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It is estimated that 17 million people in America have asthma, with 5 million being under the age of 18. Asthma, which is Greek for 'to pant', is a chronic lung disease that triggers episodes of coughing, wheezing and shortness of breath which is caused by an inflammation of the lungs that result in the airways to narrow. It can take place at any age, and appears to have a genetic link. Although its symptoms are controllable, it is not thought to be curable.

Triggers for asthma can vary from one person to the other and may include allergens (dust, smoke, molds, pollens, and animal dander), chemical agents (cleaning products, perfumes, etc.), emotional stress and exercise. The best way to halt asthma attacks is to prevent them in the first place. Simple steps include controlling and managing house dust mites, animal related allergens, tobacco smoke, cockroach allergen, mold and other fungal spores and pollens, smoke from wood burning stoves, colds and viral respiratory infection, and physical activity or exercise induced asthma (EIA).

It was once thought that physical activity should be discouraged if you had asthma, but today this is not the case. With the appropriate precautions, exercise is not only considered safe, but it is frequently promoted as part of a sound respiratory therapeutic program. There are many ways to help avoid exercise induced asthma. If you have asthma, check with your doctor before you begin an exercise program and get a complete physical with a review of your current medicine therapy.

Some guidelines:

• Warm up with 10 minutes or so of low intensity walking and gentle stretching and before your workout.

• Avoid exercising in cold, dry air or in areas where air pollution or allergens are high. If you must exercise in a cold environment use a scarf or face mask to trap the warm moist air and prevent cold dry air from penetrating deep into your lungs.

• After exercise, be sure to include a 10 to 15 minute cool down period.

• Asthma attacks place significant stress on the body. Fatigue is common, making it even more difficult to breath. This is why a gradual progression with exercise is important. Developing cardiorespiratory fitness will make you feel less fatigued and will help lung function.

• Different types of exercise may effect symptoms of asthma. For example, outdoor running is often worse than indoor running on a treadmill. To improve cardiorespiratory fitness, begin with 20 (or less) of low intensity aerobic activity 3 times per week, eventually building to five. Exercise in 10 minute intervals with a short rest in between. Use a cross training method applying different exercise modalities (i.e. treadmill, bike, rower). Swimming rarely causes EIA due to the warm moist air (however swimming in chlorinated pools may be a trigger for some).

• Exercise intensity is also related to EIA and should be kept at a moderate level. You should be able to talk in short sentences throughout your workout.

• Long duration exercise causes more exercise induced asthma then shorter bouts. Sports that promote stop and go activities such as tennis, volleyball & resistance training may cause less EIA in some individuals.

• Keep your exercise up beat by making the most of your workouts, and avoid becoming bored or stressed, pick activities that you enjoy and can do.

• If a medication is prescribed you can use it before exercise and monitor peak air flow with a peak flow meter. Your inhaler can be used during exercise also if symptoms arise. Talk to your doctor about how to use your inhaler with exercise. If notwithstanding your efforts, symptoms develop and persist, stop the activity and inform your doctor. Your doctor may recommend simple changes in medication that make the difference.

• Drink plenty of fluids before, during and after exercise. Dehydration causes airways in the lungs to constrict, and makes breathing more difficult. Studies have shown that this is true even if the individual is not exercising. Thirst is a poor indicator of when to rehydrate, by the time you sense thirst your body is already lacking essential fluids.

• Avoid alcohol and caffeinated beverages such as coffee, tea or sodas; these are diuretics, which dehydrate you even further.

• Exercise-related breathing problems also occur in individuals who have not been diagnosed with asthma. People with allergies may experience many of the same symptoms, as exercise causes increased oxygen demand, breathing rate, and cooling and drying of the airways.

Although right now there is no cure for asthma, it can be managed with proper treatment and lifestyle management. Controlling symptoms may include using an inhaler or other medicine, as well as identifying and avoiding factors that may trigger an episode. Educating yourself as much as you can about asthma and your response to exercise gives you improved control and a greater chance of living an active life.