No community in the United States has more people with more health problems than Tutwiler, Mississippi. A community of about 2,000 people situated at the crossroads of state highways 49 West and 49 East, Tutwiler sits surrounded by thousands of flat acres of genetically modified corn and soybeans, rice, and cotton. The treeless landscape of crops is broken only by the walls of razor wire around Tutwiler Women's Prison, the home of Mississippi's death row. The weather is dependably hot and humid much of the year, and if environmental contamination doesn't get you from the ground or the water, it will fall on you from the sky. Tutwiler deserves its reputation as the birthplace of the blues.
That's what happened to family treated by Tutwiler's only physician, Dr. Ann Brooks, who is also a Catholic nun in The Sisters of the Holy Names (SJNM). "There are a lot of factors here," Dr. Brooks said. "The factor of the overhead pesticide spraying. The household smoking. The household smoke from wood stoves. Cockroaches. Dust mites. Precipitous births of underweight babies with underdeveloped lungs. Lint from the cotton gin."
In our conversation in Tutwiler in April 2004, Dr. Brooks recalled treating one family whose house stood amid frequently treated farm fields. The entire family had asthma. Asthma episodes often are triggered by sudden anxiety or agitation, and on one occasion when a farm plane accidentally dumped a load of seed rice directly onto the tin roof of the family's house, "the entire family suffered asthma attacks," she said.
Another factor in the high rates of asthma in Tutwiler is the absence of food choices. There is no grocery store in Tutwiler, although one can buy fried chicken at the Shell station near the intersection of 49E and 49W, and chips at the Arco station at the north edge of town (at the time I visited the station, its only stove was out of order). There is a convenience store five miles (8 km) away, and a market about 20 miles (32 km) away in Clarksdale.
Interestingly, the Kentucky Fried Chicken restaurant in Clarksdale, run by Tutwiler resident Loretta Hill, serves a buffet of exceptionally fresh and delicious vegetables as well as its fried fare, but many residents of Tutwiler never travel that far away from home, because they do not own cars. The great benefit of Tutwiler to the rest of the world is that conditions are so bad that it is easy to see the greatest results from the smallest dietary change.
One of the questions being considered in nutritional research in Tutwiler is whether reducing consumption of salty foods (in this case, just reducing the amount of salt used to cook fried chicken) reduces incidence of asthma. For many years, scientists speculated that a high-salt diet might actually protect against asthma. There was ample evidence that high levels of sodium preserved in the bloodstream preserved catecholamines, that is, the stress hormones. These hormones aggravate heart problems but help keep the bronchial passageways open.
Researchers also found that, in the test tube, a low-sodium, low-pH environment greatly increased the activation of eosinophils into lung tissues. Eosinophils are the white blood cells that trigger asthmatic attacks.
If the concentration of sodium in the test tube medium was decreased just 25 percent, from 160 mEq to 120 mEq, eosinophil activity increased 1000 percent. If at the same time pH was lowered from 7.6 to 7.0, eosinophil activity increased 2000 percent. These results seemed to suggest that a high-salt diet, combined with an alkaline diet (a diet rich in fruits and vegetables and low in sugar and fat), could greatly reduce the activation of the white blood cells that cause asthma.
These findings, however, are an example of how lab results don't always apply to the human body. While the human body can operate with sodium levels as low as 120 mEq and as high as 160 mEq, both extremes are associated with serious, life-threatening illness. It is not normally possible to raise one's sodium levels high enough to have an effect on asthma.
Moreover, if the bloodstream concentration of sodium in a real, living human being could reach the levels the researchers believed would stop immune responses, the excess sodium would cause pH inside the cell to go down, not up. Excess sodium disables the proton pump that normalizes the acid-base level inside the cell.
What you can do about asthma? For asthma and other forms of chronic obstructive pulmonary disease, a good recommendation is a low-sodium (restricted salt), "alkaline" (low in sugars and fats), high-potassium (high in fruits and vegetables), diet with plenty of water, but it's important to tailor any diet plan for asthma to individual considerations. Let's start with the easiest.
Asthma and related conditions respond to the amount of water you drink. While nutritionists ordinarily recommend 8 cups (2 liters) of water a day for most conditions, for asthma 8 glasses (4 liters) of water every day is better.
Why drink water if you have asthma? Some of the medical literature suggests that dehydrated cells in the linings of the bronchial passageways are especially susceptible to inflammation and rupture by white blood cells. Proper hydration will not prevent asthma attacks not related to exercise, but it may greatly reduce their severity.
What about restricting salt? There is general agreement in the medical literature that people who have exercise-induced asthma benefit from sodium restriction. During heavy exercise, muscle cells burn glucose without oxygen. This causes a buildup of lactic acid, the "burn" from heavy exercise. Muscle cells get rid of the "burn" by exchanging protons and sodium. If they contain excessive amounts of sodium, they cannot get rich of the "burn." Distressed chest muscles may trigger an asthma attack.
If you have mild asthma and you do not regularly use an inhaler, you only need to restrict your consumption of salty foods if your asthma is worst when you exercise. If your asthma attacks seem just to come and go without any particular trigger, and you do not use medication, it is possible that avoiding excessive salt consumption, just not using salt at meals. This could reduce wheezing, mucus formation, and shortness of breath, even if you eat the same foods as the rest of your family.
On the other hand, if you do take steroids, limiting your sodium consumption to no more than 2,500 mg a day will help prevent side effects from your medications. Three other nutrients, however, are helpful to everyone who has asthma.
Magnesium relaxes muscles. Intravenous magnesium sulfate is part of standard treatment for severe asthma in the emergency room, and often begins to relieve symptoms as soon as it is administered. It is preferable, of course, to take magnesium before emergencies arise.
A large British study of dietary magnesium intake and asthma symptoms in 2,633 people found that asthmatics who had a greater dietary intake of magnesium had a significantly greater lung capacity and significantly less airway hyperreactivity. They could breathe deeper and their airways more relaxed.
It's important to remember that taking magnesium just for a few weeks will not reduce your need for an inhaler, because the body pools magnesium very slowly.
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