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Exercise can also help. Interestingly, school teachers who have asthmatic children in their classes are often confused about exercise. One child has a doctor who says, 'This child has asthma, so he can't take gym.' Another child's doctor says, 'This child has asthma and should be encouraged to exercise.'
Who's right?
'They're both right,' says Dr Falliers. 'Until the asthma has been treated, a child should be excused from exercise. But as treatment progresses, the child should be encouraged to develop and improve his or her fitness.'
That's because improving overall fitness can help keep asthma under control.
'If you're not fit - if you haven't exercised in six months -and then you start exercising, your heart will beat very fast,' explains Dr Falliers. 'But if you're physically fit, your heart will beat more slowly. And a slower heartbeat means better absorption of oxygen from the lungs. Being fit is like having your carburettor properly adjusted: you run and breathe more smoothly.'
Of course, exercise can also help keep your weight down, which is also beneficial for asthmatics.
'If you have two inches of excess fat around your diaphragm, it's going to make it harder for you to breathe,' says Dr Falliers. 'For a person with asthma - or any kind of breathing problem - being overweight is like wearing a very tight garment. You don't have enough room for your muscles to expand the lungs.'
The type of exercise you choose will make quite a difference in how well you tolerate exercise. Activities that involve brief spurts of action, separated by rests, are much less apt to trigger asthma attacks than sports that call for continuous exertion. An asthmatic who goes in for baseball or golf, for example, is not as likely to start wheezing and coughing as one who plays basketball or runs the mile. Swimming too is ideal for asth­matics, provided that rest is taken at proper intervals.
'So often, it's not the exercise that triggers asthma, but fast breathing of cold air,' says Dr Falliers. 'Cold air irritates sensitive airways. If you breathe through your nose, instead of your mouth, the air will be warmed, and you may not react.'
A light, cotton face mask may also help to protect against cold, dry air - or pollen and air pollution, for that matter. Scientists at the National Asthma Center in Denver observed the effectiveness of face masks on ten boys and girls, all asth­matic. After exercising for six minutes, the youngsters experi­enced much less asthma than usual - or none at all. The researchers concluded that a 'simple face mask may be an inexpensive [drug-free] alternative for alleviation of exercise-induced asthma' - especially in runners and skiers with asthma. (Journal of the American Medical Association)
Similar research at Yale University also showed the protection offered by face masks against exercise-induced asthma. In both air conditioned and refrigerated rooms, asthmatics with face masks fared better than those without masks - probably due to the re-warming of air inside the mask, said the researchers, adding, 'We have shown that under [these] circumstances . . . the use of a mask offers a simple, inexpensive and effective form of [protection]'. (Annals of Allergy)
Wearing a scarf pulled up over your mouth before going outdoors in winter achieves the same effect.
During the nineteenth century, it was noticed that sailors with scurvy stopped wheezing when they ate citrus fruit. Modern research shows that vitamin С may help to widen air passages during exercise or exertion. In one study, volunteers who customarily suffered asthma after exercise were given 500 milli­grams of vitamin С before an exercise test. Their tolerance of exercise was doubled (Journal of the American Medical Associ­ation).
Vitamin С also seems to help asthmatics whether they tolerate exercise or not. In another study, asthmatics who took 1,000 milligrams of vitamin С a day had less than 25 per cent as many asthma attacks as those receiving an inactive dummy pill. When they stopped taking vitamin C, however, they once again suffered the same number of attacks as the untreated people (Tropical and Geographical Medicine).
So breathe easier. By definition, asthma is a reversible condition. And relief depends largely on factors that you can control.
'Proper education of the public and the right health attitude - not waiting until the damage is done, but preventing it - will be the secret of success in controlling asthma,' says Dr Falliers. 'And if that puts us allergists out of a job, that's just fine!'


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