To Your Health

Q. My child can no longer play soccer on his team because he developed "exercise-induced asthma." My grandfather died of asthma more than 50 years ago. Could my child die from this condition? How can I help him?

A. Deaths from asthma are rare these days, with emergency medical services equipped with oxygen as well as many potent drugs that can rescue asthmatics. Also, chances are your grandfather suffered bronchial asthma rather than exercise-induced asthma. By far the most deaths occur in these "over 50" asthmatics, with an annual death rate even now of about 1 per 1,000. Exercise-induced asthma (EIA) occurs primarily in those under age 20 and has an even lower death rate.

Vitamin B-6 has the best reputation for reducing the amount of medication needed by asthmatics, though the amount needed (50 to 200 milligrams per day) is higher than some parents want to give their child. This amount is probably safe when other B-complex vitamins are included even in a modest 10-15 mg per day range.

Recently a four-week trial of vitamin C supplements (2,000 mg per day) was found to reduce the severity and frequency of EIA in children. Again, although there were no ill effects reported in this trial, this dose of vitamin C is disturbing to some parents.

Beta-carotene was found to protect against EIA in about half the children who were given 100,000 IU per day for a month. This is about 10 times the amount supplied in food. Beta-carotene, the form of vitamin A found in vegetables, is much safer than the retinol form found in liver and other animal products, but it still seems like a risky amount to many parents. Another "carotenoid," lyopene (abundant in tomatoes) was reported last year to provide about that same benefit in only one week at half the dose. The drawback for lycopene is its cost, though that may come down as it becomes more popular.

Children with low levels of selenium have a high risk of asthma. As little as 45 mcg of selenium has cleared up the breathing difficulties even when lung function tests do not change.

Although researchers report only small improvements when asthmatics use fish oil supplements, there is evidence that children who eat oily fish may have a much lower risk of getting asthma. Therefore, even though evidence supporting the use of fish oils remains weak, eating more fish may still be worth considering.

Some food chemicals, such as monosodium glutamate (MSG) have been reported to provoke asthma.

The take-home lesson from all this inconclusive research seems to be that while there is no magic button that "cures" asthma, one might hope that a team of several nutrients working together would approach complete protection against this worrisome problem.

It would certainly be a mistake to discourage your son from all vigorous activities. Even many Olympians are subject to EIA and simply compete in a field that does not require such exertion. Although soccer is no longer an option for your son, other sports that utilize shorter bursts of energy, such as baseball or gymnastics, can still be tried. Exercise is beneficial both physically and emotionally and a diagnosis of EIA, with appropriate treatment, should not hinder your son's ability to exercise to his full ability.