New Delhi: World Asthma Day (WAD) is organised by the Global Initiative for Asthma, (GINA) (www.ginasthma.org), a World Health Organization collaborative organisation founded in 1993. WAD is held each May to raise awareness of asthma worldwide. GINA has chosen “Asthma Care for All” as the theme for the 2023 World Asthma Day.
What is asthma?
“Asthma is a lung disease commonly seen in people of all age groups. Here, one’s airways get narrow and swollen and are blocked owing to excess mucus. This condition affects millions of people in the country and can become fatal if one doesn’t seek timely intervention. The factors causing asthma are allergens, pollen, dust, molds, pet dander, perfume, fumes, chemicals, air pollution, respiratory infections, second-hand smoke, family history, certain medications, stress, exercise and cockroaches and even mice,” Dr Sushant Meshram, Prof and Head, Dept Of Pulmonary, Critical Care And Sleep Medicine at Nagpur’s Govt Medical College told HT Lifestyle.
India has 17 per cent of the world’s asthmatics
India is home to over 30 million asthmatics, accounting for nearly 17 per cent of the world’s asthma burden. India also contributes to a disproportionate 43 per cent of the world’s asthma deaths. This is because of underdiagnosis, wrong diagnosis, and wrong treatment. “Denial of the diagnosis, lack of knowledge, along with myths, misbeliefs and social stigmas associated with asthma and its treatment, aggravate the problem. Moreover, there are highly effective treatments but very few take the right treatment and do so regularly. Inhalation therapy is the safest, fastest and most effective treatment for asthma. However, less than 10 per cent of asthmatics in India use it regularly,” Dr Sundeep Salvi, Director of the Pulmocare Research and Education (PURE) Foundation chest clinic in Pune told The Indian Express (TIE).
Asthma is linked to obesity
According to GINA, which releases the annual strategy report on World Asthma Day every year, obesity increases both the prevalence and incidence of asthma and worsens asthma control. According to Dr Salvi, who is a member of the global scientific committee of GINA set up by the WHO, the National Institute of Health, and the National Heart, Lung and Blood Institute, USA, the first study on the subject was done in India in September-October 2021. It had shown that overweight and obese children had a 79 per cent greater risk of asthma than healthy children.
It is difficult to treat obese asthmatics
Obese asthmatics generally respond poorly to inhaler medication that is otherwise very effective in non-obese individuals said Dr Salvi. Dr Jayashree Todkar, bariatric and metabolic consultant and surgeon told TIE that obesity treatments are not just about regulating inches or kilos. According to her, all system improvements that have been impacted by obesity need to be done. Scientific-based treatments like bariatric surgery resolve asthma in more than 70 per cent of patients.
Obesity is strongly associated with chronic fatigue and breathlessness/shortness of breath on even a small amount of exertion. “Obesity-induced hypoventilation is a multifactorial syndrome found commonly in patients with central obesity (waist circumference > 100 cm in men and >90 cm in women ) and/or Body Mass Index of > 33kg/m2.
High intra-abdominal pressure, the inability of the lower lobes of the lungs to fully expand, associated hypertension and preload on the heart are mainly the causative factors. A particular feature of central obesity is acid reflux or gastroesophageal reflux disease (GERD) which leads to recurrent irritation of the throat, spillover of acid into the trachea and then causing an intractable cough and irritation of the breathing pipe. Many label it incorrectly as bronchial asthma but it fails to respond unless the causative central obesity is treated scientifically. Hence proper assessment of asthma in obesity is required,” Dr Todkar adds. According to studies, there are an estimated 135 million people in India who have general obesity, 153 million have abdominal obesity and 107 million have combined obesity
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