Posts Tagged ‘sulphur’

Diet to Protect against Asthma
There is growing evidence that several aspects of the modern Western diet make asthma more likely to develop. Parts of this evidence are very convincing, while other findings are less conclusive as yet. Some people might argue that, until all the facts about diet and asthma are firmly established, no dietary changes should be recommended. However, all the dietary changes that might protect against asthma are also very valuable for general health.
This diet is potentially useful for:
0Atopic families who wish to reduce the chance of their chil- dren developing asthma. Other preventive measures, such as allergen avoidance and exercise (see Chapter 8), are obviously important as well.
•    Anyone who already suffers from asthma – with this diet, their symptoms may diminish.
The main elements of the anti-asthma diet are:
•    A high intake of fresh fruit. Researchers in Britain and the Netherlands have shown that people who eat more fruit have better lung function, and are less likely to develop asthma or bronchitis. Apples have a particularly good effect on the airways, according to one recent study. Many other studies show a link between Vitamin C – the major vitamin in fruit – and asthma prevention. This makes sense because Vitamin C is an antioxidant which inactivates the pro-inflammatory substances (called oxidants) that are found in cigarette smoke and other polluted air. In addition to Vitamin C, many fruits contain beta-carotene (see below) – mangoes and apricots are the richest sources.
•    Regular helpings of carrots, which contain the orange pigment beta-carotene. This is another antioxidant that can help prevent inflammation in the airways. It should be obtained from food, not supplements (see p. 207).
•    A high intake of fresh green vegetables, especially broccoli, spring greens, dark green cabbage, peas, parsley and courgettes. One Australian study has shown that children who eat fewer vegetables are more likely to wheeze. The benefits of vegetables may be partly due to the fact that they contain beta-carotene and (if eaten raw or only lightly cooked) Vitamin C. Dark green vegetables are also a good source of magnesium, and researchers find that people with a higher magnesium intake have healthier airways. Magnesium is believed to protect against asthma by helping the muscles of the airways to relax.
•    Plenty of tomatoes and tomato products, such as tomato juice, tomato sauce, ketchup and paste. The special protective effect of tomatoes is not entirely explained by their Vitamin C or beta-carotene content – another antioxidant, called lycopene, may be the crucial ingredient here. Good news for fast-food fans – the benefits of tomato paste are even seen among pizza eaters who are significantly less vulnerable to asthma.
•    Daily intake of sunflower seeds, or sunflower oil and margarine. These are by far the best natural source of Vitamin E, another antioxidant (see left) which helps to reduce the risk of becoming asthmatic. Vitamin E taken in supplements seems to have much less beneficial effect than natural Vitamin E from food.
•    A good intake of the minerals zinc, manganese and selenium, as well as magnesium (see p. 206). Shortage of any of these minerals may be linked with asthma. It is important not to eat too much wheat bran or unyeasted wholemeal bread, especially with main meals, as these block the absorption of several minerals.
Good sources of zinc include meat, shrimps, clams and oysters, with smaller amounts in cheese and egg yolks. Nuts, lentils and beans are fairly good sources of zinc, while soya protein blocks its absorption.
As well as being found in dark green vegetables, magnesium is plentiful in sardines, peanuts, hazelnuts, walnuts and lentils. Other fish, lean meat, milk, cheese and bananas contain smaller amounts.
Manganese is found in eggs and milk, and though the amounts are small, these are good sources because the mineral in them can be absorbed easily. While green leafy vegetables, whole grains and tea apparently contain more manganese – and are frequently recommended as a source of this mineral – in fact very little can be absorbed from those foods. Lentils are a moderately good source of manganese.
Selenium is most plentiful in fish and meat. It may be scarce in home-grown plant foods in areas of the world (notably Finland and parts of New Zealand) where selenium is lacking in the soil.
•    A limited intake of meat, especially red meat, plus a com-
-    plete avoidance of kidney, liver and other offal meats. An entirely vegetarian diet incurs a risk of mineral deficiencies however (see above). On balance, it is probably best to eat meat once a week or less.
•    A low intake of salt. Researchers in Kenya found that children eating a high salt diet (which equals the average salt intake in Britain and other parts of the developed world) were at greater risk of becoming asthmatic. For existing asthmatics, increasing the amount of salt eaten can make asthma worse, while reducing salt can lessen symptoms. Male asthmatics seem to be more vulnerable than females. Salt probably affects the muscles of the airways, making them more likely to contract.
The role of supplements
You should try to get all the nutrients you need from food rather than supplements. However, there are times when a supplement can be useful. Any asthmatic who has to cope with the effects of high air pollution, especially ozone and sulphur dioxide (see pp. 130-31), may find a supplement of Vitamin C beneficial. However, you should avoid very high doses of Vitamin C (e.g. I g/day) as they can cause disturbed sleep. Use natural sources for Vitamin E (see p. 206) if you can, but taking a supplement is better than nothing.
Vegans should think about taking a multi-mineral supplement, given the difficulties of ensuring an adequate intake of zinc, manganese and selenium from vegetable food (see left). Vegetarians may also benefit from a mineral supplement.
Some supplements, in certain circumstances, can do more harm than good. Omega-3 oils (also called w-3 oils, concentrated fish oils, or EPA and DHA) may make asthma worse for some people (see box on p. 221). Beta-carotene (sold alone and as part of mixed antioxidant supplements) may, according to some studies, promote cancer at the high doses used in many supplements. It should only be obtained from food.
Foods and drinks that bring on asthma attacks
The anti-asthma diet tackles the inflammation of the airways and the underlying tendency of the airway muscles to go into spasm – in other words, it is concerned with the long-term treatment or prevention of asthma. In addition, you should obviously avoid any foods which aggravate asthma in the short term. Various foods and drinks can bring on an asthma attack:
•    Foods and drinks containing sulphur-based preservatives tend to give off the irritant gas sulphur dioxide while being chewed or swallowed. Some asthmatics are more sensitive to sulphur dioxide than others. The foods that most commonly cause problems are dried apricots and other dried fruit (except those labelled ‘unsulphured’), shellfish, french fries, ready-made salads and fruit salads. Sulphur-based preservatives are used widely in the catering industry. On packaged food, look for ’sulphite’ and’metabisulphil or E numbers 220-227. Soft drinks, wine, beer and cider almost always contain sulphur-based preservatives.
•    Foods that cause heartburn (GER – see p.38) can aggravate asthma for some people.
•    Alcoholic drinks may make the airways contract for some asthmatics (see box on p. 160).
•    Some asthmatics need to avoid foods containing histamine (see box on p. 67).
•    A few asthmatics respond badly to the smell of food cooking. The most severely affected can suffer an asthma attack from anyfood aroma. Cromog lycate -type drugs (see p. 148) or anti -choli nerg ics (see p. 156) may block this reaction.
Needless to say, if you have a sensitivity reaction to any food listed for the anti-asthma diet you should not eat this food.

Air Pollution and Allergy

Air pollution plays a variety of roles in allergic reactions. Some pollutants irritate the nose and airways (and sometimes the skin) making them more sensitive to allergens. These pollutants can worsen existing allergic symptoms and may promote the development of allergies in children, by making the airway membranes more permeable. Other chemical pollutants may affect the immune system directly, increasing any existing tendency to allergic reactions.
Indoor pollution
For many of us, the air in our houses is much more polluted than any outdoor air. Several of the indoor pollutants irritate the nose and airways, and some can trigger asthma attacks. A few of the pollutants found indoors can also make allergies and asthma more likely to develop in young children.
Background pollution
One of the worst irritants in indoor air is tobacco smoke. Other people’s cigarette or pipe smoke can trigger asthma attacks in the short term, and makes asthmatics generally worse in the long run. Passive smoking might also affect the immune system making allergies more likely to develop, though this is not proven. Do whatever you can to eliminate tobacco smoke from your home.
Everyone is different
This article considers air pollution from the point of view of someone with classical allergies (e.g. hayfever or asthma). Those with chemical intolerance (see p. 84) may well be more severely affected by air pollution.
If you smoke yourself, there are many good reasons for giving up:
• If individuals from atopic families (see p. smoke, they have a far greater chance of developing allergies and/or asthma when exposed to an allergen in the air.
• For those who had asthma as children and have since grown out of it, cigarette smoking doubles the chance of it coming back.
• Parents of asthmatic children who smoke indoors make their children’s asthma worse. Teenagers can be just as badly affected by passive smoking as young children.
• Smoking during pregnancy significantly increases the risk of a woman’s baby developing allergies and asthma. (Smoking also leads to more prematurity, still-births and cot deaths.)
If possible, have an electric cooking stove rather than a gas one –or fit a powerful extractor fan. Cooking with a gas stove generates a lot of nitrogen dioxide, a gas that you can’t smell or see but which affects the airways. This same gas also comes from motor traffic, but peak levels of nitrogen dioxide in kitchens with gas cookers are often ten times the average level on city streets, and frequently exceed standards for outdoor air set by the world Health Organisation. Other sources of nitrogen dioxide include cigarettes, gas fires and kerosene-burning stoves.
For some people with allergies, nitrogen dioxide enhances their response to the allergen. So if you inhale dust-mite allergen together with nitrogen dioxide, it may have more effect than the Smoke screen
Smoke particles from coal or wood do not seem to make allergies more likely to develop - in fact, quite the reverse. In rural areas of Germany, researchers have found that children with coal or wood stoves in their homes were less likely to have allergies or asthma. An Australian study made a similar finding. Bronchitis and pneumonia are more common in those children with wood and coal stoves and these infections may stimulate the immune system in such a way that allergies are less likely to develop later. However, wood smoke may be a cause when asthma begins in an adult.
allergen alone. Breathing sulphur dioxide (see below) and nitrogen dioxide together boosts the reaction to allergen more powerfully than either gas alone.
Nitrogen dioxide might also make asthma attacks more likely, but the evidence on this is conflicting.
For young children, a high level of nitrogen dioxide at home may make the development of allergic reactions more likely. A recent Canadian study showed that children exposed to high levels of nitrogen dioxide in the home - usually from gas cookers - were ten times as likely to develop asthma as those breathing low levels of nitrogen dioxide. If a dog, cat or other furry pet was kept, and there were high nitrogen dioxide levels, the risk of developing asthma shot up even higher, to 25 times that of children with low nitrogen dioxide and no pets. (Other studies have not produced the same spectacular results, but their methods of measuring nitrogen dioxide exposure were less precise.)
Try to eliminate materials that produce formaldehyde fumes, or seal the items with a good coat of paint. Formaldehyde is given off by chipboard and to a lesser extent by MDF (medium-density fibreboard). Injected cavity wall insulation can also produce persistent formaldehyde fumes, and is very difficult to get rid of -moving out is often the only option. A recent study from Australia showed that children exposed to formaldehyde, especially in the bedroom, were more likely to develop allergic reactions: the higher the level of formaldehyde exposure, the more severe the child’s allergic sensitisation.
Those with asthma have more frequent symptoms if exposed to high formaldehyde levels. A recent study from Finland shows that easy-to-clean plastic wall-covering and flooring increases the risk of asthma in children.
A Canadian study found that children whose first home was less than 20-30 years old were 50% more likely to develop asthma than children living in older houses. One possible explanation for this lies with the materials used in the construction and fitting of new houses, especially the plastics, wood preservatives and insulation materials. Solvents, and chemicals such as formaldehyde, are still being given off by these materials some years later.
Air fresheners provoke asthma attacks in some people. For a few individuals they can cause general symptoms of ill-health that are similar to those described for mild chemical intolerance (see p. 84). Those affected generally don’t realise that the air freshener is the source of the trouble. This malign effect is not entirely surprising, since air fresheners work by giving off a chemical that targets part of the brain - the part involved in processing sensory input from your nose. The chemical ‘freshens the air’ by partially disabling your sense of smell. Better to open a window.
Cleaning products, furniture polish and deodorant were never intended to go into the nose and airways, but that’s what happens when they are sprayed from an aerosol, and they can trigger asthma attacks. Steer clear of aerosols as much as possible - there are usually alternatives.
Pollution peaks
Read the instructions and ingredients lists on all products carefully. It is not just a question of what’s in them, but also what gases they might give off when used. One asthmatic died within minutes when the de-rusting agent she was using on her dishwasher produced a large amount of sulphur dioxide gas: her airways tightened up so much that she couldn’t even use an inhaler to save herself. ‘Sulphuric’, ’sulphate’ or ’sulphite’ in the list of ingredients should ring warning bells if you have asthma: sulphur dioxide gas could be given off by this product.
Bleach, and other chlorine-based cleaning products, such as toilet cleaner and scouring powder, should be used sparingly, and with plenty of ventilation. These products release chlorine gas which, in large amounts, can irritate the airways of asthmatics. Never allow bleach or toilet cleaner to become mixed with any other product. Take care with any product containing hypechlorte, chloramine, ammonia, acids or morpholine and with the chemicals used for swimming pool water. All these can trigger asthma attacks.
If doing repairs or DIY work about the house, take special care. Always ventilate the work area well, and wear a dust mask if sawing or drilling.
The smell of paint is due to solvents, and these can act as irritants to the nose and airways. When decorating, ventilate well, and use low-odour water-based paint. Some of the best low-odour paints, tested and shown to be safe for paint-sensitive asthmatics, are only available by mall order: see p. 255.
‘Instant foam’ kits sold for DIY insulation can provoke asthma in those who were not asthmatic previously. Two different substances are mixed to create the polyurethane foam, and during the mixing process, isocyanate is released – this is one of the most powerful asthmagens known (see box on p. 132). The level of isocyanate can breach the safety limit set for factories.
Avoid using fly spray or other insecticides: look for other methods of pest control. A study from Ethiopia showed that people using an insecticide in their houses were twice as likely to develop allergies. A study of Canadian farmers suggested that asthma might be linked to the use of carbamate insecticides (e.g. carbofuran). The sprays used for cockroaches can act as irritants for those with allergic rhinitis or chronic sinusitis.
If advised that your house needs spraying with insecticide, for woodworm or other wood-boring pests, ask for more information before you go ahead. Is the spraying really necessary? What will happen if the house isn’t sprayed? How quickly will it happen? Is there any other method of eradicating the pest? Spraying is often done when it is not really essential – houses remain standing even with woodworm holes all over them. Unless you have a heavy infestation that is threatening the structure of the house, you are probably better off not having the house sprayed. The heavy and ongoing exposure to insecticide that spraying of a house involves is something you and your family should avoid if at all possible. All the sprays used are toxic to some extent – don’t believe those who tell you otherwise. A heavy exposure to pesticides can sometimes make allergic symptoms worse or precipitate chemical intolerance (see p. 85).
The garage, workshop or garden shed can also be very polluted. Petrol, kerosene and paraffin can affect some people with rhinitis or asthma, and can bring on their symptoms. These fuels should always be kept in airtight containers. Paints sold for cars often contain isocyanates, among the most common causes
of work-related asthma (see box on p. 132). If using such paint, wear a mask with an activated carbon filter and make sure the area is well ventilated. Avoid prolonged or repeated exposure.
Outdoor pollution
Some of the pollutants in outdoor air can make allergic reactions worse and can trigger asthma attacks in people who are already asthmatic. A study of hospital admissions in London, Paris. Barcelona and Helsinki found that high levels of pollution increased hospital admissions for asthma by about 3%.
The pollutants that matter to those with allergies are:
• ozone, which soars to high levels on sunny days, mainly in country areas that are near large cities. The reason for this is a chemical reaction which occurs when car exhaust fumes are exposed to sunlight, producing ozone, a highly reactive form of oxygen. Further chemical reactions, involving another ingredient of exhaust fumes, then break the ozone down again. Thanks to this second reaction, there is usually little ozone in city air. But in a relatively rural area 20 miles or so upwind of the city, the pollutants are too dispersed for the second reaction to occur, and the ozone from the urban traffic can accumulate.
Ozone levels in the air tend to peak in the late afternoon and early evening – but it takes 4-24 hours for ozone to produce its effects on the airways. Indoors, ozone breaks down very quickly because of contact with other gases inside the house.
Ozone can increase the effects of allergens, such as pollen, on the nose and airways.
In addition, ozone makes the airway muscles contract, even for people without asthma. Healthy people tend not to notice these effects, whereas some asthmatics may have more symptoms, and may need more drugs, on days when ozone levels are unusually high.
• diesel particulates, which can become a problem in town centres, and close to main roads used by vans and lorries. Unlike ordinary petrol, diesel fuel contains oil, so when it burns it produces tiny black particles. These consist of flakes of carbon (soot), coated with complex chemicals that are produced by the
But what about the ozone layer…?
Is ozone good for us or bad for us? People often get confused about this, because of all the discussion about
‘the destruction of the ozone layer’. But that ozone layer (which screens us from harmful ultraviolet light) is a natural phenomenon and it is thousands of feet up, well away from our lungs. At ground level, in the air we breathe, ozone is unnatural and potentially damaging .
The size of the particles
Diesel particles are 1-10 microns in size, with most smaller than 2.5 microns. Tobacco smoke, coal smoke, fumes from oil-burning boilers, and the smoke from frying food all contain very much smaller particles, down to a hundredth of a micron (.01 microns) in size. (A micron is a thousandth of a millimetre.)
In pollution reports, counts for particles in the air (mostly diesel particles these days, except in heavily industrialised areas) will often appear as ‘PM1 0′, meaning ‘Particulate Matter less than 10 microns in diameter’. This particle size is chosen because larger particles tend to settle in the nose and throat, and not reach the airways of the lungs. The term ‘Small Particles’ is sometimes used to mean PM10.
To deal with air pollution, you need a really good mask with two filters: a dust filter that can take out very small particles and an activated carbon filter that absorbs irritant fumes and gases. Note that while activated carbon filters remove most pollutants, they do not take out nitrogen dioxide unless they have been specially treated.
partial combustion of the oil. It is probably these surface chemicals, rather than the soot particles themselves, that have such bad effects on the nose and airways.
Some research suggests that diesel particulates might increase the risk of allergies developing – to pollen for example. Additionally, when levels of diesel particulates are high, asthmatics tend to have more symptoms. If levels rise above 50 micrograms per cubic metre there is a sharp increase in asthma attacks – and a recent study in Birmingham showed that such levels are regularly reached at roadsides.
• sulphur dioxide, which often reaches high levels in areas of heavy industry, particularly near coal-fired power stations and coking plants. It acts as an irritant to the airways and can trigger attacks in asthmatics, who are far more sensitive to sulphur dioxide than healthy people (see box on p. 207). However, at the sort of concentrations normally encountered, even in quite polluted air, sulphur dioxide does not have any effect on most asthmatics.
• nitrogen dioxide, which is produced by all types of vehicles, and by power stations and some factories. In towns and cities with heavy traffic, nitrogen dioxide can build up to high levels. This gas is also found indoors (see p, 128) – often at far higher levels.
Oil refineries and cement works
In addition to these widespread pollutants, there are localised areas of air pollution, around industrial sites, that are frequently accused of causing health problems, including high rates of asthma. The kinds of industrial sites regularly mentioned include:
• oil refineries and oil-burning power stations
• cement works that use waste solvents for fuel
• dock areas where oil is loaded into tankers.
None of these accusations has been investigated in any detail, so it is impossible to say if there is a real link with asthma.
Avoiding outdoor air pollution
If you live in the kind of area that experiences high levels of ozone (see p. 130), plan your outdoor activities, especially jogging or playing sport, to avoid summer afternoons and early evenings.
Those who live very close to a main road, with a lot of lorries going past, would probably improve their own health, and reduce the chance of their children developing allergies and asthma, by fitting air conditioning or high-quality HEPA air filters – or by moving house. However, the benefits, in terms of decreased risk, are not enormous, and it is important to take other preventive measures as well (see Chapter 8).
When driving, if you stop behind a lorry or bus, keep your distance, close the window and turn off the fan. Diesel vehicles often emit a thick cloud of particles as they set off, and this can come straight into your car, setting off severe attacks for some asthmatics.
A car with air conditioning will reduce your exposure to diesel particulates while driving. When buying a new car, you can make a contribution to air quality by choosing a non-diesel vehicle, preferably one with a catalytic converter fitted. Alternatively, buy a diesel vehicle with a particle filter on the exhaust (now fitted as standard in Germany).
In Britain, the Vehicles Inspectorate of the Department of Transport encourages the public to report lorries and buses seen pumping out black smoke (look in the phone book for the number).
If you are asthmatic, breathing through your nose may help as this can filter out some damaging pollutants before they reach the airways in your lungs. (If your nose is usually blocked, try the exercises on pp. 230-31).
When levels of ozone or sulphur dioxide are high, taking a supplement of Vitamin C and eating plenty of foods that contain Vitamin E and beta-carotene (see p. 207) can protect your airways.