Holistic Approaches to Asthma Treatment
Lawrence B. Palevsky, MD, FAAP, DABHM
Asthma is a common word in many households. A growing number of children live on
beta-2 agonists, steroids and anti-leukotriene medications that treat the acute and chronic
symptoms of asthma. These medications have helped save many lives. However, these
medicines, unfortunately, do not cure the asthmatic condition. They merely serve to quiet
the visible expression of symptoms.
Medicines do not influence the factors that generate the imbalances in the body causing the
onset of wheezing. The imbalances that trigger the symptoms of asthma persist despite the
use of medication and the relief of symptoms. These imbalances arise mostly from
problems within the child’s immune system. The key to treatment lies in the evaluation of
the underlying factors that contribute to the development and expression of asthma
symptoms. The goal is to assess the imbalances and address their causes.
Asthma is defined as a reversible, chronic, obstructive, airway disease. On clinical exam, a
child with asthma is found to be wheezing and coughing. Often there is difficulty
breathing, labored breathing, poor air movement, shortness of breath and irritability.
Occasionally, a child may be pale or have blue lips. In the worst case scenario there is
somnolence or coma. However, the lungs are rarely involved. Rather, the smooth muscles
of the affected airways are in spasm and there is swelling and inflammation of the lining of
the airways.
An important segment of our immune system is found in the lining of the airways. And
significant portions of the immune system are found in the linings of the digestive tract, the
skin and the nervous system, including the brain. The body obtains its major protection
against the outside world from the proper functioning of these four areas of the immune
system. All parts of the immune system are in constant communication with each other.
An acute asthma episode is triggered by a challenge to the immune system at one, several or
all four of these areas of the body.
In a healthy child, when the immune system is stressed, chemicals are released that produce
inflammation. These chemicals are made by immune cells that migrate to the site(s) where
the body is challenged. Redness, heat or fever, swelling, tenderness and loss of function
are the five signs and symptoms of inflammation that are clinically present, either singularly
or in combination. By the end of the inflammatory process another group of immune cells
begins to produce chemicals that have anti-inflammatory properties. These antiinflammatory
chemicals aid in quieting the area of inflammation. As a result, the symptoms
of inflammation begin to resolve. The body, in the ideal situation, is genetically
programmed to heal itself.
The resolution of symptoms during an inflammatory response is dependent on the delicate
balance between the production and activation of pro-inflammatory and anti-inflammatory
immune chemicals. An acute episode of asthma occurs when this delicate balance is tested.
Thus, asthma is a condition of acute and chronic inflammation. The goal of treatment is to
evaluate any one of a number of contributing factors in a child’s environment that can
produce a state of inflammation. Perfumes, smoke, pollen, volatile chemicals, exhaust
fumes, pollution, animal dander, metals, dust and mold are some of the inhalants that can
adversely affect the immune response in the linings of the airways and trigger an episode of
wheezing. Dairy, soy, nuts, sugars, dehydration, processed flours and grains, processed
fats, fried oils, nutritional deficiencies, food dyes, chemicals, preservatives and additives,
metals, soda, junk food, fast foods and certain prescription drugs and over the counter
medicines can instigate an inflammatory response in many parts of the body especially in
the airways of children who are prone to wheezing.
Emotional stressors such as fear, anger, anxiety, worry and grief can both acutely or
chronically stimulate an inflammatory response in the nervous system leading to an immune
response in the airways of children with asthma. Even extreme emotional outbursts,
positive or negative, along with exercise, can bring about a state of inflammation. Birth and
head trauma along with other traumas to a child’s body can cause an impairment of blood
flow, lymph flow and nerve supply to and from the muscles of the chest wall and the
smooth muscles of the lining of the airways. This dynamic can compromise a child’s
ability to breathe efficiently and maximize air exchange in as many airways as possible.
The parasympathetic and sympathetic branches of the autonomic nervous system regulate
the state of contraction and relaxation of the smooth muscles of the lining of the airways,
respectively. When both branches of the autonomic nervous system are in balance, the
smooth muscles are not in spasm. Some children with asthma can develop bronchospasm
when there is over stimulation of the parasympathetic branch and/or a weakness in the
sympathetic stimulation of these airway smooth muscles. Any one of the above
contributing environmental factors—respiratory irritants, ingested materials, physical and
emotional nervous system traumas and stressors—can influence the over or under
stimulation of the parasympathetic and sympathetic branches of the autonomic nervous
system, respectively, leading to the onset of bronchospasm in children with asthma.
Prostaglandins, leukotrienes and cytokines are the major immune chemicals that function in
the body to produce pro and anti-inflammatory responses. The ingredients that make up the
building blocks for these chemicals come directly from the diet. Most of these chemicals
are made up of proteins (cytokines), polyunsaturated fats in the omega-6 and omega-3 fatty
acid family (prostaglandins, leukotrienes and thromboxanes) and from complex sugars
(oligosaccharides) that are fundamental to the proper function of every one of our cells,
especially the immune cells. Many of these fats, sugars and proteins are essential in our
diet and cannot be manufactured in the body. Many vitamins and minerals are needed to
help stabilize the structure of fats, sugars and proteins in cell membranes and aid in their
production, release and function.
When a child with asthma consumes an overabundance of omega-6 fatty acids and simple
sugars, which favor the production of pro-inflammatory immune chemicals, and/or
consumes an insufficient amount of omega-3 fatty acids and complex sugars, which favor
the production of anti-inflammatory immune chemicals, the stage is set for the development
of wheezing with swelling and inflammation of the airways. The trigger(s) that cause the
body’s immune cells to release these pro-inflammatory chemicals during an acute asthmatic
episode may come from any one of the contributing factors mentioned above—respiratory
irritants, ingested materials and physical or emotional traumas and stresses to the nervous
system.
There was great enthusiasm when the anti-leukotriene medications (e.g., Singulair) came
out on the market. It was seen as a major breakthrough for children with chronic
inflammatory conditions like asthma and inflammatory bowel disease since we knew that
these children had high circulating levels of pro-inflammatory leukotrienes. Leukotrienes
are some of the most potent inflammatory agents in the body. Prescribers of these
medications hoped for a reduction in the symptoms of inflammation in these children. In
reality, the medicine does nothing to stop the body from producing the leukotrienes. So
what happens to these pro-inflammatory leukotrienes? They continue to circulate in the
body. The inflammatory response persists in spite of an alleviation of symptoms. Many
children with asthma do not need these medicines to block the action of the proinflammatory
leukotrienes. A simple change in their diet will reduce leukotriene production
altogether.
A diet of mostly nutrient empty processed foods with a deficiency of important vitamins
and minerals, an abundance of simple sugars and an excess of unhealthy fats favors the
production and release of pro-inflammatory chemicals and weakens the anti-inflammatory
response. A diet high in simple sugars causes insulin levels to remain high or fluctuate in
very high and low ranges. These types of insulin responses stimulate the release of proinflammatory
prostaglandins, leukotrienes and cytokines which weakens the production of
their anti-inflammatory counterparts as well.
The goal of treatment is to introduce the idea to the family that the child’s illness, in this
case asthma, is presenting them with an opportunity to make changes in their lifestyle.
They do not need to follow along the path of medication and frequent medical visits.
Wheezing, coughing and swelling and inflammation of the airways are signs and symptoms
that tell the family there is dis-ease in the environment. The child is calling out that
something is out of balance in his/her life. The family can educate themselves about how
some or all of the contributing factors mentioned above are creating the dis-ease for the
child. In reality, the child’s asthma, seen as an illness, serves as the cure for the true disease
in his/her life—the underlying stressors. Ultimately, the child with asthma can provide
the family with the opportunity and incentive to live a healthier life.
For some children with asthma, improving the air quality alone can reduce further wheezing
episodes. For others, addressing and lightening the physical and emotional stressors can
help the child breathe easier. For the most part, changing the diet of a child with asthma has
the greatest impact on improving his/her health. If a child with asthma ingests and
incorporates into the cells of the body a balance of the essential dietary ingredients that
make up the building blocks of the pro- and anti-inflammatory chemicals, an exposure to an
occasional trigger may have no untoward effect on the immune system. In other words,
children with asthma need to eat properly for their bodies to function the way it is intended.
Some children continue to have asthma despite removal of the confounding triggers. These
children require more intensive therapy that may respond to evaluation and treatment of
metal toxicity, liver and intestinal detoxification, vitamin and mineral supplementation,
herbal treatment, treatment of severe food allergies,
homeopathy, Chinese or Ayurvedic medical treatment and/or continuation of conventional
medicines. It is possible for a child with asthma to live symptom and medication free for
the rest of his/her life.
Treatment Approaches
Recognize, understand, reduce and eliminate contributing factors:
Clean up the environment reducing exposure to known respiratory irritants. Continue to
look for other possible airborne irritants that are not very obvious.
Teach older children to take full, proper breaths. Have them sit or stand in an upright
position in a calm environment. Ask them to inhale through the nose and feel their
diaphragm pushing down towards their feet while the abdomen relaxes, pushes out from
their bodies and fills like a balloon. Make sure the shoulders and chest wall are still and not
part of the respiratory effort. Ask them to feel their chest wall filling with air after their
abdomen expands. On the exhale, have them reverse the process letting the air exit through
the mouth, allowing the abdomen to return to its normal position bringing the belly button
back towards the spine. Encourage them to practice this type of breathing at all times,
especially during more stressful encounters, until it becomes second nature. Yoga,
hypnosis and meditation are several tools to help children with asthma improve their
breathing.
Clean up the diet by removing unhealthy fats. These include partially hydrogenated oils,
margarine, vegetable shortening, cooking oils such as corn, vegetable, safflower and
sunflower oils and fried foods and oils. These oils are found in supermarket and bakery
packaged foods and used in restaurants for cooking and frying. Read labels. Use olive oil,
organic butter, ghee, grape seed oil, coconut oil and cold pressed oils for cooking and
flavoring. I do not recommend flax seed oil for children as a source of omega-3 fatty acids.
There is scientific evidence that the oil is not processed in the body to help promote antiinflammatory
responses due to weak enzyme systems in children. If children are unwilling
to eat fish and sea vegetables for their omega-3 intake, there are good tasting cod liver oil
preparations made by Carlson Labs and Nordic Naturals. (3,5,8)
Clean up the diet by removing simple sugars and regulate insulin levels. These sugars
include glucose, sucrose, fructose and lactose and processed white flours. These sugars are
ubiquitous in cereals, juices, cookies, cake, candy, pastries, soda, soft drinks, shakes, snack
bars, milk, cheese, ice cream, bread, pasta, crackers and, junk, snack and fast foods. (5, 7,8,
9)
Sugar, like salt, is dehydrating to the body. Dehydration increases histamine levels.
Histamine is another pro-inflammatory chemical that can worsen asthma. Water is an antihistamine
and helps reduce histamine levels. Sixty-seven to seventy percent of a child’s
body is made up of water. Give children with asthma water as their main beverage and
keep them well-hydrated. I have personally watched several wheezing children clinically
improve using hydration as a main part of their treatment. (1, 2)
Clean up the dyes, preservatives, food colorings, artificial sweeteners and additives found
in most foods listed in numbers 3 & 4 above and in many prescription drugs, antibiotics
and over the counter medicines. Several of these chemicals are known to interfere with
important enzymes needed for production of pro- and anti-inflammatory immune chemicals.
Encourage a diet of whole, fresh, simple foods including vegetables, legumes, nuts, seeds,
meat, chicken, fish, eggs, whole grains, sprouted breads and some fruit. Flavor foods with
fresh culinary herbs and spices. Depending on factors specific to the individual child, some
children with asthma will improve on a diet of non-starchy vegetables, meat, chicken, fish
and eggs, nuts and seeds and fats with small amounts of grains, legumes, starchy
vegetables, sugars and fruit. Others will improve on starchy vegetables, legumes, whole
grains and fruit with small amounts of non-starchy vegetables, animal proteins and fatty
foods. (6, 8) Processed foods and beverages taste good yet they have little to no nutritional
value. As a mainstay in the diet, they can be harmful to a child’s health, especially for a
child with a chronic inflammatory condition like asthma.
Relieve tension on the autonomic nervous system. The best way to do this is through
evaluation and adjustment by a chiropractor, or cranial work by an osteopath or cranial
sacral therapist. Some children, whose asthma is more related to an imbalance in their
autonomic nervous system rather than a problem with their diets, will respond better to
these types of care. The diet changes will still be of benefit nonetheless.
Avoid Motrin and other non-steroidal anti-inflammatory medications. In a subset of
children with asthma, these medications will increase the production of pro-inflammatory
leukotrienes.
Address stressors that may affect the emotional state of the child. Increased peer pressure,
academic pressure, over stimulation, over scheduling, problems in the home, inability to
express emotions such as fear, anger, anxiety, worry and grief with build up of these
emotions, exposure to violence, anger or fighting, and feelings of smothering and
suffocation are some of the concomitant stressors that serve as triggers for children with
asthma.
References:
Batmanghelidj, MD, F., ABC of Asthma, Allergies and Lupus
Batmanghelidj, MD, F., Water: For Health, For Healing, For Life: You’re Not Sick,
You’re Thirsty
Enig, Ph.D., Mary, Know Your Fats
Ivker, DO, Robert, Nelson, ND, Todd, Asthma Survival: The Holistic Medical Treatment
Program for Asthma
Weil, MD, Andrew, Spontaneous Healing
Wolcott, William and Fahey, Trish, The Metabolic Typing Diet
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Copyright © 2003 Lawrence B. Palevsky, MD
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