Breathing is a bodily function that, for most, happens without much thought. However, it can quickly become a very uncomfortable ongoing event for more than 25 million adults and children in the United States (1). The pulmonary condition known as asthma can occur due to genetic history, prenatal exposures, and/ or other environmental causes (1).
What is Asthma?
Asthma is characterized by symptoms such as a dry cough, wheezing, chest tightness, and shortness of breath (2). There are many different forms of asthma, from childhood through adulthood. For example (3),
Transient wheezing is typically found in children who are 5 years or younger and is typically due to underdeveloped lung function, exposure to maternal smoke, and/or daycare and sibling exposures to other rhinoviruses.
A milder form, known as non-atopic wheezing asthma, can last through adolescence. Non-atopic asthma is not due to an allergy; instead, it is exposure to respiratory syncytial virus (RSV) in early childhood.
Finally, atopic asthma, or "classic asthma," is due to traditional types of exposures and is caused by an immune system IgE response.
Stick with me for the “geeky “science
For individuals with specific food, environmental, or other exposures, coupled with a genetic predisposition, an immune response can trigger asthmatic symptoms that require ongoing attention. This immune response leads to chronic inflammation, which in turn releases mast cells, increases eosinophils (a type of white blood cells), and activates T helper cells (a type of immune cells), among other things. In the case of asthma, T helper cell 2, or Th2 cells, respond to the lungs and other inflamed airways, producing the immunoglobulin-E or the IgE response (4). This immune response is a key factor in the development and management of asthma and understanding it can empower individuals to take control of their condition.
Common Triggers
Certain lifestyle factors can significantly influence the development and management of an asthma diagnosis. For example, a traditional Western diet high in fat, sugar, and low in fiber can disrupt the microbiome, creating more inflammatory microbes, leading to dysbiosis and a weakened immune system (2). In addition, certain foods are more likely to cause an allergic response, such as dairy, wheat, shellfish, nuts, and eggs (2). Sulfites are found in dried fruit and wine most commonly, and salicylates are found in many fruits, veggies, and aspirin (2). For someone who may be prone to asthma, overwhelming an already weakened immune system may cause increased symptoms. This highlights the importance of a balanced diet and careful food choices in managing asthma.
Elimination Food Plan
The best first step to address chronic asthma symptoms is to remove or reduce triggers that can be affecting the immune system leading to increased inflammation. Choosing the appropriate foods is a simple effective place to start. There are many known contributors to an inflammatory response, such as dairy, peanuts, wheat, and other commonly consumed foods (5). Therefore, working with a nutritionist to start a standard or personalized elimination diet for someone with asthma is highly recommended (4).
An elimination diet focuses on the removal of a few key foods or food groups for a limited period of time, with the intention of reintroducing them slowly based on each individual’s response to the food that has been removed (6). Dairy, for example, when removed for 8 weeks, showed a 22% improvement in asthma symptoms in children (6). Other key potential allergens that are helpful to be aware of and remove during this time (and after, if possible) are food additives, like artificial colors, flavorings, sweeteners, and preservatives. (1).
it is not all about eliminating but also including!
It is crucial to support the gut microbiome and other systems by consuming adequate fiber from a variety of fruits and vegetables. Fruits and veggies also serve as an important source of antioxidants, which tend to be low in those with asthma (1). Additionally, consuming fatty fish, like sardines and salmon, 1-2 times per week has been shown to decrease Th2 cells and inflammation, which can sustainably reduce asthma symptoms better than those who only consumed these fish 1-2 times per month (7).
There are areas of caution to be noted when deciding if an elimination diet is the best option. For example, anyone who has had disordered eating patterns or may be susceptible to eating disorders may not be a good fit.
It is important to work with a nutrition professional to ensure it is the best option for you and is one you can adhere to and maintain for a period of time. A nutritionist can also ensure that adequate nutrients are consumed throughout and monitor progress allowing for changes that may be needed over time. The elimination diet is not meant to be followed forever!
Summary
Overall, reducing exposures and managing symptoms are key to asthma management. Minimizing exposure to toxins and eliminating common allergenic food sources and additives are great places to start. Be sure to reach out to a nutrition professional to determine what’s best for you.
Ready for more? Check out the other blogs in this series:
Written by Kimberly King, MS
Last reviewed and Updated June 27, 2024
The information provided is for educational purposes only and is not intended to replace the guidance of your healthcare provider(s).
References:
1. Rakel, D. Integrative Medicine. 4th ed. Elsevier; 2017:450-456.
2. Escott-Sump S. Nutrition & Diagnosis-Related Care. 8th ed. Wolters Kluwer; 2015: 534-536.
3. Ross, K. M4_Pulmonary [PDF]. SCNMInstructure; 2021
4. Stoodley I, Garg M, Scott H, Macdonald-Wicks L, Berthon B, Wood L. Higher Omega-3 Index Is Associated with Better Asthma Control and Lower Medication Dose: A Cross-Sectional Study. Nutrients. 2019;12(1):74. Published 2019 Dec 27. doi:10.3390/nu12010074
5. Quirt J, Hildebrand KJ, Mazza J, Noya F, Kim H. Asthma. Allergy Asthma Clin Immunol. 2018;14(Suppl 2):50. Published 2018 Sep 12. doi:10.1186/s13223-018-0279-0
6. Alwarith J, Kahleova H, Crosby L, et al. The role of nutrition in asthma prevention and treatment. Nutr Rev. 2020;78(11):928-938. doi:10.1093/nutrit/nuaa005
7. Virdee K, Musset J, Baral M, Cronin C, Langland J. Food-specific IgG Antibody-guided Elimination Diets Followed by Resolution of Asthma Symptoms and Reduction in Pharmacological Interventions in Two Patients: A Case Report. Glob Adv Health Med. 2015;4(1):62-66. doi:10.7453/gahmj.2014.068
Images created using CanvaPRO. Licensed to Kim Ross Consulting LLC