Skin + Respiratory Health

Naturopathic Nutrition Year 2: Skin and Respiratory Health

• Today's lecture will cover asthma, bronchitis, chronic obstructive pulmonary disease, the integumentary system, acne vulgaris, rosacea, atopic dermatitis, and psoriasis.

Asthma

• Asthma is a chronic respiratory disorder characterized by variable airway obstruction and hyper-responsiveness to stimuli.
• Affects 11.6% of children aged 6 to 7 years worldwide.
• More common in boys in early childhood, but more prevalent in girls during adulthood.
• Hallmark symptoms include wheezing, intermittent shortness of breath, chest tightness, and dry cough.
• An asthma attack exhibits shortness of breath, coughing, or chest tightness.
• Itching of the chest or neck, especially in children may occur during an asthma attack.
• The wheezing that’s involved happens when breathing out (expiratory wheeze).
• The symptoms of an attack may start slowly and gradually worsen, lasting minutes, hours, or even days.
• Dry cough, anxiety, and sweating are common symptoms during an acute attack.

Asthma Pathophysiology

• Usually mediated by immunoglobulin E (IgE) and precipitated by an allergic response to an allergen (e.g., pollen, animal dander).
• Leads to the release of inflammatory mediators such as histamine leukotrienes, and prostaglandins, which cause bronchospasm.
• When untreated, mast cells, eosinophils, and T-helper cells migrate to the airways.
• Mucus production by goblet cells plugs the airway and, together with increased airway tone and hyper-responsiveness, causes the airway to narrow exacerbating symptoms.
• Airway remodelling (chronic inflammation) causes bronchial smooth muscle hypertrophy, formation of new vessels and interstitial collagen deposition, resulting in persistent airflow obstruction.
• Lipoxygenase products are the most potent chemical mediators in asthma, leukotrienes are 1000x more potent stimulators of bronchial constriction than histamine.
• Asthmatics have an imbalance in arachidonic acid metabolism, leading to relative increases in lipoxygenase products.

Asthma Causes and Risk Factors

• Immune tolerance: Th1/Th2 balance is important as an excessive Th2 response encourages IgE release and inflammatory mediators leading to development of asthma.
• Heightened Th2 immune response during pregnancy predisposes infant to allergic disease.
• Hygiene Hypothesis: Pathogen exposure supports neonatal immune development by increasing Th1.
• Inadequate antigen exposure causes abnormal responses to innocuous stimuli.
• Development of oral tolerance: the GI immune system gradually differentiates between antigens to ↓ Th2 response.
• Pre- or post-natal exposure to antibiotics may increase the risk and severity of asthma due to dysbiosis.
• First year of life is critical in development of the gut microbiome, Gut dysbiosis linked to early disruption of the immune system and the development of chronic atopic and inflammatory diseases.
• Compromised gut microbiome leads to antigen stimulation of the antibody pathway causing heightened Th2 response with increased antigen sensitivity and abnormal responses.
• Presence of pathogenic bacteria and fungi (e.g., Candida albicans) been linked with development of allergic sensitization and asthma.
• Not breastfeeding: It's protective via several mechanisms, including immune development and gut microbiome.

Asthma Risk Factors and Causes cont.

• Early weaning (< 6 months): Longer breastfeeding shown to have result in ↓ risk of wheeze and has a protective effect until school age.
• Exclusively breastfeed for 6-9 months: Early weaning and feeding infant formula ↑ risk of food allergy, including asthma.
• Obesity: Increases risk, symptoms and frequency / severity of attacks, changes in mechanical properties of the lungs and chest wall (↓ ERV & FRC).
• Diets promote obesity (↑ saturated fat and sugar, ↑ omega 6:3, a low fibre diet and antioxidants)
• Obesity is linked with low Bacteroidetes bacteria
• Increase in cytokines released from adipose tissue contributes to airway hyper-responsiveness and remodeling.
• Preservatives such as Benzoates, sulphur dioxide, and sulphites in food/drink
• Molybdenum deficiency as it is a co-factor for sulphite oxidase (oxidizes sulphite to sulphate, enabling safe urinary excretion).
• Food colourings: azo dyes (esp. tartrazine).
• Low vitamin D and magnesium.
• Drugs: aspirin, NSAIDs, ẞ-adrenergic & opiates → bronchospasm.
• Aspirin and NSAID sensitivity cannot be predicted, thus they are best avoided.
• Female sex hormone fluctuations: raised estrogen (favours Th2)
• Linked with ↑ risk of severe exacerbations in asthmatic women vs. non-use, previous HRT poses the greatest risk rather versus current HRT.
• Perimenstrual asthma: cyclical worsening of asthma during the luteal phase and / or first few days of menstruation.
• Triggers: cold temperatures, humidity, stress, exercise, pollution, irritants in air such as smoke, dietary factors

Asthma Diagnostic Approaches

• Medical history, physical examination, lung function tests (spirometry / peak expiratory flow). No gold standard test.
• Extrinsic (allergic / atopic) asthma (60-90% of cases) involves an IgE-mediated response with common triggers like pollen, mould, dust mites, pet dander.
• Intrinsic (non-allergic) asthma (10-40% of cases), more common in females, typically develops later in life and bronchial reaction, IgE can sometimes be involved and cold temperatures, humidity, stress, exercise, pollution, irritants (smoke), and respiratory infections.
• Naturopathic investigations: Relies on allopathic diagnosis and considers dietary, lifestyle, occupational factors e.g., a diet diary, thorough case history, elimination diet (see GI lecture), identification of triggers, IgG/IgE food profile such as the York Test IgG foods and IgE foods test, IgG/IgE inhalant allergy profile tests and Food / chemical intolerance tests
• May include analysis for for optimal digestion, microflora colonization, immune health, food additives, colourings, pharmaco-active agents, environmental & chemical irritants and potential food allergy or intolerances.

Asthma Treatment

• Reduce pre-disposition in child, consider parental nutritional status and pre-conception toxin exposure.
• Follow CNM Naturopathic Diet
• Eat fresh, natural, unprocessed organic food, eliminates / reduces common allergenic and eat fish/purified fish oil supplement.
• Breast feed. 1st year of child's life critical (minimise chemical exposure) as immature liver is unable to detoxify many compounds and ensure good sleep and minimise stress.
• Dietary exclusions the most common foods associated with asthma are cow's milk, eggs, chocolate, rice, soy, corn, citrus fruit & apples, salicylates.
• Avoid sulphites, nitrates, MSG and very cold drinks as well as gas-producing foods.
• Dietary reduction of sugar/dairy/wheat/additives/preservatives/colourings and red meat (to aid with arachidonic acid & lower prostaglandins and leukotrienes.
• Support dehydration, excess intake of salt, stress, anxiety all contribute to asthma exacerbations.
• Dietary additions to aid with oxidative stress

Asthma Support

• Antioxidants: vitamins A, C, E, carotenes, co-factors (zinc, selenium, copper, and flavonoids (particularly quercetin) to inhibit leukotriene and histamine release and protect lung with integrity and from oxidising agents,
• Increase Selenium a co-factor of GPO (often low in asthmatics).
• Increase vitamin E to improves lung function, optimises Th1 and suppresses Th2 ↓ IgE and atopy.
• Flavonoids such as Quercetin, decreases airway inflammation and hyper-responsiveness up to 3 g / day (adult dose) before meals.
• Support SIgA levels with probiotics includes S. boulardii, zinc, A, D, colostrum, optimise omega-6:3.
• Ensure optimal digestive function as low HCl and protein maldigestion is linked to asthma.
• Aid with dietary fiber to improve lung function, is antioxidant/anti=inflammatory.
• Inversely associated between fibre intake and pro-inflammatory interleukin-6 (IL-6) receptor a tumour necrosis factor-2 and C-reactive protein.
• Fiber Metabolized by gut bacteria into SCFAs which positively influence immune and metabolic responses.
• Vitamin B complex to decrease histamine release, beneficial for those with allergies/asthma.
• Reduces secretion of cortisol in times of stress and frequency/severity with methylation as a component as well as oxidation.

Nutrients for Asthma

• Vitamin C stimulates neutrophils, increases lymphocytes and interferon with decrease effect to the arachidonic acid.
• Modulates genes for asthma/allergy and modulates levels linked to allergy: maternal levels are protective to asthma.
• Magnesium helps with lung function as relates to bronchial reactivity & antagonism, calcium movement uptake in bronchial smooth muscle leads to relaxation dilation in the case of attacks aids in bronchial function.
• Zinc helps increase in T & lymphocytes reg. of in white cells shifting the T1,T2
• Probiotics to help help w/ immunity & B to increase that that TH2 profile cytokine B2
• Improves resp. health, reduces inflam. markers & also aids production of inflammatory glands

Asthma Herbal Support

• Herbal supports include.
• Coenzyme q10 (150mg) aids antioxidants and reduces asthma symptoms that way while reducing side term effects of the same.
• Boswellia is inhibits leukotriene & Improves breath.
• Ginger & tumeric include dual inhibitors of arachidonate aid & fresh juices.
• Avoid pollutants ( tobacco smoke, household chemicals,cleaning products, paint, molds, pollen, dust, dust mites
• Posture (compression of the lungs exacerbating symptoms especially while using smartphones).
• Tissue Salts (Kali /Mur. Mag Phosphurus 2 pills).
• Essential oils (diffuser) may reduce airline flammation .

Bronchitis

• Acute or chronic inflammation of the bronchi.
• Mucosal oedema, infiltration with macrophages and neutrophils.
• Hypertrophy of bronchial glands and smooth muscle.
• Irreversible scarring of the airway walls, which leads to reduced airflow
• Hacking, unproductive cough
• Fever, sore throat, shortness of breath, headaches, blocked nose
• Reduce bronchial irritants by smoking avoidance, smoky conditions, environmental irritants, reduce/avoid sugar, salt, saturated fat/dairy based (cows and wheat).
• Diet includes high allergens and histamine rich foods.
• Natural dietary aid includes the CNM Naturopathic Diet such as warm soup, adequate herbal fluids / teas.
• Ensure adequate fluid intake for broth.

Bronchitis Supplements

• Follow the principles of the CNM Naturopathic Diet. The diet should consist of:
• Easy-to-digest foods, such as soups.
• Adequate fluid intake, ensure you have sufficient water, herbal teas, juices, and broths.
• Mucolytic foods (change the viscosity of mucus for the purpose of aiding in its expectoration from the body), such as garlic and onions
• Catarrh-reducing ingredients, such as horseradish.
• Ginger, which reduces inflammation and is an antiseptic.
• Bromelain (from pineapple), a proteolytic enzyme, which will also decrease airway inflammation. It is mucolytic, and has the potential as an antiviral agent.
• Acute bronchitis, which is associated with a weak terrain and subsequent immunity aid through thyme. Finely chop 1 onion and 2-3 sprigs of fresh thyme, and cover with Manuka honey.
• Oinions contain immunity that supports,sulphur aids mucolytic.
• Thyme aids as antimicrobial/expectorant,Manuka reduces honey and inflammation.
• Vita A(5,000) Maintains secretion membrane helps with muscillary movement as well.
• Enhances/interukin2 + redu. lung inflame

Chronic Obstructive Pulmonary Disease

• COPD = a chronic inflammatory response of the lungs causing airflow limitation due to airway and functional lung tissue damage that is progressive and not fully reversible.
• Combination of emphysema and chronic bronchitis.
• Emphysema: Dilation of alveolar sacs by destruction of alveolar wall, leading to collapse of alveoli during expiration = breathlessness.
• Chronic bronchitis: Inflammation and thickening of bronchial lining with mucus hyper-secretion = cough and wheezing.
• Causes & Risk Factor smoking exposure over time.
• Treat through Smoking cessation.
• Cigaratte toxin to intimate effects through (inflammatory to epithelial cells).
• Healthe weight managment for overwheight and aid heart.
• With that is associated a weight loss aid w/ physical movement help/sarcopedia.
• Add nutrient include diet that have bad effects to the immuno system.
• Help the breathing by help haemoglobin, reduce intake and add nutrients into it . Increase fresh food such as jiuce.
• Add fruits and add kitchen and warm aid in energy with omegas as the protein is essentail.
• Add Vitamin D into with low A & E and into byo as they the utilization increases.
• Increased oxidative stress during disease
• Increase fat into with N3 with to increase the the bonds mucus into the system along with the flow and bacteria.
• Add the mushrooms for high pathogens w/ B Lymph cells and tonal energy, improv with a exercise tolorane.

Integumentary System

• The skin, hair, nails, sebaceous and sweat glands and sensory receptors form the integumentary system.
• The skin acts as a barrier against chemicals, pathogens and other substances.
• The integumentary system plays a major role in detoxification via the excretion of waste products.
• Any underlying organic problems e.g. liver, kidneys, lungs or gut can manifest in dysfunctions of the skin.
• Any underlying dysfunction, such as toxic overload, must be considered when seeking to address common skin disorders including acne, eczema, rosacea and psoriasis.

Acne Vulgaris

• Inflammatory skin condition characterized by excess sebum production, follicular hyperkeratinization of sebaceous ducts, and follicular colonization by Cutibacterium acnes, Acne more likely affects skin with dense sebaceous follicles, primarily on the face but also on both the chest and back.
• Commonly affects adolescents: incidence decreases with age more common in males due to sensitivity to androgen hormones.
• microbial colonization involved (w/ acnes).
• Clinical presentation: (pimples).
• Dome shaped form through Sebum with formation below deeper.
• Low self-esteem linked to anxiety or depression.
• Hormonal/androgen increased.
• Most of them stem from by testosterone / abundance.
• Activity of alpha reductase increases the activity which then insulin and zinc.

Factors of acne culgairs

• Increase with stress,PCOS-like insulin
• Insulin Resistance and production.
• Genetics and insulin levels linked w acne and lead to obesity

Approaches of Acne

• Infulence with vitamin and microbiome and autoimmunity overalap w food and levels DHT and proliferations
• Treatment needs clear Dampness and food, a manifestation (heat) and dampness
• Location is linked with the with face

Dietary & Prevention Approaches

• Dietary plays the key role in the process and what not to include:
• To avoid increase of risk over intake with refined gains or alcohol from a glycaemic level.
  • And to balance fiber
• Decrease omega with zinc
• Increase intake of water.
• Supplement to the body for collagen with barrier properties