Stress management & healthy diets: strategies for allergy and asthma relief.

You've read about how to change your environment to decrease allergy and asthma triggers. Now let's talk about strategies focused on diet and stress management.

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My first recommendation? Lose weight. A 1999 study found women with a body mass index (BMI) of 30 or more had three times the risk of asthma compared to women with BMIs less than 20. (23) The connection may be due to more fat cells, which release inflammatory chemicals that can contribute to asthma (and allergies). Plus, if you're overweight, your asthma symptoms are likely to be worse. (24)

Next, pay attention to your diet. We're learning an amazing amount about the beneficial effects of certain foods on allergies and asthma. Here are my top three dietary strategies:

1. Eat fish at least twice a week, or take fish oil supplements. Studies find people who eat a lot of fish high in omega-3 fatty acids are both less likely to develop asthma and, if they have the condition, have less severe symptoms. (25,26)

2. Up your intake of antioxidants. There's some evidence that free radical damage, or oxidation, may contribute to the inflammatory process that marks allergies and asthma. Antioxidants, of course, neutralize free radicals. For instance, studies find low levels of vitamin C, a powerful antioxidant and a natural antihistamine, in people with asthma, so increase your consumption of high vitamin C foods like citrus fruits and red and yellow peppers, and take a vitamin C supplement, either alone or as part of a multivitamin. (27) Basically, if you aim for seven or eight servings of fruits and vegetables a day, and make your grains whole grains, you should get plenty of antioxidants.

3. Munch an apple a day. Packed with a powerful antioxidant called quercetin that helps control inflammation, apples, along with other quercetin-containing foods like onions and green and black teas, have been linked to a lower risk of asthma. (28)

Now focus on controlling the stress in your life and your reaction to it. Although asthma was once thought to be a psychosomatic illness (i.e., imagined, or "all in your head,"), today we know that's not true. However, we also know that stress can trigger an asthma attack just as much as a smoke-filled room.

One of the best things you can do when you feel overwhelmed or under stress is close your eyes (assuming you're not driving at the time) and visualize a calming, relaxing place. It could be a tropical resort, a peaceful room lit only by a single candle or a field covered in wildflowers.

Now breathe slowly in through your nose and out through your mouth, making a humming sound as you breathe out. This is called percussive breathing, and it not only serves to center you and stem the release of stress hormones, but helps release the tight feeling around your chest that can lead to an asthma attack.

By combining environmental changes with preventive medication, a healthy diet, weight loss and stress management tools, I'm sure you'll find that you're better able to control both allergy and asthma symptoms.

RELATED ARTICLE: Heartburn and Asthma

If you have asthma and frequent heartburn, the two may be related. Studies show that as many as 70 percent of people with asthma also have gastroesophageal reflux disease, or GERD, in which stomach acid washes up through the esophagus. (29)

We're not quite sure why the two co-exist, but suspect the asthma somehow contributes to a relaxation of the esophageal sphincter, the muscle that is supposed to keep stomach contents in the stomach.

It may also be that GERD contributes to asthma in some way, since at least one study finds that anti-reflux surgery can significantly improve asthma symptoms in patients with both. (30) You don't have to go the surgical route, however. Try to avoid acidic or fatty foods that exacerbate GERD, like tomatoes, chocolate, fast food and fried food. Also avoid peppermint or spearmint candies or herbs. And, as mentioned earlier, losing weight can help with both conditions.

Visit www.healthywomen.org for more information on asthma, allergy and GERD.

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By Pamela Peeke, MD, MPH

NWHRC Medical Advisor

Dr. Peeke is a Pew Foundation Scholar in Nutrition and Metabolism, and Assistant Clinical Professor of Medicine at the University of Maryland in Baltimore. She writes about health and lifestyle issues important to all women.