Asthma and Exercise

According to the American College of Sports Medicine (ACSM), asthma is: “a syndrome characterized by reversible obstruction to airflow and increased bronchial responsiveness to a variety of stimuli, both allergic and environmental”. In other words, asthma is a chronic inflammation of the bronchi (airways) in the lungs.

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Asthma varies from person to person and ranges in severity from mild to severe. It is induced by different stimuli, such as allergens or exercise. The stimulus that brings on an asthma attack in a particular individual must be known and considered when establishing an exercise regimen for that individual.

Exercise capacity can either be limited as a result of having asthma, or exercise can in fact induce an attack, thereby exacerbating the condition. This may cause individuals to avoid exercise wherever possible.

The symptoms of exercise-induced asthma include the following (ACSM):

·        Wheezing
·        Coughing
·        Shortness of breath
·       Chest discomfort

The symptoms may last up to 30 minutes after an exercise bout. If the exercise bout is prolonged, then symptoms may occur during the session. If the condition is mild, then individuals can usually exercise at an intensity of 75% of maximum heart rate before symptoms are induced. In more severe cases, mild exertion may induce symptoms. Although exercise may induce symptoms, it is important to include exercise in the management of this condition.

Individuals with well-controlled exercise-induced asthma are able to exercise with little or no symptoms. The training effects will be the same as in individuals who do not have asthma. Thus, these individuals should follow the same exercise guidelines as those for individuals who do not have asthma and thus should include cardiovascular, strength and flexibility exercises into their routines. In more severe cases, where exercise intensity is limited by symptoms, individuals can concentrate on improving endurance, rather than high-intensity fitness and should also include resistance and flexibility exercises.

It is important to realise that one can and should continue to lead a very healthy and active lifestyle, even if they have been diagnosed with asthma. You must consult your doctor with regards to exercise and to take the medication that has been prescribed by your doctor in order to keep the condition under control and to reduce symptoms during exercise. If you have asthma and don’t know how to start an exercise programme, starting off with a biokineticist can point you in the right direction.

Understanding Your Body Composition

When discussing ones body weight, people always ask what their body mass index (BMI) is, as if it’s the most important thing to consider with regards to their health. Many of you will know that BMI is a calculation that is used to determine the ideal body weight according to ones height. The following formula can be used to calculate BMI:

BMI = Weight (kg) / [Height (m)]²

Obesity puts one at an increased risk for cardiovascular disease. Below is a table which gives normative values for BMI, as well as the associated risk of disease for a specific BMI range.

Classification	BMI (kg/m2 )	Risk of other obesity related medical complications
Underweight	<18.5	Low (but has risk of different set of other clinical problems)
Normal range	18.5-24.9	Average
Overweight	25.0-29.9	Mildly increased
Obese	>30.0
Class I	30.0-34.9	Moderate
Class II	35.0-39.9	Severe
Class III	>40.0	Very severe

Adapted from ACSM’s Guidelines for Exercise Testing and Prescription (7^th ed.).

While BMI is a useful tool in determining appropriate body weight and associated disease risk, it has its limitations which it is important to be aware of when assessing your body weight for health.

BMI does not consider the composition of the body, that is, what portion is muscle and what is fat, a very important distinction to make. A higher fat percentage puts one at an increased risk for cardiovascular disease. However, it is possible that a person with a BMI that classifies one as ‘obese’, when in fact the person is a body builder and has a very high muscle mass. The image below illustrates this. On the other hand, one may be anorexic and have a high fat percentage.

The area of the body where the weight is carried must also be considered. Men tend to carry most of their weight in the waist area, whereas women tend to carry it in their hips. Carrying it in the waist area puts one at an increased risk for cardiovascular disease, as it is closer to the heart and other vital organs. Thus, it is important to monitor ones waist circumference as well when considering health risks. As a guideline, men should have a waist circumference below 102 centimetres and women below 88 centimetres.

So, don’t panic if you find out that a reading, such as your BMI, is slightly high. There are numerous other calculations and factors to consider when looking at your weight and your general well-being.