The Asthma Diet

Patients with bronchial asthma can also participate in their care and management by carefully monitoring their diets. Although there is no extensive evidence that ingestion of a certain food product is beneficial in treatment of asthma, there is evidence that sensitive asthmatics should avoid certain foods, preservatives, and dyes.

Patients who have experienced allergic reactions to specific foods must carefully avoid these products. Immediate reactions may include development of hives (urticaria), wheezing, collapse of the circulation, and swelling of the throat (anaphylaxis). Common sources of allergic or asthmatic reactions include shrimp and other shellfish, eggs, milk, soy, and peanuts. Asthma attacks triggered by food allergies are much more Common in children, particularly those with the allergic skin rash known as eczema. In adults these reactions are much less frequent and do not often trigger asthmatic attacks.

It is important to distinguish between a history of a specific allergic reaction that a patient has experienced and a positive allergy test alone. In many instances a positive allergy test (skin or blood) for a particular food may result despite the fact that the patient has ingested the food without reaction. In patients who have severe, unstable asthma it may be helpful to withdraw this food or food group and observe the patient's response. This should not be necessary in patients with less severe asthma that is well controlled.

A recent study has suggested that a diet rich in magnesium may be beneficial to lung function and may actually reduce wheezing and bronchial irritability. Magnesium is found in cereals, nuts, green vegetables, and dairy products. In patients who are not sensitive to these products, a diet rich in magnesium may help.

Sulfites

Sulfites are a common food and beverage preservative that may cause asthmatic attacks in sensitive individuals. These preservatives have been used to make products appear ";fresh"; and reduce spoilage. Salad bars in restaurants were common sources of sulfite exposure until 1986, when the FDA banned the use of sulfites on fruits and vegetables served as ";fresh."; It is believed that the irritant producing the asthmatic reaction is sulfur dioxide gas liberated from salts of sulfite, bisulfite or metabisulfite.

Not all asthmatics are sensitive to sulfites. Sulfite sensitivity may develop at any point in life and is most common in severe asthmatics. As a rule, however, it is best for all asthmatics to avoid sulfites, especially if they have had asthmatic reactions while dining in restaurants (";restaurant asthma";). Patients who are sensitive will have immediate asthmatic reactions. Sulfite reactions may also include stomach pains, hives, and anaphylactic shock. Some of the products containing sulfites that may cause reactions include processed potatoes, baked products, fresh shrimp, fruit drinks, dried fruits, beer, and wine.

Patients with sulfite sensitivity should read labels carefully and choose foods that do not contain sulfites. In 1986, the FDA ruled that sulfites used specifically as preservatives must be listed on the label. This ruling includes beer and wine bottled since that time. Sulfites used in food processing but not serving as preservatives in the final food must be listed on the label if present at levels of 10 parts per million or higher. Currently, there are six sulfiting agents allowed in packaged foods. The names by which they are listed on food labels are sulfur dioxide, sodium sulfite, sodium and potassium bisulfite, and sodium and potassium metabisulfite.

Sulfites have been used as preservatives in medications, too, including some asthma medications. Some nebulizer solutions may contain sulfites. This would explain why some patients may experience bronchospasm instead of bronchodilatation after a nebulizer treatment. For these sulfite sensitive patients, nebulizer solutions that do not contain sulfites are available.

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