The Complete Guide to Integrative Therapies
The asthma epidemic - and how to beat it
'. . . we thought we had made a mistake . . .'
When researchers in Germany decided to look at the number of children with asthma, and compared the numbers in a West German city with numbers in two highly polluted cities in East Germany, they expected to find more asthma in the East. They did find more coughing and wheezing in the East, but when it came to asthma, the results were exactly the opposite. Initially the researchers reacted with disbelief. 'We checked all the data entries again because we thought that we had made a mistake,' said the research team leader, Dr Erika von Mutius of the University Children's Hospital in Munich. The children in West Germany had far more allergies than those in the East, and therefore more asthma, despite breathing cleaner air.
WHY IS ASTHMA ON THE INCREASE?
There is no doubt now that asthma truly is on the increase. At one time it seemed possible that doctors had just become more inclined to diagnose asthma, rather than, say, 'wheezy bronchitis' or 'a cough', producing an artificial increase in the asthma statistics. New research shows that, although this diagnostic shift has happened, there is also a genuine and sizeable increase in the number of asthma sufferers. Between 1975 and 1995, asthma rates in children doubled in many parts of the world, and the rates for adults also rose sharply. It is no exaggeration to call this an epidemic.
A Western epidemic
The asthma epidemic is affecting all the rich, Westernized countries of the world. It is also affecting immigrants to Western countries arriving from places where asthma is rare.For example, when people from the Polynesian island of Tokelau move to New Zealand, their chances of getting asthma double. Similar increases have been seen among Filipinos moving to the USA, and Asians from East Africa moving to Britain. The new cases of asthma occur among adult immigrants, as well as their children. For black South Africans moving to Cape Town, rates of asthma in the next generation are 20 times higher than in the rural villages where the people originated.
Chinese people in Taiwan, who have stayed in the same place but gradually adopted a Westernized lifestyle, now have eight times more cases of childhood asthma than they had in 1974. In Ghana, the wealthier people living in the cities are also experiencing more and more asthma, whereas the poor people living in the same cities have far less asthma, and people in the remote villages have little or none. Research has revealed the same thing in Zimbabwe. All these communities have also experienced rising levels of other allergic diseases.
Looking at all this research, it is obvious that the asthma epidemic is being caused by some factor or factors in modern Westernized life. Whatever the factors are, they seem to have appeared in the early 1960s and they affect rich and poor alike in Britain and other Western countries, but failed to affect people in East Germany before German unification.
Another puzzling fact about the worldwide distribution of asthma is that rates seem to be very high in parts of Latin America, particularly Brazil and Peru, and not just among the wealthier classes.
What is causing the epidemic?
Air pollution is usually blamed, but the case against air pollution just doesn't stand up. Although it can make asthma worse for people who already have the disease, and it may produce a small increase in the number of people developing asthma, there is no way that air pollution is the major cause of the asthma epidemic. Some places with extremely clean air, such as New Zealand, have very high rates of asthma (see pp. 205-6). The poor urban children in Ghana (see above) are breathing the same polluted air as the rich urban children, but suffer much less from asthma.
So what is the cause? There is no simple answer to this question, but many different factors have been identified. Some of these are universal in Westernized countries and communities, others are not. It looks as if the factors in question vary from one country to another, from one region to another, and even from one asthmatic to another. So some of the factors listed below may be relevant to you and your family, and some may not. Bear in mind that all these factors will probably make no difference to a person who does not have the inborn tendency to develop allergies and/or asthma (see p. 25). It is primarily those with the inherited susceptibility to asthma who will be affected by these changes in lifestyle.
It is interesting that the large differences between East and West Germany (see p. 78) only occurred in the generations born after 1961: before that, West Germans had as little asthma as those in the East. The same is true when people in Sweden are compared with those in Estonia. As one researcher points out, 'Living conditions in the formerly socialist countries of Europe are, in many respects, similar to those that prevailed in Western Europe 30-40 years ago, including the type of air pollution, the panorama of childhood infections, types of immunizations, building standards, and food.'
Looking at the worldwide picture, there is a general link between asthma and affluence, but within developed countries such as Britain, asthma rates are the same in all social classes. In other words, the risk factors are shared by rich and poor alike in the West. This would fit in with risk factors such as a high-salt diet (for example from crisps and other salty snacks), sedentary indoor lifestyle, altered patterns of childhood infections due to sanitation and medical care, and poorly ventilated housing leading to allergen build-up. Such factors are shared by rich and poor alike in developed countries, but are still rare in rural Africa and Asia where asthma rates remain very low.