How To Improve Lung Health: A Guide For Asthmatics

As cold air can induce asthma attacks, it’s important to look at ways that asthma sufferers can boost and maintain lung health during the colder months.

What is asthma?

Asthma is a respiratory condition that affects breathing. It is one of the most common respiratory conditions globally - 262 million people worldwide ^[1] and 5.4 million people in the UK have been diagnosed with the condition ^[2]. It can affect people of any age, but it typically first appears during childhood - however, this is not the case for everyone. There is currently no cure for asthma, but there are a range of treatments and lifestyle changes you can make to manage the symptoms better, reducing the impact they have on your day-to-day life.

How does asthma affect the lungs?

When someone has asthma, their lungs and airways can become slightly swollen. This increases the susceptibility to irritation from allergens, viruses and other foreign particles that could induce asthma flare-ups. It also means airflow is restricted, making breathing difficulties and wheezing more likely.

How does colder weather affect asthma sufferers?

Although its impact can differ from person to person depending on predominant triggers, colder weather can often exacerbate asthma symptoms for several reasons. This is because:

• Cold air dries out the lungs, causing irritation
• Cold and flu viruses thrive in cold air due to their hardened lipid coating
• Mucus production increases, partially restricting the airways
• More people huddle indoors, which means closer proximity to indoor asthma triggers and other people

Aside from using asthma treatments, there are several ways for asthma sufferers to reduce the likelihood of experiencing asthma attacks that are triggered by the cold air:

• Drink plenty of fluids to thin-out mucus
• Get a flu jab as early as possible
• Clean their home and clothes frequently
• Wash their hands regularly
• Wear a mask while outside
• Work with a GP to establish an asthma plan for the winter months
• Use a preventer inhaler

How can you boost your lung health?

A final way for asthma sufferers to better prepare themselves for asthma triggers, as well as reducing the likelihood of experiencing asthma flare-ups generally, is for them to improve their lung health. This can be done in the following ways:

1. Avoiding environmental triggers

Sometimes the air you breathe can contain triggers that induce asthma symptoms. These can be irritants, allergens, pollutants or cold and flu viruses. When exposed to these triggers, your lungs can become irritated, and an immune response can be initiated by your immune system. This leads to the production of histamine or immunoglobulin, which causes swelling in the airways - inducing asthma symptoms like wheezing, difficulty breathing and coughing. When it comes to your own indoor environments such as your home, you have more control over the impact of these triggers, whereas for outside environments, you have less control. Regardless of how much control you have over the air contents for any environment, you can still reduce the impact of triggers by following certain steps. This will then mean your lungs have less chance of being irritated and you’re less likely to experience inflammation and an influx of asthma symptoms.

Indoor environments

Indoor asthma triggers are very common, and can affect people with asthma more in colder months due to spending more time inside, often with other people. The most common indoor triggers include dust, indoor smoke, mould and pet hair. There’s a number of ways you can reduce the impact of indoor triggers, such as regularly cleaning, reducing moisture levels, eliminating indoor smoke and creating pet free zones.

Outside environments

Some indoor triggers can also be found outside, such as smoke, mould and dust. People with asthma also have a higher likelihood of developing hay fever, meaning pollen from trees, weeds and grass are also triggers that could exacerbate asthma symptoms. In addition to this, weather and pollution are other triggers that people with asthma could be affected by. In order to reduce the impact of these outdoor triggers, the following steps should be taken:

• Wearing a mask
• Avoiding people while they’re smoking
• Checking the air quality levels and weather forecast before making plans outside (it may be necessary to move plans to days where the weather is better or the air pollution is lower)

Preventing respiratory infections

Developing a cold or flu virus can worsen asthma symptoms, so it’s important to take steps to reduce the likelihood of catching them. Colds and flu viruses are also spread more easily during colder months, due to more people huddling together in close spaces indoors. As well as this, cold and flu viruses develop more resilient lipid coatings, meaning they can stay in the outside air for longer. When it comes to reducing your chances of developing a cold or flu virus, here are some tips:

• Get the flu vaccine as early as possible
• Wash your hands often and thoroughly
• Stay away from overpopulated areas
• Wear a mask

Make sure that if you have caught a cold or flu virus, you stay home, get lots of rest and use necessary cold and flu treatments.

2. Use inhalers correctly

Inhalers, both prevention and reliever, are effective treatment options for people with asthma. Ventolin reliever inhalers contain the active ingredient salbutamol, which belongs to a group of medications known as bronchodilators. They work to relieve the symptoms of asthma as they are occurring by relaxing the muscles in the lungs and widening the airways to make it easier to breathe.

Although most people with asthma know of inhalers, many people make mistakes whilst using them, which can reduce their effectiveness and impact the inhaler’s ability at sending the medication into the lungs. For more information on using an inhaler effectively, read our expert guide.

3. Exercise

Although it’s possible to experience some asthma symptoms whilst exercising, physical activity is a great way to improve the health of your lungs. A 2011 study found that, when assessing how exercise impacted asthma, asthma patients who followed a 12-week exercise intervention had improved asthma control and quality of life compared to asthma patients who did not take part in the exercise intervention ^[3]. The group of patients who exercised also had significant improvements in aerobic fitness and required less asthma medication than those who did not do the exercise intervention. A 2020 study also looked at the association between exercise and asthma, finding that regular exercise improved asthma control amongst patients, and that exercise ‘should be included as an important part of asthma management in adults’ ^[4].

Whilst exercising, the lungs bring oxygen into the body to provide energy and remove carbon dioxide. The heart also has a role by pumping oxygen the lungs have taken in around the body to the muscles being used during the exercise. Regular physical activity for people with asthma can improve asthma symptoms in the following ways:

• Increased lung capacity
• Strengthened muscles
• Improved cardiovascular fitness
• Reduced inflammation
• Improved endurance

Some of the most recommended physical activities are low-intensity exercises, or those with short bursts of exertion. If you want to know more about which exercises are most beneficial, read our guide on staying active with asthma.

There are several ways someone with asthma can reduce the impact of exercise on their asthma symptoms:

• If the weather is cold or if pollution/allergen levels are high, consider exercising indoors.
• If exercising in the cold, wear a mask over your mouth and nose to warm the air you breathe.
• Carry your reliever inhaler with you, and use it 15 minutes before starting exercise, or whenever your GP has recommended you use it.
• Start exercising slowly - warm up before your main exercise activity and cool down afterwards.
• Avoid exercise if you are unwell.

4. Make dietary changes

Other than eating a balanced, healthy diet, it’s also recommended that asthma sufferers avoid certain groups of foods that can induce asthma symptoms.

Inflammatory foods

This group of foods are often present in traditional Western diets and can impact people with asthma in more than one way. Some examples of these foods include:

• Red and processed meats
• Carbonated and sweetened drinks
• Fried foods
• Refined carbohydrates (white bread, white rice and pasta, breakfast cereals)
• Snack foods, high in sugar and salt content
• Alcohol

Many of these foods are high in sugars, saturated fats and trans fats, as well as being processed. The inflammation from these foods is caused by the body activating an immune response once you have consumed them. Inflammatory cells and cytokines (the proteins released by cells that stimulate more inflammatory cells) cause swelling and bruising. For the lungs, this means restricted airways which can initiate asthma symptoms.

Consuming these foods on a regular basis, especially if you are not burning the calories off through physical exercise, can lead to weight gain. This can worsen your asthma symptoms, as extra weight around the chest can compress the lungs, making it more difficult to breathe. In addition, tissues of fat induce inflammation which can affect the lungs by restricting airflow.

Sulphites

Another group of foods that are not recommended for people with asthma are those which contain sulphites. Sulphites is an umbrella term for the following 6 substances:

• Sulphur dioxide
• Sodium sulfite
• Sodium bisulfite
• Sodium metabisulfite
• Potassium bisulfite
• Potassium metabisulfite

Sulphites are chemicals that are used as preservatives to slow the growth of bacteria and mould, as well as stopping discolouration in fruits, vegetables and seafood. Studies show that sulphite sensitivity affects up to 13% of people with asthma, causing symptoms like trouble breathing, wheezing, dizziness and nausea ^[5]. Sulphites occur naturally in some foods such as; asparagus; lettuce; tomatoes; eggs and salmon.

They can also be added to certain foods and drinks, including:

• Peeled potatoes
• Wine and beer
• Fruit juices
• Pickled foods
• Shrimp and shellfish

When it comes to avoiding sulphites, there are a few things that people with asthma can do, including:

• Always check food packaging labels for any of the sulphites listed above.
• Be wary of the foods listed above, both containing sulphites naturally and as an additive.
• When eating out, ask the server if any of the food ordered contains sulphites.
• Check with your GP if your asthma medication contains sulphites.
• Prepare yourself with an action plan in case you accidentally consume sulphites.

5. Stop smoking / stay away from smoke

It has been well established that smoking is harmful to your health and increases your risk of developing several serious health conditions. For asthma sufferers, there’s an increased risk of damage to lung health - not just through smoking but also through being exposed to second-hand smoke. This is because people with asthma have airways that are more sensitive to irritants and allergens, such as smoke.

Tobacco smoke irritates the airways and inflames the lungs. This can induce asthma symptoms and attacks, as well as making the condition harder to control and the lungs more susceptible to colds and flu viruses. In addition to this, if an asthma sufferer smokes, tobacco can reduce the impact of asthma treatments.

If you are able, it is best to stop smoking and stay clear of tobacco smoke, as well as indoor spaces where people may be smoking.