Blog

Spotlight on Asthma

By Alex on 03/05/22 | Family Health

Asthma is a chronic respiratory disease – a long-term disease of the lungs. It causes your airways to get inflamed and narrow, and this makes breathing difficult. Typical symptoms include coughing, wheezing, shortness of breath and chest tightness. And it’s on the up. In England, more than 1 in 4 children now have asthma, compared to 1 in 18 back in the 1970s.

The question is, why? Most experts agree it’s likely down to changes in diet, lifestyle or environmental factors, with food allergies being very high on the list of contributing factors. Yet few sufferers are informed in any detail about the key contributory factors or checked out thoroughly for food allergies. Prescriptions for corticosteroid creams or inhalers are routine when you visit your GP (and, to be clear, you should always visit your GP if you are in any way concerned about your health).

There’s little doubt that the main anti-inflammatory drugs used to treat eczema and asthma, although they are very effective in providing relief particularly in the short term, can make things worse in the long run and there are often side effects. Conceptually, the best approach is to consider that an asthma attack is triggered when a person’s total load exceeds their capacity to adapt. While there may be a specific trigger (like stress or cigarette smoke) these triggers can be seen as ‘the straw that broke the camel’s back’ rather than the actual cause. Perhaps, then, the goal should be increasing your capacity to adapt and lessening the total load.

As a nutrition professional, I can tell you that checking for allergies and food intolerances, upping your intake of antioxidants, essential fats and other natural anti-inflammatory foods will, at worst, reduce the need for drugs and at best, may relieve symptoms. However, this is absolutely not a substitute for medical guidance or medication.

While there’s a lack of good studies to prove the benefits of an all-round nutrition-based approach (which doesn’t mean that there’s no point in doing this, just that no one has actually studied it), there are plenty of good reasons to give these suggestions a go and see what happens to your symptoms.

NATURAL APPROACHES TO ASTHMA

FIND OUT WHAT YOU’RE ALLERGIC TO
There are two kinds of allergies: IgE and IgG (sometimes referred to as intolerances/sensitivities). IgE (Immunoglobulin E) reactions are what you think of as conventional allergies. People with asthma often have higher levels of IgE, making them hypersensitive to certain substances. You can test your IgE sensitivity and identify specifically what you are reacting to with an IgE blood test. If you have asthma, you may already have had this done. If not, this can be done privately.

The test involves taking a pinprick of blood with an easy-to-use home kit and posting it to the laboratory for testing. Most asthma suffers also have IgG sensitivities to foods. These intolerances are not as obvious (or immediate) as an allergic reaction and may not always precipitate an asthma attack. If they do, asthma symptoms may not occur until 24 hours later. Common foods that cause reactions are milk products, gluten cereals (wheat, rye, barley, oats) and yeast. However, I would not recommend cutting out entire food groups without the support of your GP or nutrition professional.

AVOID YOUR PROVEN ALLERGENS OR FOOD SENSITIVITIES
Once you know what you are reacting to, you need to avoid your allergens. When it comes to IgE sensitivities, these last for life. You can, however, ‘grow out’ of IgG sensitivities if you avoid the allergens a number of months and take steps to allow your body to heal.

However, not all allergens are easy to avoid. If, for example, you are allergic to pollen, you won’t be able to manage to avoid it completely. So, if you are pollen sensitive, you might choose to avoid grains (which are grasses) and dairy products (made from grass) during the pollen season as the body can ‘cross react’ to similar proteins.

If you are allergic to house dust mites, which live in mattresses and carpets, you’ll need to go to war on these little creatures by changing your bedding regularly and always washing on a hot wash and dry really well. House dust mite allergy has increased enormously since central heating became the norm because these bugs love moisture and don’t like big temperature changes. If you think you have an infestation, either get a new mattress or put yours out to sunbathe on a couple of extremely hot days. You might also look into having the mattress steam cleaned. Then use a house dust mite proof cover for your mattress and pillows. You can buy them from most big department stores and online.

Invest in a bed base that lets the bed air really well. Although you may love the tidiness of a well-made bed, the best thing to do to prevent mites is to not make the bed and instead leave it to air naturally. You should let the room air as well – don’t be afraid to throw open the windows. In an ideal world, you wouldn’t have a carpet in the bedroom either.

IMPROVE YOUR DIGESTION
One of the major causes of food allergies is poor digestion. A lack of stomach acid often means you don’t digest protein properly, so you end up with undigested food proteins in the gut. If your digestive tract becomes at all inflamed, for example by alcohol, these food proteins can cross into the blood and trigger allergies.

Once you’ve identified and avoided your known food allergens, I’d recommend a 30-day digestive rest programme. This means minimal gluten (which irritates the gut), lots of fruit and vegetables, digestive enzymes with each main meal, plus other supplements (as needed) to help restore the integrity of the gut lining. Ask me for details.

INCREASE YOUR INTAKE OF ANTIOXIDANTS
There’s no doubt that increasing your intake of antioxidants makes a difference to all aspects of health, including asthma. Numerous studies have shown that a high intake of fresh fruit and vegetables reduces asthma severity, and there is a strong implication that it is the high antioxidant nutrient content of fruits and vegetables that does this. The antioxidant nutrients that come out top are vitamin C, vitamin E, beta-carotene and bioflavonoids (which are especially rich in berries).

What will you want to add to your diet? Lots of broccoli, peppers, berries, citrus fruit, apples (all rich in vitamin C), carrots and tomatoes (rich in beta-carotene and lycopene) and seeds and fish (rich in vitamin E).

And remember that old saying about an apple a day keeps the doctor at bay? Here’s why. A survey of 1,500 asthma sufferers in the UK found that people who ate at least two apples per week experienced a 22% to 32% lower asthma risk than those who ate fewer. Apart from vitamin C, apples contain the antioxidant quercetin, which reduces histamine and has been shown to have broncho-dilating properties (which is code for the fact they keep your airways nice and open).

To have all bases covered, try to ‘eat a rainbow’, which means 'have as many different colours of vegetables as you can'. This is because fruit and veg tends to be colour-coded for the types of helpful plant chemicals they contain. What we know is that these plant chemicals have a synergistic effect in the body (their sum is greater than the individual parts), so try to get in as many different colours as you can over the course of a week.

INCREASE YOUR INTAKE OF NATURAL ANTI-INFLAMMATORIES
The actual constriction of the airways happens due to an inflammatory reaction. Allergic reactions can cause a release of histamine that triggers inflammation and consequently this constriction.

Most anti-asthma drugs are acting as anti-inflammatories, the most common being steroid inhalers. These mimic the action of the body’s own cortisol hormone that acts as a powerful anti-inflammatory.

Nature’s most powerful anti-inflammatories are omega-3 fats, boswellia, curcumin, ginger, quercetin and MSM, which is a form of sulphur. Astaxanthin may also help.

So how can you get more of these into your diet?

Eat a diet high in oily fish (wild or organic salmon, mackerel, herring, kippers, sardines and tuna steak), omega-3 rich flaxseeds and pumpkin seeds to help lower levels of inflammation.

IMPROVE YOUR AIR QUALITY
Most people with asthma are hypersensitive to changes in air quality and do much better in clean air. It’s well worth investing in a decent ioniser for the bedroom and/or your major living space. Ionisers take dust and other tiny particles out of the air, including smoke and pollen.

In addition to ionisers for your home, you can now buy discreet personal ionisers that can you can wear and help protect you whether you are out in the fields or in a smog-filled city street.

WORKING WITH YOUR DOCTOR

Many of the recommendations made here to reduce your inflammatory and allergic sensitivity can be put into action without interfering in any way with medical treatment. And they may well reduce the need for it.

For instance, if you have asthma and you find taking in some of these suggestions makes your condition much better, it is worth talking to you doctor about whether it makes sense to reduce how often you use your inhaler – do NOT simply stop using it, however, without medical advice.

One of the most important factors to check for is allergies. Your doctor may be willing to refer you for allergy tests. It is important, however, that you are checked for both IgE and IgG allergies. As few doctors check for IgG-based allergies, you may need to do it using food allergy/ intolerance test.

Why not book in a free 30 minute health review with me and I can tell you more about testing.

Spotlight on Long COVID

By Alex on 12/04/22 | Family Health

What’s the deal with post-COVID syndrome?

Over the last two years, nothing has ruled our lives and occupied our minds as much as the SARS-CoV2 pandemic. If we have not been personally affected yet, we all know someone who has. There is light at the end of the tunnel. One by one, countries are lifting their COVID restrictions to varying degrees and travel across borders is becoming easier.

COVID-19 turned out to be a disease that comes in all shapes and sizes. Some people will have contracted SARS-CoV2 without even knowing as they do not develop symptoms. Most people affected experience mild to moderate symptoms, but about 20% get severely ill. Of those, 5% develop critical illness. According to the WHO, almost 6 million people have died to date in connection with this coronavirus,

Typically, people infected with the virus develop symptoms within four to five days after exposure. If the disease is mild, they recover within seven to ten days. If they get severely or critically ill, it can take three to six weeks to recover.

A minority requires hospitalisation, and the treatment can be long and traumatic. At first, it was thought that those who recovered from acute COVID-19 would simply get on with their lives once they regained their strength. Yet, as the pandemic progressed, it transpired that a significant percentage of people felt below par for weeks or even months after the initial infection.

“Long COVID” or “post-COVID syndrome” is even more multi-faceted than the acute disease itself. For some people, it means that symptoms persist for much longer than usual. Others develop completely new symptoms, and even people whose initial infection went unnoticed can develop long-COVID.

Most long COVID patients will test negative for SARS-CoV2. In other words, the virus has gone, but the patient remains ill.

Long COVID symptoms

In acute COVID-19, people affected often experience flu-like symptoms – with or without fever - cough, sore throat, chest pain, shortness of breath, loss of smell, loss of appetite, headaches, diarrhoea and more. Those suffering from post-COVID syndrome experience such symptoms for much longer than usual, some continuously, some on and off. However, long COVID can also present with a completely new set and a broader range of symptoms, such as fatigue, poor quality of life, joint pain, muscle pain, skin rashes, palpitations, mental health problems, and more.

Post-COVID syndrome can resemble other similarly puzzling diseases, such as postural orthostatic tachycardia syndrome (POTS) or myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS). Indeed, more than 10% of patients who have had COVID-19 later receive a diagnosis of either POTS or ME/CFS.

Another condition long COVID is reminiscent of is mast cell activation syndrome (MCAS). The SARS-CoV2 virus has been found to trigger inflammatory immune cell responses, including that of mast cells. Patients suffering from MCAS experience frequent episodes of anaphylaxis, i.e., allergic symptoms such as hives, swelling, low blood pressure, difficulty breathing and severe diarrhoea. They also find that they are reacting to more and more things, including foods, over time.

Diagnosis can be tricky

COVID-19 and long COVID are still new and poorly understood. Long COVID affects all ages, people with or without pre-existing conditions, those who had acute COVID and those who apparently didn’t. Risk factors for long COVID include being female, over 70 and having pre-existing conditions. However, it still occurs in younger, male, and previously healthy people, including children.

The wide array of symptoms – of which sufferers may have one, two or many – may also distract from the root cause of a patient’s discomfort. There are no definitive tests (yet). Post-COVID syndrome can manifest itself in conditions affecting the lungs or the heart, the nervous or the digestive system, sometimes even in one person.

Many people who contracted SARS-CoV2 remain asymptomatic and never know they had it. Just a couple of weeks after infection, tests come back negative. Not everyone makes antibodies either, and in those who do, their number goes down after recovery from the acute illness. By the time long COVID symptoms develop, antibodies may be completely undetectable. Such circumstances hamper the diagnosis of post-COVID syndrome.

What treatment options are there?

Considering how new and varied the disease is, it is not surprising that for now, treatment options are few and far between. There is as yet no drug that would ease symptoms, let alone cure the illness. As long COVID symptoms resemble those of POTS and ME/CFS, repurposing medications developed to treat those conditions may be helpful in long COVID, too. More research is needed in that area.

At the moment, the most promising treatment seems to be rehabilitation. Light exercise tailored to the patient’s capability, breathing exercises to strengthen the lungs and cognitive behavioural therapy (CBT) over four to six weeks have been shown to improve the condition.

Does exercise help?

Exercise is generally seen as one of the pillars of good health, and it does indeed improve or even prevent a plethora of health conditions. However, in long COVID, a survey found that 86% of participants relapsed following mental or physical activities. Even light exercise as used in rehabilitation may be too much for some sufferers of post-COVID syndrome. A high resting heart rate, high or low blood pressure or low blood oxygen saturation mean that exercise is counter-indicated.

What about nutrition?

For now, research into nutritional therapy for long COVID is scarce. However, just as scientists are hopeful about repurposing pharmaceutical treatments designed to treat POTS and ME/CFS, there is the option of doing the same with the non-pharmaceutical therapies that are used to manage these conditions. As POTS and ME/CFS have been around for longer, research is available about how optimum nutrition can help, and many nutrition professionals are experienced in working with POTS and ME/CFS patients.

In the absence of research specific to post-COVID syndrome, the current advice is to follow a generally healthy diet that reduces inflammation, strengthens the intestinal microflora, and supports the immune system. This way of eating is considered to do no harm, and it may actually help.

As long COVID patients can sometimes show MCAS symptoms, it stands to reason that dietary approaches developed for MCAS – e. g. a low histamine diet - may be an option here. Again, there is no research yet to say whether this would work. A low histamine diet is challenging and can be quite restrictive. It should, in any case, only be attempted with the guidance of a nutrition professional.

Watch this space

Both COVID-19 and post-COVID syndrome are still new, and a lot of research still needs to be done to understand those conditions fully. Post-COVID has many faces, and sometime soon, scientists will probably present a list of the different guises it comes in. Each one of them may require its own treatment. Given that millions of people worldwide have been affected, there is a substantial population of patients. This helps because the more people are likely to benefit from a solution, the more interest there is in funding and conducting studies. Also, there are more people available to potentially participate in such studies.

So, for now, we can only make the most of the (sparse) current treatment options, such as rehabilitation. Eating junk foods and burning the candle at both ends are unlikely to improve long COVID, so a healthy diet, sleep, me-time, and relaxation seem like a good place to start. Typically, exercise is part of this list of healthy habits. For long COVID patients, however, it can be counterproductive.

While recovery from post-COVID syndrome can be slow, patients are getting better, and the majority make a full recovery. If you are suffering with long COVID and would like to talk to me about improving your diet and lifestyle, feel free to book in a call here.