Physicians have long recognized that people with asthma tend to be overweight. The common assumption is that weight gain occurs because many asthmatics avoid exercise since physical activity can trigger symptoms. In fact, years ago, people with this chronic respiratory disorder were often advised to avoid exertion entirely.
Today, however, experts encourage people with asthma to exercise for overall good health and to help relieve their symptoms.
"Exercise is not only safe if done properly, it's an integral part of [asthma] treatment," notes the Physician and Sportsmedicine Journal in a special guide to exercising with asthma. "Regular workouts will make you stronger and more energetic. . . . Studies have shown that physically fit people have fewer attacks, need less medication and lose less time from work or school."
Problems Caused by Inactivity?
Not only is exercise helpful for people with asthma, but inactivity may contribute to breathing problems. New evidence indicates that sedentary lifestyles and excess weight may not be the result of asthma, but a cause of the disease.
"Our research has found that obesity increases the risk of asthma in adult women and in children," notes Carlos Camargo, an assistant professor of medicine at Harvard Medical School.
His recent study of 16,862 children, ages 9 to 14, found that those who were the most overweight were two to three times as likely to have asthma as the least overweight subjects. Last year, Camargo came to a similar conclusion after studying 116,678 members of the Nurses Health Study II. Exactly how obesity increases asthma risk is unclear, Camargo says, "but it may be related to a sedentary lifestyle. In the lab we've shown that if you take really shallow breaths, your airways can close down. When kids sit and watch TV for hours on end, their breathing tends to become shallow, which may increase bronchial reactivity and airway irritation."
This notion represents a startling reversal of past assumptions about obesity and asthma, two of the fastest-growing, most pervasive public health problems in the United States. Incidence of asthma, which now affects about 5.3% of adults and 6.3% of children, has more than doubled since 1980. During that same period, the proportion of obese adults ballooned from 25% to nearly 35%, and the number of "extremely" overweight children nearly doubled.
Connection Between Poverty, Asthma
"Both diseases follow an intriguing pattern," Camargo notes. "The richer the country, the more obesity and asthma. But within the richer countries, it's the poorer people who have more asthma and obesity."
Experts offer many other theories to explain the poverty-asthma connection. For example, the needy are more likely to live in rundown housing with allergens such as dust mites, cockroach droppings and mold.
"But it's also important to recognize that more kids today are sitting around indoors instead of running around outside," Camargo says.
Physical activity helps relieve asthma in a variety of ways.
"The normal response to exercise is that your airways will open up," says Sally Wenzel, a pulmonologist at National Jewish Medical Research Center in Denver. "When you're out of condition, you're less likely to get this broncho-dilating effect."
Excessive weight on the chest can make it difficult to expand the lungs, notes Wenzel, who says exercise's potential for weight loss also can help people breathe easier. And the self-esteem boost from being active "is important for all asthmatics, but especially children," she says, "so they're part of the mainstream of society."
In addition, "physical activity helps control stress, which can be a trigger for asthma," says Jeffrey Wald, an allergist in private practice in Overland Park, Kan. "I've had a lot of patients with asthma report they've benefited from taking karate, which teaches breath control. In general, anything that promotes relaxation is going to be beneficial."
Managing Sickness Through Yoga
Many asthma sufferers are turning to yoga, which centers on deep, focused breathing and tension relief.
"Fear is the governing factor in asthma because you think you're choking," says Alice Christensen, founder of the American Yoga Assn., a nonprofit educational organization based in Sarasota, Fla. "Your heart starts racing, you begin to panic, and it's very difficult to remain calm and balanced."
Christensen developed several calming strategies for breathing when her son, now in his 50s, had asthma as a child.
"I had to invent fun ways to get him away from the fear and stress he experienced," says Christensen, who features a chapter on yoga for asthma in her book "The American Yoga Association Wellness Book" (Kensington Books, 1996).
She offers this simple tranquilizing exercise for people who feel agitated and breathless:
* Sit in a chair with your feet flat on the floor.
* Exhale completely as you bring your head down toward your knees. Count to 3.