt or a glass of milk, then it might be worth swapping these products for dairy-free alternatives for a few weeks to see if this makes a difference. Some parents report their kids thrive on Guernsey A2 milk, goat or sheep milk products instead of cow, even if there isn’t firm scientific evidence explaining this.
The reason why some babies and toddlers have frequent upper respiratory distress and breathing issues can be due to multiple food allergies and/or intolerances. Reactions can happen even if they are solely breastfed due to the allergens being passed from mother to child through their breastmilk. It can often be hard to work out what the trigger foods could be to begin with, however the usual suspects tend to be milk, soya, eggs and nuts. In this scenario it means that the breastfeeding mother needs remove these trigger foods whilst they are feeding their child, and also avoid them whilst weaning them onto solid food until their immune system is able to tolerate these allergens (which does not always happen if the allergy is very marked and causes anaphylaxis). This is where working with a professional trained in paediatric nutrition and allergies can really help.
Histamine intolerance also plays a role in asthma, wheezing and other breathing problems and this might mean that you notice a building of symptoms after eating large quantities of tomatoes, avocado, spinach, oranges and other high-histamine foods. The histamine tends to build up over the day, so this can mean more wheezing and a tickly throat around bedtime.
Inflammation and oxidative stress
Inflammation of the lung tissue is one of the primary reasons why someone might become breathless or wheeze. This inflammation often causes some longer-term damage to the lung cells, and this is known as oxidative stress.
The link between raised oxidative stress and asthma is fairly robust. Research suggests that reactive oxygen and nitrogen species influence airway inflammation and are a contributing factor in asthma severity. With oxidative stress there is an imbalance between antioxidants and free radicals in the body; free radicals can cause damage in the body and require antioxidants to make them less reactive.
This is where eating brightly coloured fruits, vegetables, salads, nuts, seeds, pulses and wholegrains are so important. The variety of pigments (polyphenols) in the food help to reduce the oxidative stress. So, look out for foods with high antioxidant levels such as berries, citrus fruit, tropical fruits, leafy greens and cacao powder. Try to include a variety of anti-inflammatory spices in your diet like turmeric, garlic, rosemary and thyme.
How about covid?
Research has found that people with asthma were more likely to be hospitalised with Covid or have more serious outcomes. They very often also need to manage their asthma more intensely after contracting the virus. We have all learnt how much damage Coronavirus can do to the lung function, leaving behind residual inflammation and oxidative stress which can wax and wane over several months and it is worth looking at the anti-inflammatory approach if this is the case.
Allergies can also have a profound effect on individuals with asthma. The obvious culprits are household allergens such as dust, feather pillows, mould, and our beloved pets, including cats, dogs and horses. It’s worth looking at identifying these first to see if there are some easy hacks to lessen the chance of an attack.
A close friend of mine experienced several asthma attacks every single night of her life until she reached the age of ten when her parents switched her pillow from a feather pillow to a hypoallergenic one – imagine not sleeping through the night for 10 years when a simple pillow switch could have made all the difference!
Research shows there is an increase in allergic diseases in Westernised lifestyles because of increased urbanisation, antibiotic use and spending more time indoors. We are now exposed to pollution through both air and traffic, infectious agents, tobacco smoke, and fungi. All of these may exacerbate asthma (and other allergic diseases).
It is thought that our houses can be very polluted from aerosols and sprays, strong smells and chemicals, as well as products containing high VOCs (Volatile Organic Chemicals). Thankfully not many people smoke tobacco indoors anymore. Making the environment at home more “clean and green” by choosing natural cleaning products and essential oils instead of artificial air fresheners can really help. So can getting into the habit of keeping windows open to help bring in the fresh air and eliminate the household toxins.
Mould from water damage in the home, school or workplace is also thought to exacerbate upper respiratory health problems as well as asthma and over time can be very detrimental to health. Mycotoxins (substances produced by a fungus) can also be present in some grains, coffee, fruits and nuts if these are contaminated with mould. Mycotoxins can be passed from mother to child via breast milk if the mother has been exposed to environmental mould or mycotoxins via the diet.
These mycotoxins can be very disruptive to the airways as well as to the immune system and the gut microbiome. Presence of significant mycotoxins can easily increase sensitivity to food items as well as environmental allergens and chemicals. In a nutshell, mould has the potential to dysregulate the immune system, rendering it poor at fighting infection and hypersensitive to the environment.
A simple urine test can establish whether mycotoxins are part of the person’s overall health picture, and if these are present at significant levels then an experienced practitioner is able to help reduce body mycotoxin burden through diet, lifestyle and supplement support. They can also advise on specialist professional mould removal services to identify the source of the mould within the home and can remediate any damage. Proper air ventilation is vital, and this can be as simple as opening windows or using a good quality air filter. It is also important to ensure grains such as bread and flour as well as coffee, fruits and nuts are fresh and free from mould.
On the flip side, spending time in nature, especially in areas that have high tree diversity such as woods, forests and green spaces can help to support the airways and lung health.
8 steps to support lung health inflammation
Quercetin – A powerful antioxidant and one of the most abundant polyphenols in our diet. This is super important for combating free radical damage which is often linked to inflammation. Research shows that its anti-allergic functions help to inhibit pro-inflammatory mediators and histamine production. It has also been found to help repair both chronic and acute lung damage. Quercetin may also reduce inflammation and allergy symptoms. You’ll find quercetin in red onions, apples and red peppers, as well as lambs’ lettuce and pea shoots. Quercetin can also be found as a food supplement and some preparations are suitable from 3 years plus.
Polyphenols – Research shows that high polyphenol content within our diets are linked to better lung function. We can increase our antioxidant levels by consuming drinks naturally high in polyphenols such as cacao and green tea. High polyphenol-rich foods include berries, green leafy veg, broccoli, garlic, onions, oily fish and nuts. Try eating the rainbow of fruit, veg and salads every day and you can’t go far wrong. These are foods you can start to build in even from the baby weaning feeding stage if your family have a history of asthma.
Gut flora – Research shows that lung dysfunction and gut microbial imbalance (including bowel issues such as inflammatory bowel disease) increases asthma related symptoms and lung inflammation. This is why we need to ensure our gut health is in tip top shape and this is where cultured foods such as kefir, live yoghurt, sauerkraut, pickled cucumbers, miso and apple cider vinegar play a role. Babies, toddlers and older children tend to love the yoghurts and the pickled cucumbers!
In clinical trials, the bacteria Lactobacillus rhamnosus was shown to prevent the development of airway hyperactivity. Whereas Bifidobacterium Lactis was demonstrated to have anti-inflammatory effects and helps to regulate the gut-lung axis.
Vitamin C – Vitamin C is a powerful antioxidant. It is key to lung health as it is abundant in the extracellular fluid that lines our lungs. Our bodies don’t make vitamin C so it’s important that we consume foods that contain it. Foods rich in vitamin C are citrus fruits such as oranges and satsumas, strawberries, blackcurrants, broccoli, brussels sprouts and sweet bell peppers as well as fresh parsley. Vitamin C can also be given as a food supplement from as young as 3 months old even if the baby is not weaned onto solids.
Vitamin D – According to the National Institute for Health and Care Excellence (NICE) in the UK, it is estimated that one in six children and one in five adults are deficient in vitamin D. These are worrying statistics bearing in mind the significant role vitamin D plays in immune regulation and respiratory infections. Studies have shown that asthma symptoms, asthma control and overall severity of asthma were exacerbated with vitamin D deficiency.
The two easiest ways to boost your vitamin D levels are through sunlight during the spring and summer and with food supplements during the autumn and winter. The NHS and Public Health England both recommend vitamin D supplements for everyone from October through to March except for babies who consume more than 500ml of infant formula. The minimum daily supplementation is 10mcg (400IU) and the upper tolerable level for vitamin D in teens and adults is 100 mcg (4,000 IU).
Turmeric – The main active ingredient in turmeric is curcumin and it has powerful anti-inflammatory and antioxidant effects which studies have shown to be beneficial in bronchial asthma, showing that curcumin helped improve airway obstruction. You would need to devour a vast amount of turmeric to see improvements, but there would be some health benefits to regularly eating a delicious curry and even kids enjoy often slurping on a turmeric latte. Curcumin is also absorbed more efficiently when paired with black pepper known as long pepper.
Omega 3 – An interesting study looked at the prevalence of asthma amongst Eskimos and noticed it was very low. One of the reasons cited was because their diet naturally contains a lot of omega-3 fatty acids from eating oily fish which have anti-inflammatory properties. It has also been observed that omega-3 could be protective and even therapeutic due to the drivers of lung inflammation.
You can find omega-3 fatty acids in oily fish such as salmon, herring, mackerel, anchovies and sardines as well as flax and chia seeds, walnuts and some fortified foods. If you’re not a big fan of eating fish, you can take a good quality omega-3 food supplement (fishy or vegan) to top up your levels and these are usually suitable to give from as young as 6 months old.
Magnesium – This mineral is known as a bronchodilator, meaning that it helps to relax bronchial muscles, expanding airways allowing more air flow to and from the lungs. When air ways are more relaxed it may help ease shortness of breath. A great way to up your intake of magnesium is to include foods that contain it such as whole grains, dark green leafy vegetables, dark chocolate, avocados, nuts and seeds (almonds, cashews and brazil nuts; flax, pumpkin and chia seeds). Of course, if you don’t regularly consume foods high in magnesium then you also have the option to include a good quality food supplement into your daily schedule to ensure you don’t run low on this mineral. Also try adding magnesium flakes to a warm bath which children can enjoy as much as adults.
As you can see, asthma is not just about supporting lung health, other systems in the body are involved such as gut health. By working on these you may be able to dial down asthma symptoms such as trouble breathing.
If you or someone you love is really struggling, and you want to explore what’s discussed in this article but are unsure where to start, do get in touch with our very experienced NatureDoc clinical team.
- Asthma and Lung, UK
- Increased intestinal permeability in bronchial asthma
- Intestinal permeability is increased in bronchial asthma
- How a leaky gut leads to inflamed lungs
- Asthma, Food Allergy, and How They Relate to Each Other
- Asthma: an epidemic of dysregulated immunity
- Immune dysregulation in asthma
- Assessment of Selected Intestinal Permeability Markers in Children with Food Allergy Depending on the Type and Severity of Clinical Symptoms
- Emerging pathogenic links between microbiota and the gut–lung axis
- Gut microbiota metabolism of dietary fiber influences allergic airway disease and hematopoiesis
- A Viewpoint on the Leaky Gut Syndrome to Treat Allergic Asthma: A Novel Opinion
- Oxidative Stress in Asthma
- NO chemical events in the human airway during the immediate and late antigen-induced asthmatic response
- Rapid loss of superoxide dismutase activity during antigen-induced asthmatic response
- Association between Green Space Structure and the Prevalence of Asthma: A Case Study of Toronto
- Quercetin with the potential effect on allergic diseases
- Polygonum aviculare L. extract and quercetin attenuate contraction in airway smooth muscle
- NHS – Vitamins and minerals – Vitamin C
- Protective effect of polyphenols in an inflammatory process associated with experimental pulmonary fibrosis in mice
- Favorable association of polyphenol-rich diets with lung function: Cross-sectional findings from the Moli-sani study
- Risk factors for asthma: is prevention possible?
- Lactobacillus rhamnosus probiotic prevents airway function deterioration and promotes gut microbiome resilience in a murine asthma model
- Pulmonary dysfunction in 114 patients with inflammatory bowel disease
- Efficacy of Lactobacillus Administration in School-Age Children with Asthma: A Randomized, Placebo-Controlled Trial
- Adjunctive Probiotics Alleviates Asthmatic Symptoms via Modulating the Gut Microbiome and Serum Metabolome
- Beneficial effects of Saccharomyces boulardii CNCM I-745 on clinical disorders associated with intestinal barrier disruption
- The infant gut bacterial microbiota and risk of pediatric asthma and allergic diseases
- Vitamin C supplementation for asthma
- Asthma, inhaled oxidants, and dietary antioxidants
- Diet and asthma: nutrition implications from prevention to treatment
- The impact of vitamin D on regulatory T cells
- A Review on the Role of Vitamin D in Asthma
- Impact of COVID-19 on people with asthma: a mixed methods analysis from a UK wide survey
- Risk of serious COVID-19 outcomes among adults with asthma in Scotland: a national incident cohort study
- Asthmatic Patients with Vitamin D Deficiency have Decreased Exacerbations after Vitamin Replacement
- Effects of Vitamin D levels on asthma control and severity in pre-school children
- Vitamin D for the management of asthma
- Vitamin D supplementation to prevent asthma exacerbations: a systematic review and meta-analysis of individual participant data
- NHS – Vitamin D
- PHE publishes new advice on vitamin D
- NIH – Vitamin D – Health Professional
- Can damp and mould affect my health?
- Indoor mould exposure, asthma and rhinitis: findings from systematic reviews and recent longitudinal studies
- Mold, Mycotoxins and a Dysregulated Immune System: A Combination of Concern?
- Mycotoxin and Gut Microbiota Interactions
- Evaluation of Mycotoxins in Infant Breast Milk and Infant Food, Reviewing the Literature Data
- Dietary exposure to mycotoxins in the French infant total diet study
- Evaluation of Efficacy of Curcumin as an Add-on therapy in Patients of Bronchial Asthma
- Curcumin Attenuates Asthmatic Airway Inflammation and Mucus Hypersecretion Involving a PPARγ-Dependent NF-κB Signaling Pathway In Vivo and In Vitro
- Low prevalences of coronary heart disease (CHD), psoriasis, asthma and rheumatoid arthritis in Eskimos: are they caused by high dietary intake of eicosapentaenoic acid (EPA), a genetic variation of essential fatty acid (EFA) metabolism or a combination of both?
- Polyunsaturated fatty acids and inflammatory diseases
- Health Effects of Omega‐3 Fatty Acids on Asthma: Summary
- National Institutes of health – Omega-3 Fatty Acids
- Magnesium sulfate for treating exacerbations of acute asthma in the emergency department