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Having children, I can't help have an interest in this issue. Fortunately, we have not had any problems at all in our family, but I did get rid of the gas stove to be on the safe side. There appear to be numerous factors contributing to the modern asthma epidemic and many preventive steps that can be taken. How to Avoid Asthma Asthma is almost unknown in Africa and other underdeveloped countries. Rates skyrocketed in the U.S. and other advanced economies until the late 1990's and have now stabilized or even decreased slightly. The increased use of inhaled steroids in asthma sufferers may be a reason for the decrease in emergency room visits caused by asthma attacks (BMJ 2005;330:1037-1038 (7 May)). Research shows there are many steps to take that combined will dramatically decrease the risk of developing asthma. Going over the below list, its easy to see why asthma rates have increased in the developed world, but not in most underdeveloped countries. Things to avoid: Get rid of foam pillows and mattresses, get rid of gas stoves and kerosene heaters, don't live near busy streets, keep smoking out of the house and out of your lungs, avoid C-sections if at all possible, avoid giving antibiotics to infants if possible, avoid eating liver and deep-fried foods, don't live in Chicago, bath infants no more than once a day, avoid damp homes and bedrooms (e.g. humidifiers), don't use margarine (Smart Balance is OK), don't feed peanut butter or peanuts to infants under age two, and avoid using herbicides and pesticides in or around the home. Get rid of old carpeting. No carpet or newer carpeting is better. Visible mold is definitely a bad sign and evidence of a need for better ventilation. Things to do: Use feather pillows, breastfeed infants at least 6 months, eat yogurt and feed it to infants, eat fish or take fish oil and take extra vitamin D during pregnancy as well as throughout life, eat apples, and take vitamin C. Exercise also helps prevent asthma. Higher intakes of vegetables and nuts also help reduce risk. Cats and dogs during the first year of life might be OK and even good. High energy vacuum cleaners appear to be a good idea. The one study of mattress covers didn't show any benefit, but they might still be a good idea. Asthma Asthma Now 8.7% in U.S.: Between 1980 and 1995, the report says, the percentage of children with asthma doubled, from 3.6 percent in 1980 to 7.5 percent in 1995. The percentage dropped in 1996 to about 6 percent, but by 2001 it had risen again, this time to a record 8.7 percent: EPA 2/27/03 European Kid Allergies Up 100%: Asthma and allergies in children increased by 200% between the 1970s and the 1990s in the European Union. Allergic disease was the most common chronic illness of childhood. WHO linked the increased to changes in the climate. Since the 1970s the length of the pollen season in Europe has increased by 10-11 days. WHO added that children in Europe were exposed to more than 15,000 synthetic chemicals in the water, air and food. It also cited the prevalence of cigarette smoke and bad air quality. Guardian 4/5/03 Asthma Sufferers Have Many More Mental Disorders, Especially Bipolar, Anxiety, and Panic: Asthma prevalence in a sample of German adults was 2.7% (current) and 5.74% (lifetime). Patients with current severe asthma were significantly more likely to have any anxiety disorder (odds ratio [OR] 2.65), specific phobia (OR 4.78), panic disorder (OR 4.61) and panic attacks (OR 4.12). A diagnosis of lifetime severe asthma was also associated with generalized anxiety disorder (OR 5.51) and bipolar disorder (OR 5.64). Current non-severe asthma was associated with the increased likelihood of any affective disorder (OR 2.42) and any severe mental disorder (OR 2.17). Renee D. Goodwin, Columbia University Arch Gen Psychiatry 2003;60:1125-1130 Asthma More Common in Women, Obese, Smokers: A telephone survey of adults in 50 states, Puerto Rico, and the District of Columbia to assess risk factors for asthma prevalence found that women were more likely than men to report current asthma [odds/ratio (OR): 1.91]; adults aged 35-64 and >65 were less likely than adults aged 18-34 to report current asthma (OR: 0.79 and OR: 0.65); persons from the lower socioeconomic status were more likely to report current asthma than others (OR: 1.36); overweight and obese people were more likely to report current asthma than were those of normal weight (OR: 1.10 and OR: 1.65); and current and former smokers were more likely than never smokers to report current asthma (OR: 1.28). Risk factors for asthma in US adults: results from the 2000 Behavioral Risk Factor Surveillance System. Gwynn RC. CDC, Atlanta. J Asthma. 2004 Feb;41(1):91-8 Steroids Increase Fractures in Asthmatics: A population-based retrospective (historical) cohort study among 226 adults, who were 35 years of age or older when first diagnosed with asthma found that during 4,022 person-years of follow-up, 100 patients experienced 211 fractures, more than the expected rate (p=0.004). Statistically significant increases were seen for moderate trauma fractures of the vertebrae (SIR, 2.9) and ribs (SIR, 2.0), as well as the proximal femur (SIR, 1.8).Cumulative corticosteroid dose greater than the median of 1,775 mg (HR, 1.8) was a predictor. Predictors of a moderate trauma vertebral fracture were older age (HR, 1.6), concomitant chronic obstructive pulmonary disease (HR, 2.4), cigarette smoking (HR, 2.3), and cumulative corticosteroid dose greater than the median (HR, 2.6). Other asthma therapies did not contribute significantly. Thus, a 70% increase in overall fracture risk among unselected community patients with adult onset asthma was mainly confined to the subset who also had chronic obstructive pulmonary disease and was influenced by substantial corticosteroid use. Long-term fracture risk following adult-onset asthma: a population-based study. Melton LJ 3rd, Patel A, Achenbach SJ, Oberg AL, Yunginger JW. Mayo Clinic. Osteoporos Int. 2004 Apr;15(4):311-6 Risk Factors and Causation: Antibiotics in Infancy Linked to Increased Asthma: Christine Cole Johnson, Henry Ford's Department of Biostatistics & Research Epidemiology, 9/30/03 European Respiratory Society's conference, Vienna. 448 children followed for 7 years; 49% received antibiotics in the first six months of life. By age 7, children given at least one antibiotic in the first six months and who lived with fewer than two pets were 1.7 times more likely to develop allergies, and three times more likely to develop asthma. Those given broad-spectrum antibiotics were 9 times as likely to develop asthma. Breast-feeding did not prevent the antibiotic phenomenon. Two pets in house in infancy did lessen impact slightly. Mother’s history of allergy increased allergy risk slightly more. Apples and Fish by Pregnant Mothers Decrease Later Childhood Eczema and Asthma: In a 5-year follow-up of a longitudinal birth cohort study of 1924 children, maternal diet during pregnancy found no consistent associations between childhood outcomes and maternal intake except for apples and fish. Maternal apple intake was beneficially associated with a 37% decrease in ever wheezing (OR highest vs lowest tertile 0.63), 46% decrease in ever having asthma (OR 0.54) and 53% decrease in doctor-confirmed asthma (OR 0.47) in the children. Maternal fish consumption was beneficially associated with a 43% decrease in doctor-confirmed eczema (OR >/=1/week vs never 0.572). Maternal food consumption during pregnancy and asthma, respiratory and atopic symptoms in 5-year-old children. Willers S, et al. Utrecht University, Netherlands. Thorax 2007 Mar 27. Apple Orchard Spider Mites an Asthma Risk Factor: Spider mites, particularly European red mite and 2-spotted spider mite, are common sensitizing allergens in apple-cultivating farmers. J Allergy Clin Immunol. 1999 Dec;104(6):1285-92. Visiting apples orchards has also been found to be associated with a higher rate of asthma in Koreans. Apples, Selenium Good Against Asthma: A food frequency questionnaire from 607 adult asthma cases and 864 controls in London found apple consumption was negatively associated with asthma (OR 0.89; p = 0.006). Intake of selenium was also negatively associated with asthma (OR 0.84; p = 0.002). Red wine intake was negatively associated with asthma severity. Dietary antioxidants and asthma in adults: population-based case-control study. Shaheen SO, Sterne JA, Thompson RL, Songhurst CE, Margetts BM, Burney PG. King's College, London. Am J Respir Crit Care Med. 2001 Nov 15;164(10 Pt 1):1823-8 Apples, Pears, Whole Milk Protect Against Asthma: 1601 randomly young adults in Melbourne completed a detailed respiratory questionnaire, a validated semiquantitative food-frequency questionnaire, skin-prick testing, and lung function tests, including a methacholine challenge test for bronchial hyperreactivity (BHR). Whole milk appeared to protect against current asthma (odds ratio: 0.66), BHR (0.68), and atopy (0.71). Conversely, soy beverage was associated with an increased risk of current asthma (2.05), and BHR (1.65). Apples and pears appeared to protect against current asthma (0.83), and BHR (0.88; 0.77, 1.00). Food and nutrient intakes and asthma risk in young adults. Woods RK, Walters EH, Raven JM, Wolfe R, Ireland PD, Thien FC, Abramson MJ. Monash University, Melbourne, Australia. Am J Clin Nutr. 2003 Sep;78(3):414-21 Bacteria Capsules for Pregnant Women Cut Childhood Asthma & Eczema: Marko Kalliomäki, Turku University, treated pregnant women with a family history of eczema, asthma or rhinitis with capsules of benign bacteria. Only 23 per cent of the children exposed to the common gut bacteria went on to develop eczema, vs. 46 per cent on placebo. Babies normally get their first gulp of mother's bacteria as they travel down the birth canal. Throughout human history, this has meant a dose of Lactobacillus and Bifidobacteria. But modern medicine is preventing this. For babies born by caesarian section, for example, the first gut inhabitants are common hospital bacteria such as Streptococci and Clostridia. During pregnancy, half the women received twice-daily capsules containing Lactobacillus rhamnosus, a benign strain of bacteria. The women carried on taking the capsules for six months after they had given birth so that their breast milk would also contain the bacteria. Children of non-breastfeeding mothers received spoonfuls of the bacteria. Lancet 357:1076, 2001 Bathing Kids Increases Asthma: Archives of Disease in Childhood 7/02, Univ. Bristol, surveyed 9,000 parents. Infants and toddlers who were bathed most often were more likely to develop wheezing and eczema. The kids in the highest bathing group were bathed twice a day and had their hands and faces washed five times a day. The article notes people growing up on farms, having older siblings, or attending daycare also have less asthma. Breast-feed, Avoid Tobacco, Good Ventilation, and No Dampness = Lower Asthma in Swedish 2-year-olds: A prospective study of 4056 infants found those in families following these guidelines had much lower risk of developing asthma. Wheezing and asthma at 2 years of age were 12.6% and 6.8%, respectively. In contrast, among families that followed one or none of the guidelines, the rates were 24.1% for wheezing and 17.9% for asthma. Allergy 2003;58:730-731,742-747. C-Sections Increase Child Food Allergies: Cesarean delivery might delay the growth of normal intestinal flora and increase allergic disease, Merete Eggesbo, Norwegian Institute of Public Health in Oslo. 2803 children. The main outcome measures were the parent's opinions of their child's reaction to egg, fish, or nuts. For children with allergic mothers, cesarean section was associated with a sevenfold increased rate of parental reports of reactions to egg, fish, or nuts in children. The risk of lab confirmed egg allergy at age 2.5 was increased by fourfold in these children. For children without allergic mothers, the association between cesarean section and the risk of food allergy was weak and not significant. No association between maternal or infant antibiotic use and an increased risk of food allergy. J Allergy Clinical Immunology, August 2003. Cats Triple Wheezing in Children of Asthmatic Mom: Children with asthmatic mom 200% more likely to have wheezing if a cat in the house. Children with non-asthmatic mom 40% less likely to have wheezing if cat in house. 448 children in study from birth to five. J. C. Celedón et al. Exposure to cat allergen, maternal history of asthma, and wheezing in the first five years of life. Harvard, 9/7/02, Lancet 360(9335):781-82 . Cats Good for Allergies: Rudiger von Kries, Institute for Social Pediatrics and Adolescent Medicine, Munchen, Germany. Allergy 10/03. A study of asthma risk in 8216 children, 5 to 7 years of age, living in rural regions of Bavaria found that, in general, pet exposure had no bearing on the risk of allergies. However, kids who were continuously exposed to cats and had cats that roamed in their bedroom were 67 percent less likely than other children to develop allergic asthma and 45 percent less likely to develop hay fever. Ed: Since cats might cause a increase in schizophrenia due to toxoplasmosis infections, dogs might be better. Chicago: Highest Asthma Maybe Due to Lake Breezes: Pollution blows out over lake and sun causes chemicals to become more toxic and blown back inland in evening, especially in early summer. Am Chem Society 6/3/03, Loyola, Paul Doskey. Chlamydia Infection May Be Protective Against Asthma and Allergic Rhinitis: Researchers studied 1211 children for a Chlamydia pneumoniae respiratory tract infection. Those with an infection and a similar control group were followed for 22 months. The incidence of asthma (0/55 vs. 5/54, p = 0.03) and allergic rhinitis [3/53 vs. 10/52, p = 0.04] as well as prevalence of asthma [1/56 vs. 9/58, p = 0.02] and allergic rhinitis [6/56 vs. 16/58, p = 0.03] were lower in the Chlamydia children. Inverse association between Chlamydia pneumoniae respiratory tract infection and initiation of asthma or allergic rhinitis in children. Schmidt SM, Muller CE, Wiersbitzky SKW. Ernst-Moritz-Arndt University, Greifswald, Germany. Pediatr Allergy Immunol 2005 Mar;16(2):137-44. Colds and Allergen Exposure Trigger Adult Attacks: Adult patients admitted with acute asthma were twice as likely to have recently been exposed to an allergen, or to be infected with a cold, than control patients. But they were eight times as likely to have been exposed to both. BMJ, New Scientist 3/29/02 Deep Fried Foods, Animal Fat, Liver, Meat Associated With Asthma: In a study of 1166 Taiwanese teenagers 13-17, asthma was associated with intakes of liver (OR = 2.32), deep-fried foods (OR = 2.13) and butcher's meat (OR 1.84). In a similar analysis, allergic rhinitis was associated with liver (OR = 1.67). No protective effect was demonstrated for any of the food items examined. Protein-rich and fat-rich foods of animal origin were associated with a higher prevalence of asthma in teenagers. Clin Exp Allergy 2001 Feb;31(2):259-64 Diesel School Bus Riders: Increased Asthma and Lung Cancer Possible: A child riding inside a diesel school bus may be exposed to as much as 4 times the level of diesel exhaust as someone riding in a car ahead of it. Exposure levels were higher in the back of the bus and when windows were closed. The study indicated that exposure of children to diesel exhaust while riding in a school bus for 1–2 hours a day, 180 days a year for 10 years might result in 23–46 additional cancer deaths per 1 million children. In addition, the investigators stated that the implications of this exposure for asthma are very troubling. new engine and emission technologies, will reduce emissions from on-road vehicles by 90%–95%. CMAJ • September 3, 2002; 167 (5) Diesel Exhaust: Living Next to Truck Route Increases Childhood Asthma: The link between exposure to diesel exhaust and asthma has been borne out epidemiologically in studies indicating that children living along major trucking thoroughfares are at increased risk of asthma and allergic symptoms (Northbridge M, Yankura J, Kinney P, Santella R, Shepard P, Riojas Y, et al. Diesel exhaust exposure among adolescents in Harlem: a community-driven study. Am J Public Health 1999;89:998-1002) and of having objective evidence of respiratory dysfunction. Brunekreef B, Jansses N, de Hartog J, Harssema H, Knape M, van Vliet P. Air pollution from truck traffic and lung function in children living near motorways. Epidemiology 1997;8(3):298-303 Diesel and Car Exhaust: Living Close to a Busy Road Increases Asthma Risk: Exposure to motor vehicle exhaust is associated with respiratory disease. Studies in children have observed associations with wheeze, hospital admissions for asthma, and decrements in pulmonary function. A sample of U.S. male veterans drawn from the general population found that adjusting for cigarette smoking, age, and occupational exposure to dust, men living within 55 yards of a major roadway were slightly more likely to report persistent wheeze (odds ratio [OR] = 1.3) compared with those living more than 440 yards away. The risk was observed only for those living within 55 yards of heavily trafficked roads (>10,000 vehicles/24 h): OR = 1.7). The risk of patients experiencing chronic phlegm while living on heavily trafficked roads also increased (OR = 1.4; CI = 1.0-2.0), Residence near a major road and respiratory symptoms in U.S. Veterans. Garshick E, Laden F, Hart JE, Caron A. VA Boston. Epidemiology. 2003 Nov;14(6):728-36 Diesel and Car Exhaust: Fumes Stunt Lung Development: Researchers examined the lung function of 3,677 children annually from the age of 10 until they reached 18. Those who had lived within 500 metres of a motorway had much poorer lung function at the age of 18 than those who had lived 1,500 meters away or more, even when factors such as smoking in the home were taken into account. John Peters, et al. Univ Southern Calif. Lancet 1/25/07. Dust Mites in 84% of Homes: National Survey of Lead and Allergens in Housing, which included 831 randomly selected households found that 84 percent of US homes had detectable levels of dust mite allergen in a bed. Half had at least 2 micrograms per gram, the threshold at which people can become allergic. In almost one quarter of the homes dust mite levels were five times as high, reaching the threshold associated with asthma development. Older homes, homes in the Northeast and homes with high bedroom humidity were most likely to have high concentrations of dust mite allergen, as were homes with musty or mildew odors. Recommendation: use impermeable mattress covers, wash bedding every week in hot water and remove all non-washable items from the bed, including stuffed animals. 3/14/03 Reuters, New York, Huggins Exercise Helps Prevent Asthma: Data shows that lungs not regularly stretched by deep breathing become prone to wheezing. Physical activity has anti-inflammatory effects. Harvard research. Thomas Platts-Mills, Univ. Virginia, Chic Trib 9/26/04. Exercise-Induced Asthma Common in Elite Cyclists: A study of 25 male professional cyclists found 72% of the subjects had upper airway or bronchial symptoms. Using a pneumotachograph, 52% showed clinical symptoms associated with bronchial responsiveness during methacholine test, a proportion which is much higher than the average population (3-20%). However, ERS-ATS pulmonary function testing criteria at rest. Professional cyclists have a far higher prevalence of bronchial hyper-responsiveness than the average population. Testing of pulmonary function in a professional cycling team. Medelli J, et al. Amiens, France. J Sports Med Phys Fit 2006 Jun;46(2):298-306. Exercise-Induced Vocal Cord Dysfunction: Vocal cord dysfunction (VCD) is an involuntary functional disorder commonly misdiagnosed as asthma. A retrospective medical record review identified 49 patients, ages 8 to 25 years, diagnosed as having VCD. 41 had previously been treated for asthma; that diagnosis was confirmed as a comorbidity in only 12. Two distinct phenotypes of VCD were observed. Symptoms were limited to exercise-induced VCD (EIVCD) in 29 and spontaneously occurring VCD (SVCD) in 20, only 4 of whom additionally had EIVCD. Eight of the 11 contacted patients with SVCD followed the recommendation to see a speech therapist, all of whom learned to control symptoms. However, 2 who also had EIVCD continued with that problem. Pretreatment with an anticholinergic inhaler prevented EIVCD in 6 patients in whom this was tried. Complete absence of symptoms, at times ranging from 1 week to 5 years (median, 5 months), was reported in 26 of the 28 contacted patients. Prevention of EIVCD with an anticholinergic inhaler in 6 patients suggests that a controlled clinical trial is warranted. Regardless of treatment, eventual spontaneous resolution was common. Long-term outcome of vocal cord dysfunction. Doshi DR, et al. University of Iowa. Ann Allergy Asthma Immunol 2006 Jun;96(6):794-9. Farm Children Protected: Exposure of children younger than 1 year, compared with those aged 1-5 years, to stables and consumption of farm milk was associated with lower frequencies of asthma (1% [3/218] vs. 11% [15/138]), hay fever (3% [7] vs 13% [18]), and atopic sensitization (12% [27] vs. 29% [40]). Protection against development of asthma was independent from effect on atopic sensitization. Continual long-term exposure to stables until age 5 years was associated with the lowest frequencies of asthma (0.8% [1/122]), hay fever (0.8% [1]), and atopic sensitization (8.2% [10]). INTERPRETATION: Long-term and early-life exposure to stables and farm milk induces a strong protective effect against development of asthma, hay fever, and atopic sensitization. German study of over 3000 kids. Lancet 2001 Oct 6;358(9288):1129-33 Fish Oil Protects Against Developing Asthma: Univ. of Sydney studied 574 kids ages 8-11. Questionnaires completed of over 200 foods eaten for 1 year period, Children were evaluated for asthma by airway hyperresponsiveness and tendency to wheeze with and without exercise. Those consuming fresh, oily fish (mullet, arange roughy, Atlantic salmon, rainbow trout) had one-quarter the risk of developing asthma. Non-oily fish and canned fish didn't help. Reference study of fish oil supplementation reducing asthma severity. Linda Hodge, Med J Australia 2/5/96;164:137-40. Fish Oil During Pregnancy Reduces Infant's Allergies: A DB PC study of 98 women who had allergies (were "atopic") giving half fish oil capsules starting the 20th week of the pregnancy found that the infants born from those mothers had evidence of greater omega-3 fatty acid concentrations in the membranes of their red blood cells, demonstrating that fish oil's omega-3s had indeed been picked up by the infants. All infant cytokine (IL-5, IL-13, IL-10, and IFN-gamma) responses all allergens were lower in the fish oil group (only IL-10 response to cat <.05). Infants in the fish oil group were 3 times less likely to have a positive skin prick test to egg at 1 year of age (OR 0.34). Although there was no difference in the frequency of atopic dermatitis at 1 year of age, infants in the fish oil group also had much less severe disease (OR 0.09). Fish oil supplementation in pregnancy modifies neonatal allergen-specific immune responses and clinical outcomes in infants at high risk of atopy: A randomized, controlled trial. Dunstan JA, Mori TA, Barden A, Beilin LJ, Taylor AL, Holt PG, Prescott SL. J Allergy Clin Immunol. 2003 Dec;112(6):1178-84 Fruits, Vegetables, Nuts Good; Margarine Bad: In a study of 700 children on the island of Crete, where asthma is less common, eating oranges, apples, tomatoes and grapes each day was shown to have a protective effect against wheezing and allergic rhinitis. Children who ate nuts at least three times a week were less likely to wheeze. High consumption of margarine more than once a week doubled the chances of asthma and allergic rhinitis. Paul Cullinan, et al. UK National Heart and Lung Institute, and University of Crete. BBC News 4/7/07. Gypsy Travelers Less Wheezing: Irish study found 31% children of settled Irish families had children wheezing in past year vs. 15% for 54 boy 6-12yo from traveling gypsy families. Maybe increased exposure to various allergens early in life helps gypsy children. Ir Med J ’98;91:215. As in the rest of Europe, there was almost a doubling asthma in Galway Ireland in early ‘90’s. HRT Linked to 80% increase in Asthma: Framingham Nurses Study of 120,000 found women on Hormone Replacement Therapy were 80% more likely develop asthma although only 1% of them developed asthma. Another article says asthma increased 80% nationally between ’82 and ’93 for school kids although increased detection may be part of explanation. Kerosene in Home Increases Asthma, Allergies: Ethiopian study found more than a doubling of rhinitis, wheezing, and allergies although abstract didn’t say how much more and could have been significantly more. Increased risk of allergy associated with the use of kerosene fuel in the home. Am J Respir Crit Care Med 2001 Nov 1;164(9):1660-4 Venn AJ, Yemaneberhan H, Bekele Z, Lewis SA, Parry E, Britton J.; Several other studies with similar findings. MBTE Oxygenated Gas Associated with Increase Asthma, Allergies: headache, throat irritation, allergic rhinitis, cough, nausea, dizziness, upper respiratory infections, wheezing, otitis media, skin rash, anxiety, insomnia, palpitations, generalized allergy, and malaise were increased during the period studied. Large increases occurred during the winters of 1993-1994 and 1994-1995 (during which there were high levels of MTBE), but not in the preceding summers (during which there were low levels of MTBE). This was especially true for asthma and wheezing. During the summers of 1995, 1996, and 1997, the incidences of the aforementioned symptoms increased greatly. U Penn study looked at billing records from 1992-7. Visits to physicians after the oxygenation of gasoline in Philadelphia. Joseph PM, Weiner MG. Arch Environ Health 2002 Mar-Apr;57(2):137-54 Margarine Doubles Childhood Asthma: A diet high in polyunsaturated fats more than doubles a child's risk of asthma. Australia. 1000 3-5-year-olds in rural area studied. Omega-6 fatty acids boost the synthesis of Prostaglandin E2, a chemical that increases inflammation in tissues in the body. Increased inflammation is linked to asthma. Omega-3, on the other hand, inhibits the formation of Prostaglandin E E2, and so helps protect against inflammation. Thorax 56, 589; New Scientist 7/19/01 Asthma 50% More Common for Overweight & 100% More for Obese: In a review of seven studies involving over 330,000 adult patients, those who were overweight or obese had a 50% higher risk of asthma. The risk for those who were obese was twice that of someone with normal weight. Rand Sutherland, et al. University of Colorado . American Journal of Respiratory and Critical Care Medicine 4/07. Ozone Days Increase Asthma Symptoms: Yale study by Janneane Gent, JAMA 2003;290:1859-1867,1915-1916 found for every 50 parts per billion (ppb) increase in 1-hour ozone level, the likelihood of wheezing and chest tightness increased by 35% and 47%, respectively, among asthmatic children using maintenance medication. Parasite Elimination Increases Asthma: Hookworms & Roundworms Good for Something!: Asthma affects 6-20% in developed nations, predominantly an urban disease. But developing countries are catching up. In Ethiopia, 5% in city but 0.5% in rural have asthma. 206 adults with asthma compared to 398 randomly selected controls. Hookworm and the large roundworm Ascaris both decrease a person's risk of asthma. A heavy hookworm burden lowers risk by around two-thirds. Tricuris or whipworm, offers no protection. New Scientist 5/22/01. (Ed: I'd rather take fish oil and have two dogs.) Peanut, Shrimp Allergenic: 1,070 cases of bronchial asthma, age from 3 to 70 years, were analyzed for their hypersensitivity to the four most common food allergens, egg white, milk, shrimp and peanuts. The severity of hypersensitivity was classified as mild, moderate and severe based on the concentration of allergen specific IgE in the sera. Results showed that there were 16.2% patients allergic to egg white, 22.3% allergic to milk, 12.6% allergic to peanuts and 34.9% allergic to shrimp. Shrimp and peanut tended to be later in onset (11-20) and more severe. J Microbiol Immunol Infect 1999 Mar;32(1):47-51. (Ed: Don't feed peanuts before age 2, don't eat peanuts while breast-feeding. The only exception is boiled peanuts, popular in Chinese cooking, because the high roast temperatures cause the allergen formation.) Peanut Allergy May Be Increasing in England: Study of 1236 normal kids found 3.3% peanut allergy vs. 1.1% in 1989. Suggests that more preg and breast-feeding mothers may be eating peanuts. 50% of peanut allergic kids with asthma and nearly all with eczema. Journal of Allergy and Clinical Immunology 11/02 Peanut Oil Creams for Infants Cause Allergies: Products that contain peanut oil often list the ingredient, sometimes described as Arachis oil. Parents often use these products to soothe diaper rash or dry skin in newborns. Following about 14,000 preschool-aged children from birth, forty-nine children were designated as "highly likely" to be allergic to peanuts. Based on interviews from the children's parents, preschool children whose parents had rubbed them with creams that contain peanut oil were almost seven times as likely as kids who had not been exposed to the creams to have an allergy to the nut. Infants who were frequent drinkers of soy milk and soy products were also almost three times as likely to have peanut allergies March 13/03, New England Journal of Medicine. Soybeans and peanuts are both legumes, and children who become sensitive to one can also become sensitive to the other. Creams with trace amounts of peanut oil may spark allergies in infants when the creams are applied to skin that has been broken down, perhaps from a skin condition. Infants who had experienced a rash--particularly one that had oozed and become crusty--were also at higher risk of developing peanut allergies. Peanut Reactions Shortened with Liquid Charcoal: Journal of Allergy and Clinical Immunology: Liquid charcoal, which is often used when people ingest poison to block absorption, can also absorb peanuts. "After you've eaten the peanut and you have an allergic reaction, you still have peanut in your stomach," explained Dr. Donald Leung, editor of the journal. "And so rather than allow further peanut to be absorbed and have an even more severe reaction ... drinking the charcoal will prevent the further triggering of increased symptoms." 7/10/03 Peanut Allergy Reduced by Frying or Boiling Instead of Dry Roasting: The methods of frying or boiling peanuts, as practiced in China, appear to reduce the allergenicity of peanuts compared with the method of dry roasting practiced widely in the United States. Roasting uses higher temperatures that apparently increase the allergenic property of peanut proteins and may help explain the difference in prevalence of peanut allergy observed in the 2 countries. China’s is much lower despite higher intake. J Allergy Clin Immunol 2001 Jun;107(6):1077-8. Wok cooking at 240-280 Celsius in Shanghai. Roasted peanuts from two different sources bound IgE from patients with peanut allergy at approximately 90-fold higher levels than the raw peanuts from the same peanut cultivars. J Allergy Clin Immunol 2000 Oct;106(4):763-8. In U.S. 29,000 anaphylactic reactions to foods treated in emergency departments and 125-150 deaths each year. Peanuts, tree nuts, fish and shellfish account for the vast majority of severe food anaphylactic reactions. Br Med Bull 2000;56(4):925-35. Peanut protein is secreted into breast milk of lactating women following maternal dietary ingestion. Exposure to peanut protein during breastfeeding is a route of occult exposure that may result in sensitization of at-risk infants. JAMA 2001 Apr 4;285(13):1746-8. In one series of 32 deaths, peanuts and tree nuts accounted for more than 90% of the fatalities. J Allergy Clin Immunol 2001 Jan;107(1):191-3 Pesticide, Herbicide, Cockroaches in 1st Year Bad: children exposed to cockroaches within the first year of life were twice as likely as those not exposed to cockroaches to develop asthma. 350 asthmatic kids with 350 controls. Herbicide exposure in the first year of life was associated with a 4.6-fold increased risk of asthma, while pesticide exposure was associated with a 2.4-fold increased risk. Found that exposure to wood or oil smoke in home from heating and exposures to the farming environment increased the risk of asthma, but the risk was strongest if the exposures occurred in the first year of life. Gilliland, USC, 5/22/03, American Thoracic Society International Conference. Pets Before Age 1 Protective Against Allergies: High pet exposure early in life appears to protect against not only pet allergy but also other types of common allergies, such as allergy to dust mites, ragweed, and grass. One cat or dog reduced risk by 33% and two or more reduced risk by 77%. followed 474 children from birth to six or seven years of age. When the children were one year old, the researchers contacted parents by telephone to find out how many pets were in the home. When the children were two years old, researchers measured the level of dust mite allergen in their bedrooms. When the children were six or seven, the researchers tested them for allergic antibodies to common allergens by two approaches - a skin prick test and a blood measurement. DR Ownby et al. Exposure to dogs and cats in the first year of life and risk of allergic sensitization at 6 to 7 years of age. Journal of the American Medical Association 288(8): 963-72 (2002). Platinum, Palladium Levels Increase; Possible Cause of Increased Asthma: Rhodium levels are already 120 times higher than in the 7500-year-old ice. Palladium and platinum levels have increased 80 and 40-fold respectively. These erode from automobile catalytic converters. Platinum refiners have higher rates of asthma. New Scientist 2/7/01 Pollution Increases Asthma in Most Athletic Kids: Six smoggy California communities vs. 6 not smoggy found children in the most active sports had up to three times the rate of asthma, but no increases were found for athletic kids from low pollution areas. Lancet 2/2/02. Probiotics Reduced Eczema: Finland used a type of bacteria found naturally in the gut, Lactobacillus rhamnosus strain GG -- to try to prevent allergy development in at-risk infants. Lactobacillus bacteria have long been used in food fermentation and are commonly found in items such as yogurt. Some forms of the bacterium dwell normally in the human intestines. Marko Kalliomaki, Turku University Hospital, pregnant women either probiotic capsules or placebo capsules every day for a few weeks before their due dates. For 6 months after delivery, women who breast-fed continued on the probiotics or placebo, while bottle-fed infants were given probiotics or placebo directly. All of the babies were considered to be at high risk of developing allergies because a parent or sibling was affected. Probiotic supplement group were less likely at age 4 to have developed an allergic skin condition called atopic eczema. Children at high risk, he said, are those whose mother, father or older sibling has asthma, atopic eczema or allergic rhinitis. By the age of four years, 25 of 54 children in the placebo group had developed allergic eczema, a condition in which the skin becomes irritated, red and itchy. But just 14 of the 53 children who had received probiotics developed the skin condition -- a 43% less. Lancet 2003;361:1869-1870. Selenium, Vitamin C Help Reduce Asthma in Children: A study of 7,505 youth (4-16 years old) in the Third National Health and Nutrition Examination Survey found that serum vitamin E had no association with asthma rates. In separate models, a SD increase in beta-carotene (odds ratio [OR], 0.9), vitamin C (OR, 0.8), and selenium (OR, 0.9) was associated with a 10-20% reduction in asthma prevalence. Serum cotinine was used to identify youth with no cigarette smoke exposure and passive exposure (7%). The selenium-asthma association was stronger in youth who were smoke exposed (p = 0.075). A SD increase in selenium was associated with a 50% reduction in asthma prevalence (OR, 0.5) in youth with passive smoke exposure compared with a 10% reduction in youth with no smoke exposure. Relationship of serum antioxidants to asthma prevalence in youth. Rubin RN, Navon L, Cassano PA. Cornell University. Am J Respir Crit Care Med. 2004 Feb 1;169(3):393-8 Swimming Pools Indoors Linked to Damaged Lung Protein: Belgium study of 1881 school kids where swimming required grade school subject. Occupational and Environmental Medicine 2003;60:385-394. Vegetarians Less Asthma, Fewer Meds, Less Chronic Disease, Fewer Surgeries & Hospitalizations, Fewer Allergies: In 1976, 27,766 Seventh-day Adventists answered questions on diet, medications, use of health services, and prevalence of disease. Approximately 55% (n = 15,228) were vegetarians. Compared with vegetarian females, nonvegetarian females reported significantly more overnight hospitalizations and surgeries during the past year and nonvegetarian males reported more overnight hospitalizations and x-rays. The average numbers of chronic diseases were 1.24 in nonvegetarian females and 1.03 in vegetarian females compared with 0.93 and 0.79 in nonvegetarian and vegetarian males, respectively. Nonvegetarian females also reported more chemical allergy (rate ratio (RR) = 1.30), asthma (RR = 1.24), drug allergy (RR = 1.17), bee sting allergy (RR = 1.17), and hayfever (RR = 1.15). Only chemical and drug allergy were more prevalent in nonvegetarian males. Medication use was increased by 70-115% in nonvegetarian females and more than doubled in nonvegetarian males. A vegetarian diet may decrease the prevalence of chronic disease, medication use, and health service use, and thus, potentially, health care costs. Am J Clin Nutr 1994 May;59(5 Suppl):1171S-1175S Lifestyle and the use of health services. Knutsen SF. Vitamin C, Manganese, Zinc, & Magnesium Shortages Associated with Increased Allergies: Scotland rural study of seasonal allergic symptoms. Increased risk of symptoms associated with the lowest intake of zinc. Lowest vitamin C and manganese intake associated with a fivefold increased in risk of bronchial reactivity. Low intake Magnesium also was slightly associated with increased risk. Therefore, reduction in antioxidant intake in British diet over last 25 year may be factor in increased asthma. Thorax 2/97, 52:166-70. Vitamin D in Pregnancy Reduces Asthma in Young Children: In a random sample of 2000 healthy pregnant women started at approximately 12 weeks gestation with follow-up of the children until age 5, a comparison of the highest and lowest quintiles of maternal total vitamin D intake conferred a 52% lower risk for ever wheezing in the children, a 65% lower for wheezing in the previous year, and a 67% decrease in persistent wheezing in 5-y-old children, all significant differences. Lower maternal total vitamin D intakes in pregnancy were also associated with decreased bronchodilator response (P = 0.04). Maternal vitamin D intake during pregnancy and early childhood wheezing. Devereux G, et al. University of Aberdeen, United Kingdom. Am J Nutr 2007 Mar;85(3):853-9. Vitamin D in Pregnancy Reduces Asthma in Young Children: In a study of 1194 mother-child pairs in Project Viva, the average total vitamin D intake during pregnancy was 548 IU/day. By age 3, 186 children (16%) had recurrent wheeze. Compared with mothers in the lowest quartile of daily intake (median: 356 IU), those in the highest quartile (724 IU) had a 61% lower risk of having a child with recurrent wheeze [P < 0.001]. A 100-IU increase in vitamin D intake was associated with lower risk (OR: 0.81), regardless of whether vitamin D was from the diet (OR: 0.81) or supplements (OR: 0.82). Maternal intake of vitamin D during pregnancy and risk of recurrent wheeze in children at 3 y of age. Camargo CA Jr, et al. Harvard. . Am J Clin Nutr 2007 Mar;85(3):788-95. Vitamin D in Pregnancy Can Be Too High: In a prospective study of 596 pregnant women, maternal 25 (OH)-vitamin D concentrations did not affect the child's body size or measures of the child's intelligence, psychological health or cardiovascular system. Children whose mothers had a 25(OH)-vitamin D concentration in pregnancy >75 nmol/l had an increased risk of eczema at 9 months (OR 3.26, P=0.025) and asthma at age 9 years (OR 5.40, P=0.038) compared to children whose mothers had a concentration of <30 nmol/l. Maternal vitamin D status during pregnancy and child outcomes. Gale CR, et al. University of Southampton, UK. European Journal of Clinical Nutrition, 21 February 2007. Yogurt Helped Allergic Rhinitis Patients: In a very small crossover study of 13 patients with nasal allergies and 7 healthy controls with all consuming two cups of yogurt or two cups of skimmed milk each for a four month period found yogurt feeding appeared to improve or prevent allergic recurrences in rhinopathic patients. Effects of dietary yoghurt on immunological and clinical parameters of rhinopathic patients. Aldinucci C, Bellussi L, Monciatti G, Passali GC, Salerni L, Passali D, Bocci V. Eur J Clin Nutr. 2002 Dec;56(12):1155-61 Yogurt: Allergic Rhinitis and Hayfever Less with Yogurt Consumption: In a study of 293 New Zealand farm children ages 7-10, inverse associations were found for early-life exposures: at least weekly consumption of yogurt with hayfever (odds ratio (OR) = 0.3) and allergic rhinitis (OR = 0.3); any unpasteurized milk consumption with atopic eczema/dermatitis syndrome (AEDS) (OR = 0.2); cats inside or outside with hayfever (OR = 0.4) and AEDS (OR = 0.4); dogs inside or outside with asthma (OR = 0.4). Farm residence and exposures and the risk of allergic diseases in New Zealand children. Wickens K, Lane JM, Fitzharris P, Siebers R, Riley G, Douwes J, Smith T, Crane J. Allergy. 2002 Dec;57(12):1171-9 Angioedema From ACE Inhibitors and ARBs: Angioedema and cough are known side effects of angiotensin-converting enzyme (ACE) inhibitors. Angiotensin-converting enzyme is a potent inhibitor of kinase II, which facilitates the breakdown of bradykinin. An increase in bradykinin levels results in continued prostaglandin E2 synthesis, vasodilation, increased vascular permeability, and increased interstitial fluid. In contrast, the angiotensin II receptor blockers (ARBs) do not increase bradykinin levels. Angioedema as a complication of ACE inhibitor therapy is not widely recognized; this complication is even less recognized with second-line ARBs. Almost half of patients with ARB-associated angioedema also had developed angioedema while receiving ACE inhibitor therapy. Angiotensin II receptor blocker-associated angioedema: on the heels of ACE inhibitor angioedema. Abdi R, et al. Harvard. . Pharmacother 2002 Sep;22(9):1173-5. Exercise-induced anaphylaxis (EIA) is a unique physical allergy that is triggered by exertion. In a cross-sectional analysis of 671 individuals with exercise-associated symptoms for more than a decade (hypotension or upper airway obstruction, urticaria, or angioedema with physical exertion but without a passive increase in core body temperature), symptoms were triggered by aerobic activities such as jogging or brisk walking in 78% and 42%, respectively. Subjects reported that the frequency of attacks had decreased (47%) or stabilized (46%) since onset. 41% were completely free of attacks in the past year. Subjects reduced their attacks by avoiding exercise during extremely hot or cold weather (44%), avoiding ingestion of certain foods before exercise (37%), and restricting exercise during their allergy season (36%) or humid weather (33%). The most common pharmacologic agents used to manage symptoms were H1 antagonists (56%) and/or epinephrine (31%). However, 28% used no treatment at all. The natural history of exercise-induced anaphylaxis: survey results from a 10-year follow-up study. Shadick NA, et al. Harvard. J Allerg Clin Immunol 1999 Jul;104(1):123-7. Thomas E. Radecki, M.D., J.D.
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