The role of foods in asthma
Asthma Treatment
My interest in foods causing chronic maladies was aroused in 1983. A mother had two sons suffering from asthma. Riding his bicycle in cold weather aggravated the elder son's asthma, and the second son suffered from recurrent abscesses in his ears that required frequent drainage with grommets inserted into the drums. One day the mother brought me a book to read entitled The 5 Day Allergy Relief System by Dr Marshall Mandell, of Norwalk, Connecticut, USA.
I read the book and it made sense to me. I placed the children on an elimination and rotation food programme with good results 'C the abscesses and asthma ceased. I therefore applied the diet to patients suffering from irritable bowel syndrome (spastic colon) and obtained good results. I subsequently investigated other conditions, and again obtained good results. I have presented papers on these various maladies and published articles in medical journals both locally and overseas. The conditions relieved include acne,1 asthma,2 eczema,3 hypertension and coronary artery thrombosis,4 irritable bowel syndrome (spastic colon),5 migraine,6 ulcerative colitis,7,8 Crohn's disease and ulcerative colitis,9 attention deficit syndrome,10 chronic fatigue syndrome,11 rheumatoid arthritis,12 and atopy (the incidence in chronic recurrent maladies).13
Asthma is the most debilitating disease. Besides the cough, tight chest and sniffling, sufferers fear they may be caught one day without their bronchial tubes dilator pump to relieve a sudden spasm that may develop, and land up in the emergency ward of a hospital, as previously experienced.
Asthma and foods in 102 adults
I attempted to conduct trials on asthma and foods at medical school hospitals in Cape Town, Witwatersrand, Pretoria, Bloemfontein and Durban without success. I therefore decided to conduct an asthma trial in private practice. I recruited asthma patients via the media, radio talks, press adverts, adverts on posters, and in the trading block where my practice was situated. Professor J M Loots, previously of the Pretoria University Sports Research Centre, performed the original lung function tests, and if volunteers satisfied conditions to be classified as asthmatic, he randomised them into controls and diet programme according to a statistical table. One hundred and two asthmatics satisfied the conditions of the trial. Half were put on the diet, and the other half remained on their own doctor's treatment.
Professor Loots repeated the lung function tests, weekly in both groups for 6 weeks. The lung function of the diet group improved by 21%, whereas the control group improved by only 1.8%. After 6 weeks, 27 of the control group decided to go on the diet and their lung function improved by a further 20%. The results were excellent, 70% of asthma attacks were due to foods only, 20% due to a food and an inhalant, and 10% due to inhalants only.
Of the 78 patients who were using various inhaled bronchodilator medications only 17 needed such therapy occasionally when they inadvertently ate a processed food containing the trigger. Similarly of the 67 patients using oral or inhaled corticosteroids only 8 needed this therapy after avoiding the trigger foods. Although 4 patients were symptom-free, they were advised by their physicians not to stop this therapy. One patient no longer needed to receive monthly cortisone injections. Nebulizer inhalation therapy used by 10 patients became redundant in all but 2 cases. Patients using fenoterol (5), ipratropium bromide (4) and fenoterol/ipratropium (1) were free of therapy except in 2 cases needing fenoterol for emergencies.
Smoking played a minor role. Of 102 asthmatics more than half (69) had never smoked, (21) had stopped smoking, and only (12) still smoked. In 8 patients passive cigarette smoke triggered wheezing.
The foods involved were:
Plant life products were the most common group of foods triggering asthma symptoms. Apples and pears were the most common fruit followed by bananas, citrus, avocado and melons among 5 other fruits. Among vegetables potato was the most common, followed by tomato, onion and 8 others. Spices only affected 3 cases. Nuts, walnuts, almonds and cashews were triggers in only 5 cases. No peanuts were involved.
Proteins were next in line. Milk products were the most common trigger. Milk itself was most common, followed by cheese, yoghurt and feta cheese. Beef figured more into the equation than other animal or bird protein.
Among grains, bread was the most common trigger, followed by wheat foods such as pasta, cakes and biscuits made with wheat. Maize followed, as well as rice, oats, tasty wheat and guava roll.
Processed foods played less of a role in 14 instances only. Beverages played the smallest role. Wine was the most common trigger followed by beer, fruit juices, coffee, tea, and in one instance only, tomato sauce.
Pollens are accepted to trigger asthma. Pollens grow into plants, trees, leaves and roots that consist of the same chemicals. So why can't pollen products trigger asthma?
Asthma and foods in 60 children
A paediatrician, specialising in lung conditions, randomised 60 children aged 6 months to 12 years into control and diet groups. He kept 30 of the control group on therapy, and referred 30 of the diet group to be placed on the elimination and rotation diet. He assessed the severity of asthma in both groups before and after the trial period. I controlled the diets.
Asthma was relieved in 25 of 30 children in the diet group without the need for any therapy. Four were on reduced therapy needing 50 mcg of cortisone inhalants once daily, instead of 250 mcg twice daily. Only one patient showed no improvement. All 30 children in the control group needed therapy to control their asthma.
After 6 weeks, those in the diet group who had not improved totally were investigated for environmental factors. Inhalants affected 5 of the children as well as foods.
The foods involved were:
Proteins: Milk and milk products (17 instances) and beef (3), were the main triggers, followed by chicken and eggs (1 each). Fruits and vegetables: (9 instances), squash family (2), and apple, banana, paw-paw, potato, tomato, beans and soya (1 each). Grains: Bread and wheat (9), and maize (1). Processed foods: (11 instances), chocolate (3), crisps (2), and Liqui Fruit fruit juice, ice cream, tomato crisps, slush puppies, and take-away chicken and hamburger (1 each). All of these processed foods contain either milk, wheat, fruit or a protein that were among the trigger foods. Only one child's asthma was triggered by preserved foods.
Follow-up: 1 - 2 years. Besides the 4 children on reduced therapy, 4 other children who originally reacted to foods only, needed therapy when they transgressed and ate foods that triggered their symptoms.
Asthma and foods in 12 breastfed infants
The mothers of 12 breastfed infants were placed on an elimination and rotation diet programme to identify whether any foods in the mothers' diet or environmental factors may trigger asthma symptoms (mucus on the chest, cough and/or rib retraction) in their infants. As few modern mothers have the time for breastfeeding, no controls were considered for a crossover investigation.
Eleven of the 12 infants were symptom-free when the mother avoided the triggers. Only one infant showed no improvement. Cow's milk was the trigger in 6 instances, wheat (2), and chocolate, wine, and citrus (1 each). Besides cow's milk an inhalant (the mother's perfume) made one infant's symptoms worse.
Conclusion
The identification and avoidance of foods that provoke asthma will lead to asthma relief in all age groups. A smaller percentage reacted to environmental factors as well. In only 2 adults, 1 child and 1 infant were no triggering factors (food or environmental) established.
The elimination diet
The purpose of the diet is to identify any food you may react to. Foods may be steamed, grilled, baked, or microwaved, but no fried foods are allowed. Only water may be drunk during the first week. Only salt may be added to foods; no spices, herbs, or sauces are allowed. Each day a different grain, fruit, vegetable and protein is allowed. Only one or two food types are eaten at any one meal. A different grain or fruit is eaten for breakfast, and a different fruit each day for lunch. Supper is a different protein and one type of vegetable each day. An unrestricted amount of the food item may be eaten at any meal. Initially the favourite food/s of an individual are omitted.
A record is kept of all symptoms that occur after each meal. Any food associated with particular symptoms that week is replaced with a different food the following week, until the patient is symptom-free. Thereafter each day only one different food or spice is added until the offending food triggering the complaints is identified. Tea, coffee and other beverages are added on different days, after the first week.
References
1. Borok G. Asthma and foods. South African Family Practice Journal 1990; 11: 355-362.
2. Borok G. Acne and foods. South African Family Practice Journal. 1989; 10: 591-592.
3. Borok G. Eczema and foods. SAMJ 2003; 93: 118-120.
4. Borok G, Loots J M, Daehne H O, van Wyk G J, Krogscheepers Z. Coronary artery disease and glucose toxicity 'C the role of refined foods. Cardiovascular Journal of South Africa 1995; 6: 96-101.
5. Borok G, Segal I. The irritated gastro-intestinal syndrome: dietary rehabilitation. South African Family Practice Journal 1991; 12: 520-527.
6. Borok G. Migraine 'C the role of foods. South African Journal of Natural Medicine 2003; 9: 24-26.
7. Borok G. Ulcerative colitis: a patient report 'C a case history, explaining the importance of food. South African Family Practice Journal 1989; 10: 468-474.
8. Candy S, Borok G, Wright J P, Boniface V, Goodman R. The value of an elimination diet in management of patients with ulcerative colitis. SAMJ 1995; 85: 1176-1179.
9. Borok G, Segal I. Inflammatory bowel disease: individualised dietary therapy. South African Family Practice Journal 1995; 18: 393-399.
10. Behaviour and Foods. Brain and Behaviour Society Congress. S A Brain and Behaviour Society Congress. Postgraduate Medical Centre, University of South Africa. 1986: 93-107.
11. Borok G. Chronic fatigue syndrome: an atopic state. Journal of Chronic Fatigue Syndrome of America. 1998; 4: 39-57.
12. Borok G. Rheumatoid arthritis and foods 'C a patient study. South African Family Practice Journal 1989; 10: 523-524.
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