As the world’s best winter athletes compete in PyeongChang for the 2018 Winter Olympics, the heavy demands of training and competition will leave many with respiratory problems.
Exercise-induced asthma is the most common medical problem among Winter Olympic athletes, especially cross-country skiers. Almost 50% of these athletes suffer from this disease, closely followed by short track speed skaters at 43%. For figure skaters it’s 21%, Nordic combined it’s 17% and for ice hockey it’s 15%. By comparing, about 9% of the general UK population suffers from asthma.
The combination of sustained high breathing and cold, dry air increases the risk of asthma-related illnesses in winter athletes. (Indoor speed skaters also have to deal with increased pollution in the form of particles from ice resurfacing vehicles.) Cross-country skiers, for example, increase their respiratory rate by about six liters per minute at rest at 180 liters per minute during a race. This huge increase in breathing causes large volumes of cold, dry air to be drawn into the lungs. This can lead to narrowing of the smooth muscles of the airways, which reduces the ability of athletes to breathe normally.
This happens through two processes. The first concerns the airways become dehydrated which causes a release of inflammatory cytokines – messenger molecules that cause the airways to narrow and become inflamed.
The second process involves respiratory heat loss which results in narrowing of the airways by nerve stimulation. When the athlete stops exercising, the airways narrow further by dilation of the blood vessels as the the airways warm up again.
Although we know that exercise-induced asthma is common in winter athletes, it can be confused with other conditions, such as dysfunctional breathing patterns and exercise-induced laryngeal obstructionwho have asthma-like symptoms.
If an athlete is diagnosed with exercise-induced asthma, they are usually given the standard asthma treatment: an asthma preventer inhaler containing steroids. It works by reducing inflammation and sensitivity in the airways, helping them to breathe. However, athletes should be careful about the type of inhaler they use as certain drugs – such as salbutamol – could put them at risk of an anti-doping violation.
In addition to using medications to treat exercise-induced asthma, athletes can supplement their inhaler therapy with:
Face masks against heat and humidity: Face masks worn during training and before competition are able to capture heat and moisture from exhaled air and use it to warm and humidify inhaled air like a defense against airway dehydration and subsequent narrowing.
Fish oils: Studies suggest that the use of omega-3 fish oils may reduce airway inflammation and provide a protective effect against exercise-associated asthma.
Prebiotics: Recent evidence suggests that a prebiotic dietary supplement that targets good bacteria in the gut may reduce asthma severity in physically active asthma patients and reduce airway inflammation.
Winter athletes with exercise-induced asthma can use an inhaler alone or in combination with one or more of the above treatments. By doing so, athletes can maintain the health and function of their airways, allowing them to compete without compromising their performance.