Answers: (1) They all suffer from asthma. (2) Their condition hasn’t kept them from attaining excellence in their sports.

And the good news is that what world-class athletes and their doctors have learned can be applied by anyone with asthma who likes to participate in sports. Whether you are a high school point guard or a club tennis player, you can take action to minimize the chances that an asthma attack will stop you in the middle of a game or, worse, land you in the hospital.

Exercise and Asthma

An asthma attack brought on by activity is known as an exercise-induced bronchospasm, or EIB for short. It is axiomatic that most asthmatics who play sports or work out vigorously have had or will have EIB at one time or another. But many people who have not been diagnosed with asthma may also experience EIB. According to Dr. Gilbert D’Alonzo, director of the Airways Disease Center at Temple University School of Medicine, asthma in general, and EIB in particular, is “the Rodney Dangerfield of diseases. It gets absolutely no respect.” Dr. D’Alonzo says that asthma, not head and neck injuries, is the leading playing-field killer. Ted Quedenfeld, director of the Exercise-Induced Asthma Research Center, also at Temple, cites a Research Center study that followed 21,000 high school athletes from 1996 to 1999. “We documented 62 asthma-related deaths. None of those kids should have died.”

What to Watch For

The cool-down period after a game or workout is when EIB is most likely to occur. Symptoms include wheezing, coughing, and chest congestion and tightness. Many sufferers feel lightheaded; a few are unable to take a deep breath. The absence of obvious breathing problems, however, is not enough to rule out EIB. Sometimes, the first sign of trouble is an athlete complaining of “just not feeling right.”

Aggravating Factors

Existing medical conditions–chronic asthma that is not under control, a respiratory tract infection, a history of allergies, and even poor general health–may contribute to EIB. Where and when you work out is important: Polluted air and cold, dry air are potential irritants for people susceptible to EIB. The kind of exercise you are doing is also important. The activity most likely to induce EIB is outdoor running (for example, football, soccer, or fast jogging). The least likely is pool swimming. In between, from more to less aggravating, are treadmill running, cycling, and walking. So instead of running during rush hour on city streets in subfreezing weather, try summer cycling in the park, or play indoor tennis.

What to Do

The treatment goal for people with EIB is the same as for athletes who suffer from chronic asthma: full participation in their sport or workout of choice at a good performance level without breathing problems. The following list of Do’s and Don’ts for high school athletes with asthma is partially based on guidelines issued by Asthma Watch, a national initiative sponsored by the Temple University Sports Medicine and Pulmonary Critical Care units. It is equally valid for the intermittent exerciser:

• If you have chronic asthma, you and your physician must have worked out a program of medication that has stabilized the condition. Quedenfeld, one of the developers of Asthma Watch, says that “an athlete with asthma who has to resort to rescue medication more than once during an exercise session, or more than three times a week, is unstable and needs to see his or her doctor for reevaluation.”
• Give yourself time to warm up properly. A number of studies have shown that short, intense exercise bursts during warm-up decrease the risk of EIB. If the outdoor temperature is very cold, however, you may want to warm up at a lower intensity than you would in warmer weather, and preferably indoors.
• Make sure your inhaler is within easy reach during exercise, play, or practice.
• Take two puffs of a short-acting airway relaxer 15-20 minutes before beginning your workout. [Dr. D'Alonzo recommends albuterol, but says that a longer-acting airway relaxer (salmeterol) should be used when a workout is likely to last for hours. For example, kids at a sports camp who will be playing three or four games in the course of 1 day need the longer-acting medication.]
• Never skip your cool-down–and take your time doing it!

Beating EIB: The Key Is Education

Both Dr. D’Alonzo and Quedenfeld agree that the key to success in the fight against EIB is EDUCATION–getting the word out nationally to parents, athletes, physicians, coaches, and athletic directors. The Asthma Watch Guidelines are being used by high school athletic departments throughout the Philadelphia area as well in as other parts of Pennsylvania, Delaware, and New Jersey. Even the National Football League is taking notice, says Quedenfeld, and is considering adapting the Temple program for use by NFL players.

This article was reviewed by a physician who practices in the Division of General Medicine and Primary Care at Beth Israel Deaconess Medical Center, Boston, and is a faculty member of Harvard Medical School.

The future of drug testing in sports could call for much higher technological intervention to detect performance-enhancing drugs. The International Olympic Committee’s World Anti-Doping Agency (WADA) predicts that gene therapy will be the next big thing among those athletes willing to do anything for the gold.

“It certainly is possible,” says Inder Verma, PhD, president of the American Society of Gene Therapy. “You could take growth hormone or [hormones to accelerate the production of red blood cells i.e.] erythropoietin (EPO) from [a person's] cells and deliver it to the same person. Whether this is going on now, I don’t know, but it is perfectly possible.”

Useful research may be hijacked

As medical research untangles our genetic code in a noble attempt to understand and cure disease, healthy but unscrupulous opportunists may stand poised to exploit the findings. It’s certainly not a new concept. Athletes have been manipulating medical knowledge to their advantage since long before steroids came into vogue. The current trend among would-be Olympians involves injecting strength-enhancing human growth hormone (hGH) to pump up muscles or endurance-boosting EPO to super-oxygenate the blood.

Controversy has been surrounding drug testing at the Sydney Olympics. Who should be tested? Who should pay for it? Does it really work? “Growth hormone is very hard to detect already,” says Verma. But for the most part, blood and urine tests (albeit highly sensitive, expensive ones) can and do weed out those who’ve ingested or injected illegal substances.

“The reason they can check for EPO now,” says Verma , “is that the version synthesized and sold [is slightly different] than EPO [naturally produced in the body]. This causes an antibody reaction and makes it distinguishable.” But when a person’s own genes are delivered, and the athlete’s body then produces more of the performance-enhancing factor, it’s a very different story.

How the hijacking can work

“If someone is absolutely bent upon doing it,” says Verma, “I’ve racked my brain and posed the question to colleagues, and I can’t come up with a way to detect it. If you take a gene for producing EPO and put it into the athlete … the protein produced would be no different than the [person's own] protein. It would be exactly the same.” Exactly the same — and thus completely undetectable.

Even high-tech molecular tests like PCR would be worthless unless you knew the gene delivery site, says Verma. Essentially, you’d need a full-body PCR, Verma says. “You could inject the gene in any number of places — the muscle, the big toe, the liver, the lung, anyplace. And you could only detect it if you know where [it had been injected]. The genetic ‘message’ is not in the blood. The only thing we could detect in serum is that the person has more EPO [than normal].”

You may smell a rat but not find it

That might be suspicious, he says, but it isn’t entirely unusual. Even in a couch potato, infections can dramatically increase red blood cells, as can traveling from low to high altitude. If somebody wanted to cheat using EPO, says Verma, there are numerous seemingly legitimate excuses to explain an usually high level. And officials would be hard-pressed to disprove them.

Right now, hGH and EPO are the most likely candidates for gene therapy abuse, Verma says, but he doesn’t rule out a host of as-yet-undiscovered agents. Researchers “could [identify] an enzyme that would give a greater degree of stamina by reducing the heart rate and allowing you to breathe more oxygen in, for example,” he says. As the Human Genome Project unfolds, the list of potential performance-enhancing genes is bound to grow.

For that knowledge to become a doping tool will, of course, require collusion on the part of the medical community. Unfortunately, concedes Verma, “this happens all the time. In East Germany, when they started doing doping with steroids, it was clearly done by doctors.” That might be ascribable to a totalitarian government, he says, “but in a capitalistic society, doctors might do it for the money. We’re no different than [anyone else].”

The message that tobacco kills is not very relevant to the youth of the day who believe in their immortality. Attractive advertisements and exciting tobacco promotions are difficult to resist, especially when the cigarette cost is affordable. In a survey done by JAMA (Journal of American Medical Associations) the majority of the people questioned replied that they do not see themselves smoking after 5 years. But after 5 years it was found that the majority of them were still hooked to smoking. Almost all answered no, when asked,”will they be smoking if given a second chance?” This shows the addictive power of cigarettes.

Some figures

The WHO report on the projection of smoking related illness is frightening.

By 2020, it is expected to kill more people than any single disease. Although the number of smokers is falling in the developed countries they are being compensated by the increase in numbers in the developing countries.

Lungs are not the only ones

If you think that lungs are the only organs that are affected then you are way off the mark. The damage starts right from your mouth to your voice-box down to the wind pipe and smaller airways and then the lungs. Smoking affects normal digestion and makes the gastrointestinal disorders worse. It delays healing of ulcers and has the tendency of making them chronic. The buck does not stop here; the other organs affected by smoking are pancreas, heart, and bladder. Men who smoke may suffer from impotence due to damage to the blood vessels in the penis.
Many women who smoke are less fertile than nonsmokers. They take longer to conceive and are more likely to have a miscarriage

Smokers are not invited

Heard about ETS it stands for Environmental Tobacco Smoking. In simple language it reads “everyone around tobacco smokesï”. It has been conclusively proved that second hand smoke is as damaging as the smoke inhaled directly from the cigarette. Countries like Singapore have banned smoking in public places.

Oh that “one little” cigarette

You probably heard about the nicotine and tar of the cigarette. But did you know that cigarette smoke also contains 4000 chemicals and 43 carcinogens.

Tobacco leaves its mark on you. Tobacco smoke can make hair and clothes stink. Tobacco stains teeth and causes bad breath. Short-term use of spit tobacco can cause cracked lips, white spots, sores, and bleeding in the mouth. It also affects our athletic performance; the smokers pant almost 3 times more than non-smokers.

In order to find the percentage of fat calories in any given food, you need to do some math. Each fat gram gives you nine calories. To determine the percentage of fat calories, multiply the fat grams by nine, and then divide by the total number of calories. For example, if one serving contains 100 calories, and five grams of fat, your per cent of fat calories is 45 (5 grams X Calories = 45 fat calories, divided by 100 = 45). If this is too complicated, several companies now offer slide-rule or wheel devices that give you this figure without computation. Although less accurate, you can try counting grams. A rough average is 22-30 grams of dietary fat per day. Over 30 grams and you are probably eating too much.

Due to the epidemic of heart disease in India, you should definitely have a blood serum test. If one or more of the following risk factors apply to you:

Too much of anything makes you fat

Fat is the worse culprit in our diets, but don’t think that counting fat calories clears the road for you to eat all the carbohydrates or protein calories you want. Carbohydrates, simple or complex, and protein can all store themselves as fat when eaten in quantities over and above what you require to fuel your daily activity.

Alcohol is another deceptive fat maker. If you read nutrition books, you’ll see that most alcohol contains no fat. But the simple sugars convert in your body and the calorie count skyrockets!
Good nutrition requires you to limit fat, avoid saturated and trans fats, and keep your total calories consumed in line with your caloric expenditure.

Role of Dietary Fat and Fibre in Weight Management
Several epidemiological studies have shown that overweight individuals eat less or as much as normal individuals. We are consuming less calories compared to our intake at the turn of this century. Even then the incidence of obesity is increasing. Hence we cannot view obesity solely as being due to consuming too many calories.

In the last five decades a changing trend is emerging in industrialized nations and affluent societies in developing countries. The total fat consumption is increasing and that of carbohydrates is creasing. There are well documented studies to show that as the per cent of fat increases in the diet, there is an increase in the tendency for obesity even if the total calorie intake remains the same, i.e., if the same number of calories are taken as carbohydrates and fats then an individual with the carbohydrate intake is less likely to develop obesity.