Newsletter Article

The Impact of Asthma on Daily Physical Activity

January 2017

Asthma is a chronic disease that causes the airways in the lungs to be inflamed.[1] Different triggers can exacerbate this inflammation and cause the muscles around the airways to contract, making it difficult to breath. Asthma can negatively affect an individual’s physical activity levels, even if their condition is considered to be stable.

Daily step counts were measured in stable asthma patients, both severe and mild-to-moderate, and healthy control subjects.[2] Even though they were considered stable the severe asthma group had significantly fewer steps per day over a one week period compared to the mild-to-moderate asthma and healthy groups. Even if someone has a stable condition and has their asthma “under control” it may still affect day to day activity levels.

A condition known as asthma COPD overlap syndrome (ACOS) occurs when a person has clinical features of both asthma and COPD.[3] A small study evaluated activity in COPD patients and compared the results to ACOS patients. The ACOS patients were actually more active than the COPD patients. They had higher levels of daily life physical activity (DLPA) at 5,428 steps per day, and also performed them at higher intensities. This shows that having combined respiratory issues does not mean that a person can’t obtain reasonable levels of activity.

Activity levels in young children could be an indicator of asthma at an older age. A long-term study examined the relationship between BMI and physical activity, and atopic diseases.[4] Children who obtained low levels of physical activity at 3-6 years and 6-10 years were positively associated with asthma by 10.8 years. These low levels at an early age may indicate asthma development later in life.

For adults with uncontrolled asthma, a study examined if an intervention targeting modest weight loss and increased physical activity would affect their asthma symptoms.[5] At the start of the study, all of the subjects were obese and had uncontrolled asthma. Compared to the control subjects, the intervention group had significantly greater weight loss and increased leisure-time activity. The between-treatment differences were not significantly different for the Asthma Control Questionnaire results. This shows that weight loss may not affect asthma symptoms more than other interventions, but it also shows that increasing activity and achieving weight loss is feasible and safe for uncontrolled asthma patients.

Asthma affects a large number of people, but is under-researched compared to other diseases like COPD and heart disease. More research is needed to understand preventative and treatments options for asthma.

Winter Squash

Winter squashes are a family of vegetables known for their thick, hard shells, mildly sweet flesh, and seed-filled inner cavities.[6] Some common winter squashes are butternut squash, acorn squash, hubbard squash, turban squash, and kabocha squash. The types of squash that we recognize today originated in an area between Mexico and Guatemala. They were originally cultivated for their seeds because early squashes contained very little edible flesh. Today, the largest winter squash producers are China, Japan, Romania, Turkey, Italy, Egypt, and Argentina.

Winter squashes are high in antioxidants and offer several other important benefits. Animal studies have shown improvement in blood sugar and insulin regulation after intake of winter squash. This is attributed to the polysaccharides it contains, as well as an important compound called d-chiro-inositol, which has been shown to help regulate blood sugar levels. Blood sugar regulation is also tied to our supply of B-vitamins, and winter squash have a good amount of five different B-complex vitamins. Winter squash seeds are rich in protein and contain linoleic acid, an omega-6 fatty acid, and oleic acid, an omega-9 fatty acid. Squash seeds are a healthy snack, but it is best to lightly roast them for a short period to preserve the nutrients.

When selecting a squash, the rind should be hard to the touch with a dull, not glossy appearance. Avoid squashes with any sign of decay. Once they start to decay, they do so at a rapid rate. Winter squashes can be stored for a much longer period than summer squashes. Depending on the variety, they can be stored between one week to six months.

Stuffed Turban Squash

1 (3 lb) turban squash
2 tablespoons butter
1⁄4 small onion, chopped
1 stalk celery, chopped
1 carrot, finely diced (optional)
1⁄2 lb pork sausage
1⁄4 cup soft breadcrumbs
2 tablespoons light brown sugar
1 teaspoon salt
1⁄2 teaspoon black pepper


Preheat oven to 350°F.
Cut the top off the turban squash, as you would for a jack-o-lantern type pumpkin.
Scoop out seeds and pulp and discard.
Place turban squash, cut sides down, on an oiled or foil covered baking sheet, and cover with more foil.
Roast for 50-60 minutes or until tender.
Scoop out tender pulp from cavity of squash.
In a saucepan, saute onions, celery, sausage and diced carrot in butter until vegetables are tender.
Drain any fat.
Mix in brown sugar, bread crumbs, salt, pepper, and cooked squash.
Stir until well-mixed.
Spoon filling lightly into the cavity of the turban squash, and cover with the top.
Place extra filling (if any) into a separate dish.
Bake squash and any extra filling for 20-25 minutes or until heated through.
Serve hot.

Recipe from

Knee Health for Runners

For many people, running may result in sore lower body joints, specifically the knees. It is often thought that running causes pain and inflammation in the knees. New research shows that this may not be the case. Recreational runners had synovial fluid extracted before and after a 30 minute run to measure specific inflammation markers.[7] Cytokine GM-CSF, which cause inflammation, actually decreased in levels from pre- to post-run. IL-15 was trending in a similar fashion as well. This helps show that running does not cause inflammation in healthy runners, and may even be beneficial for your knees.

A person with an acute knee injury has a higher likelihood of developing arthritis than someone without a knee injury. To determine if their knee joints respond differently to running, a study matched their inflammatory markers with healthy subjects.[8] The pre- and post-run biomarkers were not different between healthy and injured subjects. This may imply that biochemical responses do not change in acutely injured individuals, but other factors may lead to the development of arthritis.

A retrospective study helps to support this as well. Researchers used x-ray readings and assessments over a 10 year period and collected information on running habits.[9] There was not an increased risk of knee osteoarthritis for runners compared to non-runners.

For healthy individuals, running may not negatively affect long-term health of knee joints. However, individuals with knee joint issues may be affected differently.

Health Matters is written by Lindsey Guthrie, MS, RD, LD/N and Tyler Guthrie, MS, CSCS.


  1. American Academy of Allergy, Asthma, and Immunology. Asthma.
  2. Bahmer T, Kirsten A, Schatz F, et al. Physical activity in patients with asthma. 2016; 48(60): 1578.
  3. Postma DS, Rabe KF. The asthma–COPD overlap syndrome. New England Journal of Medicine. 2015; 373(13): 1241.
  4. Byberg KK, Eide GE, Forman MR, et al. Body mass index and physical activity in early childhood are associated with atopic sensitization, atopic dermatitis and asthma in later childhood. Clinical and Translational Allergy. 2016; 6(1): 33.
  5. Ma J, Strub P, Xiao L, et al. Behavioral weight loss and physical activity intervention in obese adults with asthma. A randomized trial. Annals of the American Thoracic Society 2015; 12(1): 1.
  6. The George Mateljan Foundation. Winter Squash.
  7. Hyldahl RD, Evans A, Kwon S, et al. Running decreases knee intra-articular cytokine and cartilage oligomeric matrix concentrations: a pilot study. European Journal of Applied Physiology. 2016; 116(11-12): 2305.
  8. Cattano NM, Driban JB, Barbe MF, et al. Biochemical Response to a Moderate Running Bout in Participants With or Without a History of Acute Knee Injury. Journal of Athletic Training. 2016; 51(5).
  9. Lo GH, Driban JB, Kriska AM, et al. History of Running is Not Associated with Higher Risk of Symptomatic Knee Osteoarthritis: A Cross‐Sectional Study from the Osteoarthritis Initiative. Arthritis Care & Research; 2016.

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