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Asthma 101 The frequency of symptoms ranges from "once in a lifetime to many times a day," says David Rosenstreich, MD, chief of the allergy and immunology division at the Montefiore Medical Center in the Bronx, NY. How often you experience symptoms depends on the severity of the disease, environmental factors and how you manage the disease. While a number of strategies can help manage asthma, about half of people with the disease don't have their condition under control, according to the American College of Emergency Physicians. Consequently, about 12 people die from asthma every day. "Even with relatively mild asthma, you can experience a life-threatening response to an allergen," says Mike Kaliner, MD, medical director at the Institute for Allergy Asthma, and clinical professor of medicine at the George Washington University School of Medicine in Washington, DC. Although asthma most commonly develops in childhood, you can start to experience symptoms at any point in your lifetime. A number of factors increase your asthma risk, including gender, environmental factors (such as pollution) and genetics. If you have a parent with the disease, you are up to six times more likely to develop the illness. Obesity can also increase your asthma risk. A 2007 report in the American Journal of Respiratory and Critical Care Medicine said that the disease is 92% more common in people who are obese. While the relationship between asthma and weight is not completely understood, more weight on your chest may make it harder for it to expand and create difficulty breathing. Obesity may also increase inflammation in the body. This, in turn, can aggravate the inflammation of the bronchial tubes associated with asthma. Allergies also increase your risk of developing asthma. For example, children who have eczema or food allergies are more likely to develop asthma. Hay fever, or allergic rhinitis, also increase your chances of developing the disease. So does sinusitis, or sinus infections. In fact, more than half of people with asthma have chronic sinusitis. Although the relationship isn't completely understood, people with gastroesophageal reflux disease ( Airway hyperresponsiveness - in other words, twitchiness of the smooth muscles in the bronchial tubes - is also associated with increased risk. These smooth muscles are supposed to be relaxed, and airway hyperresponsiveness decreases the diameter of the bronchial tubes making breathing more difficult. Smoking, being exposed to secondhand smoke, or living near highways, where you are more likely to breathe in car exhaust, also increases your risk of developing asthma. So does living in the inner city, where you are exposed to allergens such as dust mites, mold or the droppings or body parts of cockroaches or mice. If you already have asthma, you'll want to know what can trigger a symptom flare-up or asthma attack. Some of the conditions that can increase your risk of developing the disease can also act as triggers of asthma symptoms. For example, GERD or acid reflux, as well as sinusitis can make it more difficult to breathe and cause an asthma flare-up. The environmental factors that can increase your risk of developing asthma can also trigger asthma symptoms for existing suffers. Exposure to dust mites, pet dander, cockroaches, mold, cigarette smoke and other types of pollution can all trigger an attack. Fluctuations in stress hormones can also put you at risk for a flare-up. "This is why under emotional distress some people can work themselves into having an asthma attack," explains Michael B. Foggs, MD, chief of allergy, asthma and immunology for Advocate Medical Group of Advocate Health Care in Oak Brook, IL, and a fellow of the American College of Allergy, Asthma Immunology. While exercise is an important part of maintaining your overall health, physical activity that causes you to breathe harder can also trigger your asthma. You can make this worse by exercising in the cold. Fortunately a number of strategies can help you manage your asthma so you can enjoy physical activity. For more information, see related article on . Obesity can make symptoms worse In addition to these triggers, you should also be aware that obesity can make your asthma symptoms worse. People who are obese usually don't exercise as much as those of a healthy weight. Consequently, "their lungs are not conditioned as well, and they are less able to tolerate an asthma flare-up," says Dr. Foggs. "It's clear that being heavy is bad for asthma," agrees Dr. Rosenstreich. For example, one study found obese people with asthma were five times more likely to be hospitalized for the condition as people with asthma who were at a healthy weight. "For people who are overweight but not obese, the data are not as clear, but the extra pounds probably have an impact on their asthma as well," adds Dr. Rosenstreich. Fortunately, in addition to losing weight, you can take a number of steps to better manage your asthma, including seeing a specialist and controlling environmental factors. For more information, read .

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