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Years ago people with asthma were told to limit their exercise, for fear it would set off an asthma attack. Now research suggests that the best thing you can do for asthma (to control symptoms) is to get regular exercise year round - here 30 minutes per day, whether walking, biking, or other moderate activities.

From Science Daily: Just 30 minutes a day: Regular exercise relieves asthma symptoms

Millions of people suffer from asthma. Many report having poor control of their symptoms. Fortunately, new research shows there is a simple antidote: 30 minutes of exercise a day, year-round.

In a study recently published in BMJ Open Respiratory Research, experts from Concordia University, the Hôpital du Sacré-Coeur de Montréal and several other institutions analyzed the exercise habits of 643 participants who had been diagnosed with asthma. Results were overwhelmingly clear: those who engaged in optimal levels of physical activity on a regular basis were nearly two-and-a-half times more likely to have good control of their symptoms, compared with those who did no exercise. The workout doesn't have to be strenuous...."Just 30 minutes a day of walking, riding a bike, doing yoga -- anything active, really -- can result in significant reduction of asthma symptoms."

Traditionally, people with the condition have been discouraged from exercising because of a belief that it triggers shortness of breath and attacks. Bacon explains that simple precautionary measures can be taken to avoid the discomforts that can be caused by physical activity. "The issue of exercise-induced bronchospasm is real -- but if you use your releaver medication, blue puffer, before you exercise, and then take the time to cool down afterwards, you should be okay," he says. "Even if you have asthma, there's no good reason not to get out there and exercise."

That's a message Bacon hopes resonates. Within his sample group of 643 individuals, a whopping 245 reported doing no physical activity. Only 100 said they engaged in the optimal 30 minutes a day...."We need to keep in mind that doing something is better than nothing, and doing more is better than less. Even the smallest amount of activity is beneficial."...."Our study shows that those who were able to engage in physical activity on a regular basis year-round benefit most," says Bacon. If necessary, he suggests finding an indoor place to move, whether it's the gym, a staircase or a shopping mall.

An interesting Canadian study that followed young children for 3 years found that young infants may be more likely to develop allergic asthma if they lack four beneficial bacteria in their gut. Children with low levels of Lachnospira, VeillonellaFaecalibacterium, and Rothia bacteria in their gut in their first 3 months were at higher risk for asthma and tended to receive more antibiotics than healthier children before they turned 1 year old.

Other studies have shown that the risk of developing asthma and allergies has been linked with such things as taking antibiotics, cesarean birth, bottle fed with formula, not living on a farm, and not having furry pets in the first year of life.

The researchers wrote: "Our findings indicate that in humans, the first 100 days of life represent an early-life critical window in which gut microbial dysbiosis {the microbial community being out of whack} is linked to the risk of asthma and allergic disease." How do the infants get these microbes? It is thought that infants get exposed to the mother's microbiome (microbial community) via vaginal birth, breast-milk, and mouth contact with the mother's skin.  From NPR News:

Missing Microbes Provide Clues About Asthma Risk

The composition of the microbes living in babies' guts appears to play a role in whether the children develop asthma later on, researchers reported Wednesday. The researchers sampled the microbes living in the digestive tracts of 319 babies, and followed up on the children to see if there was a relationship between their microbes and their risk for the breathing disorder. In the journal Science Translational Medicine, the researchers report Wednesday that those who had low levels of four bacteria were more likely to develop asthma by the time they were 3-years-old.

Specifically, the researchers focused on 22 children who showed early signs of asthma, such as wheezing, when they were 1-year-old. They were much more likely than the other children to have had low levels of the four bacteria when they were 3-months-old. By the time they turned 3, most had developed full-blown asthma."The bottom line is that if you have these four microbes in high levels you have a very low risk of getting asthma," says Brett Finlay, a microbiologist at the University of British Columbia who helped conduct the research. "If you don't have these four microbes or low levels of these microbes you have a much greater chance of asthma."

Asthma is a common and growing problem among children. Evidence has been accumulating that one reason may be a disruption in the healthful microbes children get early in life, Finlay says."There's all these smoking guns like, for example, if you breast-feed versus bottle feed you have less asthma," he says. "If you're born by C-section instead of vaginal birth you have a 20 percent higher rate of asthma. If you get antibiotics in the first year of life you have more asthma." The microbiomes of kids who aren't breast-fed and are born by Caesarean section may miss out on getting helpful bugs. Antibiotics can kill off the good bacteria that seem important for the development of healthy immune systems.

"What's become clear recently is that microbes play a major role in shaping how the immune system develops. And asthma is really an immune allergic-type reaction in the lungs," Finlay says. "And so our best guess is the way these microbes are working is they are influencing how our immune system is shaped really early in life."

To further test their theory, the researchers gave laboratory mice bred to have a condition resembling asthma in humans the four missing microbes. The intervention reduced the signs of levels of inflammation in their lungs, which is a risk factor for developing asthma.

The bacteria are from four genuses: Lachnospira, Veillonella, Faecalibacterium and Rothia. The researchers aren't exactly sure how the microbes may protect against asthma. But babies with few or none of them had low levels of a substance known as acetate, which is believed to be involved with regulating the immune system.

It's official - the medical community has accepted that a key element in preventing allergies and asthma is early childhood exposure to allergens - whether peanuts, dust, or pets. Instead of avoiding the allergens (which was the medical advice for decades) - getting early exposure to them is key to preventing allergies. Apparently growing up on a farm is best (with exposure to farm dirt and dust), especially a dairy farm with animals and raw milk (a number of studies have found that unprocessed raw milk and its microbes also helps health). But if one doesn't live on a farm, then having furry pets in early childhood is also beneficial in reducing the incidence of allergies. The following study shows that microbes are involved - pet microbes were found in the guts of many of those children who did not develop early allergies! From Medscape:

Furry Pets 'Enrich' Gut Bacteria of Infants at Risk for Allergies

In a small, preliminary study, infants in households with furry pets were found to share some of the animals' gut bacteria - possibly explaining why early animal exposure may protect against some allergies, researchers say. The infants' mothers had a history of allergy, so the babies were at increased risk. It was once thought that pets might be a trigger for allergies in such children, the authors pointed out online September 3 in the Journal of Allergy and Clinical Immunology.

"Earlier it was thought that exposure to pets early in childhood was a risk factor for developing allergic disease," coauthor Dr. Merja Nermes, of the University of Turku in Finland, told Reuters Health by email. "Later epidemiologic studies have given contradictory results and even suggested that early exposure to pets may be protective against allergies, though the mechanisms of this protective effect have remained elusive."Adding pet microbes to the infant intestinal biome may strengthen the immune system, she said.  ...continue reading "Early Childhood Experiences Key to Preventing Allergies"

Link between Vitamin D levels and asthma.From Science Daily:

Breathe easier: Get your vitamin D

Asthma, which inflames and narrows the airways, has become more common in recent years. While there is no known cure, asthma can be managed with medication and by avoiding allergens and other triggers. A new study points to a convenient, free way to manage acute asthmatic episodes -- catching some rays outside.

"Vitamin D has significant immunomodulatory effects and, as such, was believed to have an effect on asthma -- an immunologically mediated disease," said Dr. Confino-Cohen.

Dr. Confino-Cohen and her team of researchers analyzed the medical records of nearly four million members of Clalit Health Services, Israel's largest health care provider. The Vitamin D levels of 307,900 people were measured between 2008 and 2012. Researchers also took into account key predictors of asthma, such as obesity, smoking, and other chronic diseases. Of some 21,000 asthma patients in Israel studied, those with a Vitamin D deficiency were 25 percent more likely than other asthmatics to have had at least one flare-up in the recent past.

The researchers found that Vitamin D-deficient asthmatics were at a higher risk of an asthma attack. "Uncontrolled asthma" was defined as being prescribed at least five rescue inhalers, one prescription of oral corticosteroids, or visiting the doctor for asthma at least four times in a single year.

While most of the Vitamin D in people's bodies comes from exposure to the sun, dermatologists recommend obtaining the ingredient from other sources -- fish, eggs, cod liver oil, fortified milk, or a dietary supplement -- due to the dangers of overexposure to the sun.

Based on the findings, the researchers recommend that people whose asthma cannot be controlled with existing treatments have their Vitamin D levels tested. For those with a vitamin D deficiency, supplements may make sense.

This research supports the growing evidence for the importance of microbes in the health of young children. Even the type of milk a child drinks is important. From Science Daily:

Pediatric allergology: Fresh milk keeps infections at bay

A study by researchers of Ludwig-Maximilians-Universitaet (LMU) in Munich shows that infants fed on fresh rather than UHT (ultra-pasteurized) cow's milk are less prone to infection. 

A pan-European study, led by Professor Erika von Mutius, Professor of Pediatric Allergology at LMU and Head of the Asthma and Allergy Department at Dr. von Hauner's Children's Hospital, reports that fresh cow's milk protects young children from respiratory infections, febrile illness and inflammation of the middle ear. As untreated cow's milk may itself contain pathogenic microorganisms and could pose a health risk, the researchers argue for the use of processing methods that preserve the protective agents present in raw milk.

The findings are the latest to emerge from the long-term PASTURE study, which is exploring the role of dietary and environmental factors in the development of allergic illness. The study initially recruited 1000 pregnant women who were asked to document their children's diet and state of health at weekly intervals during the first year of life.

"Among children who were fed on fresh, unprocessed cow's milk the incidence of head colds and other respiratory infections, febrile and middle-ear inflammation was found to be significantly lower than in the group whose milk ration consisted of the commercially processed ultra-pasteurized product," says Dr. Georg Loss. Ingestion of farm milk reduced the risk of developing these conditions by up to 30%, and the effect was diminished if the milk was heated at home before consumption. Conventionally pasteurized milk retained the ability to reduce the risk of febrile illness, while exposure to the higher temperatures used in UHT processing eliminated the effect altogether. 

"The effects of diverse milk treatments are presumably attributable to differentially heat-resistant components present in fresh milk. Compounds that are sensitive to heating seem to play a particularly important role in protection against respiratory-tract and ear infections," says Loss.

At the end of the first year of life, blood samples were obtained from the children enrolled in the study, and tested for biochemical indicators of immunological function. Infants fed on unprocessed milk were found to have lower levels of the C-reactive protein, which is a measure of inflammation status. "Other studies have shown that higher levels of inflammation are related to the subsequent emergence of chronic conditions such as asthma and obesity. Consumption of unprocessed milk may therefore reduce the risk of developing asthma," Loss explains.

Industrial processing of milk involves short-term heating of the raw product. Conventionally pasteurized milk has been exposed to temperatures of 72-75°C for 15 seconds, while ultra-pasteurized milk undergoes heating at around 135°C for a few seconds. The latter is also homogenized to disperse the milk fats, which prevents the formation of cream. 

In addition to fats and carbohydrates, cow's milk contains proteins that can modulate the function of the immune system. "In many respects, the composition of cow's milk is similar to that of human milk," says Loss. It has long been known that breast-feeding protects infants from infection, although how milk actually affects the early immune function remains unclear. It is possible that some of the factors involved interact directly with viruses or that they promote the development of a healthy immune system by altering the composition of the gut microflora.

That living in the country has positive effects on the immune system has been demonstrated in several previous studies. Together these investigations show, as Erika von Mutius notes, that "children who grow up on traditional dairy farms are least likely to develop allergies.

It seems like the more microbe exposure in the first year of life, the better for the immune system. From Science Daily:

Newborns exposed to dirt, dander, germs may have lower allergy, asthma risk

Infants exposed to rodent and pet dander, roach allergens and a wide variety of household bacteria in the first year of life appear less likely to suffer from allergies, wheezing and asthma, according to results of a study conducted by scientists at the Johns Hopkins Children's Center and other institutions.

Previous research has shown that children who grow up on farms have lower allergy and asthma rates, a phenomenon attributed to their regular exposure to microorganisms present in farm soil. Other studies, however, have found increased asthma risk among inner-city dwellers exposed to high levels of roach and mouse allergens and pollutants. The new study confirms that children who live in such homes do have higher overall allergy and asthma rates but adds a surprising twist: Those who encounter such substances before their first birthdays seem to benefit rather than suffer from them. Importantly, the protective effects of both allergen and bacterial exposure were not seen if a child's first encounter with these substances occurred after age 1, the research found.

"What this tells us is that not only are many of our immune responses shaped in the first year of life, but also that certain bacteria and allergens play an important role in stimulating and training the immune system to behave a certain way."

The study was conducted among 467 inner-city newborns from Baltimore, Boston, New York and St. Louis whose health was tracked over three years.

Infants who grew up in homes with mouse and cat dander and cockroach droppings in the first year of life had lower rates of wheezing at age 3, compared with children not exposed to these allergens soon after birth. The protective effect, moreover, was additive.  In addition, infants in homes with a greater variety of bacteria were less likely to develop environmental allergies and wheezing at age 3.

When researchers studied the effects of cumulative exposure to both bacteria and mouse, cockroach and cat allergens, they noticed another striking difference. Children free of wheezing and allergies at age 3 had grown up with the highest levels of household allergens and were the most likely to live in houses with the richest array of bacterial species. Some 41 percent of allergy-free and wheeze-free children had grown up in such allergen and bacteria-rich homes. By contrast, only 8 percent of children who suffered from both allergy and wheezing had been exposed to these substances in their first year of life.

From Medscape:

Allergic Rhinitis Patients Live Longer

Their runny noses might drive them crazy, but people with allergic rhinitis are likely to outlive the rest of us, a new study suggests.

"We found that allergic rhinitis patients had a decreased risk of heart attack, a decreased risk of stroke and, most strikingly, a decreased risk of all-cause mortality," said lead investigator Angelina Crans Yoon, MD, from the Department of Allergy and Clinical Immunology at the Kaiser Permanente Los Angeles Medical Center.

"They were basically half as likely to die during the study period," she told Medscape Medical News. 

Researchers studying data from the National Health and Nutrition Examination Survey (NHANES) found that people who tested positive for allergies were less likely to suffer cardiovascular events.

To explore the issue further, Dr. Crans Yoon and her team looked at a database of Southern California patients.The cohort consisted of 109,229 patients with allergic rhinitis and 109,229 people without allergic rhinitis who were matched for age, sex, and ethnicity. It also consisted of 92,775 patients with asthma who were matched with a similar group without asthma.

Risk for acute myocardial infarction was 25% lower in patients with allergic rhinitis than in those without, risk for a cerebrovascular event was 19% lower, and risk for all-cause mortality was 49% lower. Risk for all cardiovascular events was similar in the allergic rhinitis and control groups.

In contrast, risk for all cardiovascular events was 36% higher in patients with asthma than in those without, whereas risk for cerebrovascular disease and all-cause mortality were similar.

This could be the result of a difference in phenotypes in asthma patients, said Dr. Crans Yoon. People whose asthma is caused by allergies could be at less risk for cardiovascular events than people whose asthma has other causes.

Why should allergic rhinitis decrease someone's risk for death? 

Another explanation could be that the immune systems of patients with allergic rhinitis are hyperalert, aggressively fighting off disease, as well as causing symptoms, when it is not necessary. More work is needed to evaluate that.