Asthma - A Chronic Respiratory Disease
G. K. Pakavath


ASTHMA is now so common that not only have you heard of it, you
probably also know people who have it. Nepal alone has about two
million asthmatics. The numbers are increasing so alarmingly that by
2020, Nepal is likely to become the asthmatic capital of the world in
all probability.

Causes

Nobody knows for sure what causes asthma. One predisposing factor is:
family history. With one asthmatic parent the child is at risk. With
both asthmatic parents, that risk rises to 75 per cent. The second
factor is due to eczema and/or allergic rhinitis. And the third factor
is due to pre-natal or early exposure to cigarette smoke.

The various triggers that can set asthma off include dust, dust mites,
pollen, tobacco, allergies and viral infections like flu, animal hair,
emotional stress, sudden weather changes and vigorous exercise.
Parthenium, or Congress Grass, is a major cause of asthma especially
in cities like Kathmandu and Pokhara.

Asthma causes approximately 5,000 deaths a year. About 60 per cent of
asthma deaths are preventable. Incidence of immune system diseases
like asthma has increased by over 200 per cent in the last five years.
Asthma affects one in six children and one in 15 adults. Asthma
accounts for 13 million school days missed every year. Asthma accounts
for around 24.5 million work days missed a year.

These are some guidelines: Never neglect a common cold or any
infection of the respiratory system. Try yoga or meditation to relax
mentally and physically. Stay positive. Do not self-medicate. Stay
away from tobacco smoke, paint, animal fur, dust, pollen and other
triggers. Ensure that there is adequate ventilation in your room or
work place. Avoid carpeting, heavy drapes and other dust collectors in
your home.

Asthmatics must avoid food with artificial colouring and monosodium
glutamate (MSG), aerated drinks and canned food, chilled drinks and
all animal protein, including dairy. MSG is an active ingredient in
chow chow, the popular ready to eat food in the country. Perhaps, that
could be the reason for the higher growth-rate of asthmatic patients.
Yoghurt is the highest mucous forming agent. Consumption of plenty of
vegetables and fruits are highly desirable.

Exercises like deep breathing to increase lung capacity, blowing
balloons, aerobics and swimming are good asthmatics to mitigate the
severity of the disease.

Asthma, a chronic respiratory impairment, is much more severe in
patients who are also obese, compared to those who are not overweight.
According to one of the largest surveys ever done in the US that also
holds true for other countries, researchers have found that obese
patients were 66 per cent more likely to report continuous symptoms,
36 per cent more likely to miss working days and 52 per cent more
likely to be classified as having either moderate or severe persistent
asthma. The study conducted on 3,059 adults with asthma was based on
their body mass index (BMI).

In the study, researchers adjusted for certain variables, including
gender, race, age, smoking status, education level, income employment
status, family history of asthma and residence in a metropolitan area,
to ensure these variables were not playing a role in the results. Even
after taking these variables into account, the association between
obesity and asthma severity still held. The link between asthma and
obesity was more prominent in women. Over 70 per cent of the study
subjects were women.

Compared with non-overweight asthma patients, obese patients were more
likely to report having continuous symptoms, have more doctor visits,
miss more days of work, use more inhaler medications and use inhaled
steroids to control asthma. The obesity asthma connection affects
women even more severely. This could be due to an association between
the hormone Leptin, which is produced by fat cells and plays a role in
body weight regulation and inflammation of airways seen in asthma.
Obesity may also impact the lungs in other ways.

Fast food effect

Obesity causes respiratory impairment as excessive fat on our exterior
presses on our lung, causing physical reduction in the capacity for
the lung to expand. People who are obese also tend to eat fast food
that has preservatives which have allergenic effect on asthma.

There might have been a number of studies on obesity and asthma
prevalence, but until now there have been little data on obesity and
asthma severity. Obesity by itself also results in reduction of chest
wall compliance, leading to reduced respiratory reserve.

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