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June/July 2009 Issue
Asthma and Food Allergies
Discovering the link between asthma and food allergies.
When Donna O’Mara watches her 16-year-old daughter, Keri, compete in high school track meets, she gets nervous. She wants her daughter to do well but that’s not what creates the anxiety. Keri has asthma and O’Mara is concerned that the strenuous activity might prompt breathing problems. When Keri finishes her events without incident, as she normally does these days, O’Mara’s anxiety melts into gratitude.
“Ten years ago, Keri’s asthma was so bad that we weren’t even sure she would live to be 16, let alone be a competitive runner,” says O’Mara of Nassau, New York.
Born six weeks prematurely, Keri weighed only 4 pounds, 13 ounces and had health problems from the start. Although her breathing was fine as an infant, Keri did not tolerate formula. “She cried a lot from gas pains,” her mother says. Keri continued having stomachaches into her toddler years. When she was three and attending nursery school, she would get sick regularly.
“She caught a cold once a month and it would immediately turn into a bronchial infection,” O’Mara says. During these periods, Keri couldn’t move without coughing and would wheeze constantly.
“It sounded like there was a zipper going up and down in her chest,” O’Mara recalls. “If she exerted any energy at all, she would cough.” And not just a little bit. Keri’s coughing was so violent that “the blood vessels in her eyes would burst and she would vomit.”
Keri’s pediatrician tested for cystic fibrosis, a lung disease, but eventually diagnosed her with asthma. He tried every treatment in his arsenal. “Keri was living on antibiotics, steroids, inhalers and nebulizer treatments,” O’Mara says. But none of them prevented the little girl from contracting full-blown pneumonia twice when she was six years old. The second time, Keri was hospitalized in critical condition.
“She was really sick with a fever of 105 degrees. Her lungs were so weak from the first pneumonia, it felt like she was at death’s door,” O’Mara says.
At this point, O’Mara says their pediatrician confessed he didn’t know what else to do. But he didn’t just send them away. “He said there was a doctor he had heard about who was getting great results with kids with asthma.”
That doctor was Kenneth Bock, M.D., a physician who practices integrative medicine in Rhinebeck, New York. At their first visit, “he just knew what to do,” O’Mara says. Bock did some blood tests and determined that Keri was allergic to gluten and dairy. He recommended that O’Mara remove these foods from Keri’s diet. As soon as they did, O’Mara says, “We saw immediate improvement.”
In addition to asthma and chronic stomachaches, Keri also had pale skin, purple circles under her eyes and red dots on her tongue. Miraculously, after just a few weeks on the new diet, all of that went away.
Asthma and Food Allergy
Asthma is a serious, potentially life-threatening respiratory disease characterized by inflammation of the airway and lungs. Symptoms include coughing, wheezing, shortness of breath and chest tightness.
According to the Environmental Protection Agency (EPA), approximately 23 million people in the United States have asthma. That number includes 6.8 million children, an average of one out of every ten school-aged kids. Asthma is the most common serious chronic disease of childhood, the third-ranking cause of hospitalization among children under the age of 15. It is responsible for 4,000 deaths every year.
There are two broad categories of this disease—allergic asthma and non-allergic asthma. Symptoms are the same for both. With allergic asthma, allergens like animal dander, dust mites, cockroaches, mold, pollen, smoke—and certain foods, as in Keri O’Mara’s case—can trigger an attack. Non-allergic asthma is prompted by things like anxiety, stress, exercise, cold air, dry air, hyperventilation, viruses and other irritants.
Certain factors increase the likelihood of getting asthma. Having allergies is one of the most significant risk factors.
Another factor is gender. Boys are more likely than girls to get the disease but this is only true in childhood. No one knows for certain why boys are more susceptible but some experts attribute it to the fact that boys generally having smaller airways, which can increase the risk of wheezing after an infection. At age 20, men and women get asthma at the same rate. At 40, more women than men have asthma.
Family history is another risk factor. People with an asthmatic parent are three to six times more likely to develop the condition, according to the Centers for Disease Control (CDC). Other factors are airway hyper-reactivity and atopy, a type of allergic reaction. Studies indicate that 40 to 50 percent of children with eczema, also known as atopic dermatitis, develop asthma. Premature birth is yet another risk factor, which may partially explain the origins of Keri O’Mara’s asthma.
A Growing Problem
The incidence of asthma has increased more than 200 percent in the last 25 years. During that time, there have been similar spikes in three other childhood conditions—autism, ADHD and allergies, says Bock, author of Healing the New Childhood Epidemics: Autism, ADHD, Asthma, and Allergies.
A coincidence? Not likely, Bock contends. All four conditions stem from the same cause: an immune system gone haywire. “The immune system is the root source of most asthma simply because it is the root source of allergy: The immune system creates all allergies; allergies create most asthma,” he writes.
Indeed. About 75 to 85 percent of people with asthma are allergic to one or more substances, according to the American College of Allergy, Asthma and Immunology. With asthmatic children, Bock says, the percentage climbs to 90 percent. And it includes allergies to food.
Bock was alert to the link between food allergies and asthma when he first saw Keri O’Mara ten years ago. A new study published in February 2009 in Clinical & Experimental Allergy confirms his clinical experience. Conducted at Children’s Memorial Hospital and Research Center in Chicago, Illinois, the study shows that food allergy is associated with an increased risk of asthma in children. It also shows that food-allergic kids develop asthma earlier than children without food allergy and that kids with multiple allergies or severe food allergies are at even higher risk of the disease.
Researchers in this study determined food-allergy status based on traditional testing that reveals immediate allergies. Symptoms of an immediate allergy occur within two hours of exposure, primarily affect the skin, airway and digestive tract, and involve IgE antibodies. But delayed food allergy, in which symptoms can occur anywhere from several hours to several weeks later, can also put a person at risk for asthma.
What are the common food triggers for asthma?
“From a clinical perspective, the foods most involved in asthma are milk and wheat,” Bock says. “That certainly was the case for Keri O’Mara.”
Other Causes of Inflammation
Not all cases of asthma are as severe as Keri’s. Symptoms can range from mild to severe and can present in different ways, Bock says. “Sometimes patients have shortness of breath or chest tightness or, in the case of cough-variant asthma, they have just a cough.”
One thing that all types of asthma have in common is chronic inflammation. What causes it? In addition to allergies, inflammation can be triggered by chronic bacterial and/or viral infections, heavy metal overload or a hyper-permeable intestinal lining. More often, a combination of these is the problem, Bock says. He tests for bacterial and viral infections and prescribes antibiotics and anti-virals, as needed.
He also tests for heavy metal contamination. Some people possess a genetic vulnerability that renders them unable to process the onslaught of modern-day toxins, he says. As a result, metals can build up in the body and cause inflammation. In particular, exposure to mercury and lead can throw off the immune system, skewing it toward chronic inflammation, allergies and asthma.
“People with asthma may not have the classic heavy metal toxicity as determined by blood levels the Centers for Disease Control deems harmful, but they may be lead or mercury burdened. Lower levels can still affect function,” Bock says. He cites research showing that even low levels of lead, below the current federal standard of 10 mcg/dL, can be harmful to the developing brains and nervous systems of fetuses and young children.
Although Bock heavily favors a natural approach to treating asthma, “I do whatever I think the patient needs,” he says, including prescribing appropriate medication. Addressing the underlying inflammation, his treatment program has five primary elements. The first is to decrease environmental exposures to allergens, heavy metals, toxic chemicals, bacteria and viruses in the body that lead to chronic inflammation.
Second is to assess for food allergies and alter the diet accordingly.
Third is nutritional supplementation. Bock says many asthma patients are deficient in certain vitamins, such as A, D and B6, and lack minerals, particularly magnesium, zinc, selenium and chromium. He also supplements with amino acids and essential fatty acids and says that probiotics can be extremely helpful in restoring the immune system to its proper balance.
Detoxification is the fourth element and medication is the final component.
In Keri’s case, Bock first addressed her food allergies and modified her diet. He then prescribed supplements that would improve her overall nutrition, build up her immune system and heal her gut.
A Better Future
That was ten years ago. These days, Keri sees Bock once a year. She continues on a gluten-free, dairy-free diet and takes many of the supplements Bock originally prescribed.
O’Mara says Keri has not always happily complied with her special dietary regimen. “It’s been a struggle sometimes,” she admits—but one that has been well worth it, given her daughter’s restored health.
Keri needs an inhaler only about once every year or two. If she gets bronchitis, which has happened a few times, “she just gets over it like anybody else.” Whenever the teen eats things she shouldn’t, “she feels it,” O’Mara says. “She develops circles under her eyes, gets pale, coughs and is lethargic.”
Sometimes when Keri runs her track events, her chest tightens up a bit after the race. But for the most part, the severe symptoms that once threatened her life are well managed and under control, diminished to a nuisance.
“The fact that Keri would be strong and healthy enough to run races is something I could never have imagined ten years ago,” O’Mara says. “Dr. Bock really, truly changed our lives.” LW