Breathing Easy

Breathing Easy

Preventing asthma starts by understanding triggers and, perhaps, by changing the way we eat

A few months ago, I discovered I could no longer walk up the stairs. I live on the second floor of a Chicago three-flat, so this discovery was particularly troublesome. I’d been getting tired on the stairs more easily, but I suddenly felt much worse. After reaching the landing halfway between the floors, I had to sit on the ground to catch my breath. 

My heart was pounding, I was dizzy, and I could barely breathe. Heart problems run in my family, so my first thought was a cardiac issue. Once I could breathe again, I made an appointment with my doctor. I left the doctor’s office a week later with a surprising diagnosis: asthma. I had struggled with asthma in sixth grade, but as an adult? It wasn’t an issue. Until now.

Why is asthma so serious?

We know asthma as a condition that makes it hard to breathe, but there’s more to it than that. Asthma is an inflammatory condition, meaning your airways swell, constricting the airflow. 

Anna Volerman Beaser, MD, an internist and pediatric primary care doctor at the University of Chicago Medicine, tells her patients their “lungs are angry.”

During an asthma exacerbation, people have trouble breathing, plus they may cough, wheeze, or experience chest pressure. Less common symptoms include anxiety, heartburn or acid reflux, and dizziness or lightheadedness. If people don’t have medication to help, they may end up in the emergency room. 

Asthma exacerbations are scary for individuals, but asthma also has an impact on the community at large, says Volerman, who serves on the Chicago Asthma Consortium board of directors.

“All of those individual occurrences that someone has where their asthma might flare lead to missed workdays and missed school days, which has economic effects and larger societal effects for the world overall,” she says. “This doesn’t just affect people who have asthma, but it also affects everyone around us, like families and communities.”

Prevention is key

More than 25 million children and adults in the United States currently have asthma, according to the Centers for Disease Control and Prevention (CDC).

Luckily, asthma rates are leveling off, although experts aren’t sure why. According to the latest CDC data, prevalence in 2019 decreased by about a half percentage point from 2016. It’s not much, but considering rates were on the rise since 2013, it’s a big deal. Still, there’s a downside to those numbers.

My heart was pounding, I was dizzy, and I could barely breathe.”

“The reality is that overall numbers are becoming stable, but we’re continuing to see significant disparities among different groups,” Volerman says. “The disparities unfortunately haven’t closed, and they’re based on race, ethnicity, poverty, and geography.”

At-risk groups often face the effects of climate change and pollution — common asthma triggers — more heavily. Other triggers include: 

  • Indoor allergens such as dust mites and cockroach debris.
  • Pet dander, perfume, tobacco smoke, and mold.
  • Outdoor allergens including wildfire smoke and poor air quality.
  • Physical activity and exercise.
  • Viruses.
  • Strong emotions, such as fear, stress, or anxiety.
  • A genetic history of asthma in your family.

While there’s no cure for asthma, prevention is key to keeping it under control. Avoid contact with your triggers, such as the ones listed above. 

Granted, it’s not always easy to avoid every trigger. When the air quality index is above 100 — indicating a high level of ozone and other pollutants — people with asthma should limit their time outside. For indoor allergens such as dust mites, dander, and mold, vacuum regularly and follow other precautions. Wear a mask while you clean, and use unscented cleaners. 

People with asthma should work with their physician to create a personal asthma treatment and action plan. With simple lifestyle changes that include avoiding triggers, maintaining a healthy weight, and keeping your mood as stable as possible — in addition to medication, if necessary — you will be taking steps to control your asthma and keep symptoms at bay.

Asthma treatments 

Jun Ma, MD, PhD, a professor of medicine at the University of Illinois Chicago, is currently conducting a study to see if a heart-healthy diet eases asthma symptoms. 

Her research focuses on the DASH diet, which stands for Dietary Approaches to Stop Hypertension. The reduced-sodium diet prioritizes fruits, vegetables, whole grains, reduced-fat dairy, and plant-based sources of fat and protein. With 320 participants, the study is one of the first rigorous clinical trials to examine the efficacy of the DASH diet in adults with uncontrolled asthma.

Ma’s study, which will conclude in 2026, will provide evidence on whether diet can be a key tool for people with asthma. Ma anticipates the study will show how the DASH diet affects breathing and can potentially improve asthma control.

“Because asthma is a chronic inflammatory condition, and DASH has been shown to reduce systemic inflammation and potentially airway inflammation, we’ll be looking at change in inflammation to understand the effect of the DASH diet on asthma,” Ma says. 

Meanwhile, though, we can fall back on standard asthma treatments. It’s a multistep process. First, Ma and Volerman suggest tracking symptoms to see when you’re having them, where you are, and what you’re doing at the time. The log will help your medical team assess the level of asthma control and identify possible triggers.

For many people, though, preventing asthma exacerbations also involves medication. These typically include a controller medication — such as a steroid along with a long-acting bronchodilator inhaler — as well as a rescue or quick-relief inhaler, often albuterol, to use as needed for asthma symptoms or exacerbations. 

“There’s no cure for asthma,” Volerman says. “What we can do is try to minimize triggers and control symptoms to minimize those flares, but you can’t take the asthma away entirely. By minimizing triggers, you can keep the asthma controlled to the point where you’re potentially not needing medicine for it on a regular basis.”

As for my asthma, I’m not sure why it flared up again. Perhaps it was due to renovation work in my apartment building. My doctor prescribed three medications: a Symbicort steroid inhaler as a twice-a-day controller medication, Singulair pills as an evening anti-inflammatory, and a levalbuterol rescue inhaler. 

I’m happy to report that I haven’t had any asthma issues since. While lugging the groceries up the stairs is still a pain, 

I feel better. And now, I can finally breathe easier.


Originally published in the Spring/Summer 2022 print issue