green is universal

Green Medicine Solutions to the Children's Asthma Epidemic

Posted at 05:57 PM on April 07, 2008 comments (0)

By Nicholas Gonzalez, MD

A few weeks ago, I shared my general concepts of "Green Medicine" involving three components: the use of dietary, nutritional and natural substances (what I call our "personal green"), living in a clean home and office (our "local green") and working to keep the greater world in which we all must live clean for the health of us all (our "global green"). As Earth Day approaches, I thought I would take a look at asthma - a specific, epidemic and potentially dangerous problem, particularly as the disease occurs in children, the most vulnerable of us all, and walk though my "Green Medicine" approach to this disease.

Asthma 101
First, some basics. Asthma is a major health problem in the US, its incidence increasing yearly and with cases up a whooping 75% since 1980. The American Academy of Allergy, Asthma and Immunology reports the disease afflicts 20 million Americans, and is responsible for nearly one fourth of all emergency room visits. Some nine million children under age 18 suffer from asthma, with some four million of these victims of serious attacks last year. The costs, in terms of missed time from school, are staggering; in 2002 for example, the disease accounted for over 14 million lost school days.

To understand asthma, we need at least a basic primer in lung physiology. To live, we need to breathe, and with each inspiration, fresh air, and with it life sustaining oxygen, travels into the lungs within the bronchi and bronchioles, tube-like structures that reach into the furthest recesses of the lungs, the small alveoli. Here, our red blood cells absorb much needed oxygen and release carbon dioxide, good old CO2, a byproduct of normal metabolism, which we then breathe out of our lungs with expiration.

Now smooth muscle cells line all these air passages along what anatomists call the bronchial tree. These cells, when contracting, can actually reduce the diameter of the bronchi and bronchioles. Such activity can be of benefit, for example when we are exposed to severe pollution, or say smoke from a fire; with reduced air intake, we actually lessen our exposure to potentially dangerous materials.

We also lose considerable water through breathing; just think of a cold day, and the white vapor that follows each expiration. That white smoke is water vapor, exhaled with each breath day and night. If we're dehydrated - during a hike on a hot summer day, for example - we can lose a fair amount of water this way. So it makes sense that our lungs might slow down a bit to reduce the losses, and help keep our fluids in balance until we re-hydrate as needed.

Asthma occurs when our bronchi and bronchioles overreact to irritating exposures in the air, or dehydration, shutting down air flow to the point we find ourselves struggling and fighting for each breath, sometimes, ironically, fighting even for our lives. Scientists recognize a variety of substances that commonly provoke asthma in susceptible people, including pollens in spring and animal dander, as well as a myriad of pollutants. These irritants can lead to an inflammatory reaction in the immune cells lining the bronchi, which in response release histamine and leukotrienes. It's these molecules that then set off the smooth muscle contractions that can, if excessive, lead to asthma.

Asthma's Connection to the Environment
Scientists aren't sure why in so many people the bronchi over-react, but some suspect our constant exposure to increasing amounts of toxic materials in our air must be at least partially to blame. After all, our poor lungs must deal with a constant barrage of noxious materials in the air, literally thousands of different compounds, many of which are irritating to the lungs.

Infection, which creates inflammation, cold air, even exercise can provoke attacks in asthma prone children and adults. Since we tend to lose considerable water vapor via breathing both when it's cold outside, and when we're breathing heavily during exercise, I suspect these situations result when we're just not adequately hydrated, and our lungs desperately try to conserve water - perhaps too desperately.

Standard treatments for asthma include steroids, which reduce inflammation along the bronchi, and bronchodilators, which relax the smooth muscle. In our office, we have some simple approaches to the problem that often help enormously, though I must advise any patient with asthma to follow strictly their doctor's advice, and never change or stop medications without their doctor's approval.

Green Medicine Asthma Solutions
First, as a simple intervention, I always make sure any patient with asthma understands the need to drink plenty of fluids. Considerable debate rages about the amount of water humans need, and a recent study just last week said we should only drink when we feel thirsty. But with asthma, often our thirst centers in the brain seem a little slow to react, so patients end up chronically dehydrated, even though they don't feel thirsty. In my office, we advice anyone with asthma to drink at least 6-8 glasses of water daily.

I have also had a number of patients who improved substantially with the addition of simple apple cider vinegar, two tablespoons in a glass of water 2-3 times daily. Apple cider vinegar contains ample quantities of acetic acid, which we quickly absorb and which quickly acidifies the blood stream. We find that with the blood slightly on the acid side, the inflammatory responses tend to subside, and bronchoconstriction lessens. And though much nutrition advice these days promotes low fat diets, we find many of our asthma patients do better with a fairly regular intake of, yes, red meat. There's a reason, biochemically speaking, why red meat might help. Red meat contains nutrients called phosphates and sulfates that our bodies quickly convert to acid in the blood. Once again, a slightly more acidic blood seems to blunt the exaggerated inflammatory response so typical of asthma.

But, whatever diet an asthmatic chooses to follow, the cleaner the food the better, and that means organic. Fortunately, we live in a time when few doubt that organic food, be it plant or animal, not only provides more nutrients than conventional, but is cleaner. For an asthmatic, I believe organic is the only way to go.

In terms of our local environment, we always encourage our patients to think green. The fewer toxins in the environment, at home, in the office, and at school, the better an asthmatic patient will do. Use non-toxic cleaning agents, and if your house needs painting, use the gentler, greener low VOC paint readily available today. Patients often ask me to recommend air filters, but frankly, we find the best air filter to be plants - but of course, only those that won't lead to an allergic asthmatic response! Scientists now know that plants very efficiently remove pollutants, even the nastiest, from the air around us. One article on healthgoods.com reported that spider plants remove 96% of carbon monoxide, and 99% of nitric oxide, both noxious gases, after only 24 hours. Spider plants, philodendron, and aloe plants are among the most powerful pollution fights around. Plants also give off oxygen, as an added benefit for all of us. In my home and office, we have plants everywhere, and for good reason - not only do they bring a bit of nature to my city life, but they keep the air around me, my wife, and my patients clean.

The cleaner the world, the less pollution and the better it is for all of us, but particularly, the better for asthmatics. Get involved with friends and community groups; help organize a tree planting initiative in your neighborhood. Join national organizations that fight to keep the earth clean. Small efforts can add up, bit by bit, and ultimately have a powerful global effect.

Nicholas Gonzalez, MD
www.dr-gonzalez.com