Cold air/bad lungs.

The only accurate method to make a diagnosis...a specific before and after lung function test in the exact same environment doing the exact same thing that brought on the symptoms before. A spirometer can measure the volume of expired air before and after exertion. A 12% to 15% decrease after exercise indicates EIA.

If you suffer from exercise-induced asthma, running outdoors in cold weather can be a serious challenge to your The cold, dry air can bronchial spasms that restrict air from filling the lungs, which impairs exercise performance. Imagine running with a hand clamped over your nose and mouth (not sealing off the air exactly, but seriously restricting access to free flowing air) and you can empathize with those who suffer from this malady. For a runner it can be maddening, and seriously impair performance. According to the American Academy of Allergy; Asthma, and Immunology; seven percent of the population or 18 million Americans suffer asthma. Even more (11%) have symptoms with exertion (exercise-induced asthma or EIA). Symptoms such as difficulty breathing can begin within five to 20 minutes of exercise and can include wheezing, chest tightness, coughing, chest pain and shortness of breath.

Diagnosis--You Need to Go the Distance

If you wheeze and cough after exercising in cold air, don't jump to the conclusion that you have ELA. According to new research, a diagnosis of EIA made on self-reported symptoms alone can both over-diagnose and under-diagnose the problem. A recent study compared self-reported symptoms based on a questionnaire against field test results and found that symptoms do not necessarily signal impaired lung function. Conversely, lung function may be impaired without producing classic symptoms, resulting in both false positive and false negative diagnoses.

Asthma Medications and Ergogenics

The incidence of EIA among elite endurance athletes may be even higher--reports of as many as one in four Olympic athletes have EIA. While research has been conducted to determine whether high level training, per se, contributes to EIA (perhaps due to the high volume of cold air that is processed while running or cycling), results haven't been conclusive. Given the fact that there is a widely perceived belief (not necessarily corroborated by research) that some of the inhaled medications for the treatment of EIA are ergogenic and might improve performance, the importance of a confirmed, field-tested diagnosis is even clearer.

Think Apples and Salt

Several studies have focused on the beneficial effects of fruits and vegetables--particularly apples, and the negative effects of dietary salt. Both a low-salt diet and a high apple-intake (five apples a week) improved symptoms and decreased the incidence of EIA in various research studies. But the best take-home lesson from these studies is this: if you think you may have trouble breathing brought on by exercise, see your doctor and get tested. There are excellent medications that can reduce or eliminate the respiratory misery of EIA. Beta-2-agonist inhalers, including albuterol, pirbuterol, and terbutaline, taken 15 minutes before exercise can reduce or eliminate symptoms in up to 90% of patients for up to four to six hours. Who needs a hand clamped over your mouth? Winter running is hard enough with full access to the air outdoors.

(Thorax, 2000, Vol. 55, No. 2. pp. 102-108 and Vol. 56, No. 9, pp. 675- 679; European Respiratory Journal, 1999, Vol. 13, No. 4, PP. 744-750; Medicine and Science in Sports and Exercise. 2001, Vol. 33, No. 2, pp. 208-213 and 2000, Vol. 32, No. 4, pp. 732-737; The Physician and Sportsmedicine, 1996, Vol. 24, No. 1. pp. 77; American Journal of Respiratory and Critical Care Medicine, 2000, Vol. 161, No. 5, pp. 1479-1484; Internation Journal of Sports Medicine, 2000, Vol. 21, Suppl 2, pp. S98-102; European Journal of Applied Physiology, 2001 Vol. 85, No. 5, pp. 450-456)

RELATED ARTICLES: WHAT Else CAN YOU Do?

* Warm up and cool down gradually when the weather is extreme.

* Don't run in cold air when you have an upper respiratory infection.

* Use a face mask or a scarf when the air is cold.

* If you have winter allergies, the cold air plus allergy symptoms can be a one-two punch--avoid outdoor running.