What’s behind the “asthmatic advantage”?
Asthma seems like a pretty huge disadvantage for any athlete, and the last thing anyone wants in the middle of competition is a lot of huffing and puffing. So it might surprise you to find out that not only is there a much higher percentage of Olympic athletes with asthma than in the general population, but those afflicted are historically twice as likely to win a medal.
The phenomenon is known as the “asthmatic advantage,” and doctors aren’t sure how exactly the correlation came about.
“It’s not clear if somehow people with asthma have an advantage, or if there’s something about really high level sports that makes you get asthma,” said Dr. Tod Olin, pediatric pulmonologist at National Jewish Health in Denver. “The second one is probably more palatable of a theory.”
Olin said that about eight percent of the general population suffers from some measurable amount of asthma, but that number more than doubles in elite level aerobic athletes. The rates tend to be highest in cold, dry air sports like skiing and hockey.
The prevalence of the illness among winter athletes is likely caused from prolonged stress on epithelial cells inside the lungs, the same cells that trigger swelling and muscle contractions during an asthma attack.
“If you’re a six-foot-tall guy doing an aerobic sport there’s going to be about 180-to-200 liters of air going in and out of your lungs every minute,” said Olin. “It stresses out the cells, and the cells start sending these signals. If you do that over and over again for months and years it develops this problem that for all the world looks like asthma.”
Even stranger is that it’s common for athletes who developed asthma through their training to lose the condition once they retire, a rare occurrence in the general population.
So why do asthmatic athletes seem to have a greater correlation with success?
There’s more than one possible answer, and it probably stems from a combination of variables. But the simplest and most likely scenario based on observational data is that it’s primarily the athletes who are training harder over a longer period of time that are developing the illness. In other words, becoming an elite level athlete may lead to asthma, and not the other way around.
“These people are actually pushing themselves a tiny bit harder, and they might be stressing their airway more and developing the condition,” said Olin.
But there may also be a mental aspect to phenomenon as well. Olin theorizes that athletes with a pronounced vagal response system, part of the parasympathetic nervous system that helps slow the heart after an adrenaline rush, will perform better under pressure.
The vagal system’s participation in the regulation of airways helps to provide some potential answers to why there is some correlation between developing asthma and boasting a strong vagal response.
“Pronounced vagal responses will have a tendency to lead to asthma, but might be beneficial from a performance perspective. The problem is we’re not quite there yet with the science.
“In theory you could train at it, but it would be the type of training that Yoda and Luke Skywalker were doing. A lot of athletes work with performance psychologists, but really proving that you have a more relaxed response is a very hard thing to do. I think people who are high end athletes absolutely see the power of the mind as something that can fluctuate. And when you’re able to drive it in the way you want you have an advantage. But proving that is tricky.”
While research into the “asthmatic advantage” is still in its relative infancy, with doctors and scientists giving their best guesses as to the nature of the correlation, Olin believes the what is much more important than the why or how.
“To me the big message to people out there is that there are international level athletes winning with asthma. So if you have it you can go run around the block. That’s the big thing.”
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