Salbutamol, asthma and the Tour de France’s missing marginal gain
When I was a kid no one knew what salbutamol was. Having been diagnosed as asthmatic aged four and given a salbutamol inhaler I got used to explaining to teachers exactly what I was puffing on in class, and why. Today, everyone knows what it is thanks to more asthmatics (UK asthma treatment prescriptions have almost tripled since the early ’70s), and the more recent media circus involving Chris Froome
What bears closer examination here however is pro cycling’s relationship with asthma, plus the free and legal marginal gain the entire peloton appear to have completely missed.
Asthma rates in cycling: over four times higher than normal
With 9% of the UK population having some form of asthma, it’s remarkable that 40% of cyclists have it. A lung impairment, even one well managed is hardly the ideal companion for a career in the toughest aerobic sport going.
But pro cycling’s a masochist’s game - it is this that attracts all the asthmatics who, keen to make a hard gig even harder, flock to the sport in search of pain and suffering like moths to a lightbulb?
Or maybe they’re simply that full of grit they just want to show their asthma who’s boss?
Fresh air as an asthma trigger?
There’s an alternative theory that the demands of pro cycling - a lot of heavy breathing outdoors basically - are a key asthma trigger.
But as amateur cyclists don’t appear to suffer the same asthma rates this one has a rather large questionmark over it. Fresh air is generally a good thing when you can’t breathe after all.
Fresh air, probably not that bad for asthma
The most likely explanation may also be the simplest
Pro cyclists take their lungs to the limit and are tested to a higher standard than the average Joe at the local GP. When tested this way in search of absolute 100% lung function, the chances of anyone registering less than an outright 100% increase.
How much this is then open to game is up for debate.
Enter growth hormone and testosterone
After all a similar situation exists in the worlds of both testosterone therapy and human growth hormone, where the line defining ‘need’ can be grey at best.
Growth hormone for example can be prescribed for both legitimate uses (reduced growth in children, serious injury recovery), and more ‘creative’ ones like bodybuilding and men with a mid-life crisis trying to inadvisably inject their way back to youth.
While investigating this for one of the Sunday papers during my former career as a journalist, I attended a clinic in Romania supplying the stuff based on medical need - even in Romania a decade ago, it could still only be supplied on prescription - and was tested thoroughly.
And what do you know, I came up low enough to qualify for the all-important prescription...
In case you’re wondering, I didn’t take up the offer.
Cyclists, don’t ride to the doctor’s for asthma meds, ride to the grocer’s for fruit and veg!
Pro cycling's (big) missing marginal gain
Back with our wheezy cyclists though there is a bigger issue at stake, and a greater marginal gain available - legally, and for free, with no prescription or TUE needed - for all of them, and for every other asthmatic athlete out there.
Because steroid inhalers like salbutamol are a sticking plaster. They solve the symptoms of asthma but do nothing to address its cause.
And they come with a LOT of side effects, including headaches, anxiety, increased heart rate, irregular heartbeat, and - ironically - severe breathing difficulties.
Prolonged high doses can even lead to hypokalemia, which can cause tiredness, leg cramps, weakness, constipation. Oh, and cardiac arrest.
An inhaler-free asthma solution?
Sounds too good to be true, but it exists, and it’s called… an awesome diet.
In short, some foods increase inflammation (bad), and others reduce it (good). As asthma has a strong inflammatory component (inflamed airways = asthma), the recipe is to reduce inflammatory foods, and increase anti-inflammatory ones.
Inflammatory foods for asthma to reduce/avoid:
Cold beer - excellently refreshing, good for parties, less good for asthma though
Anti-inflammatory foods for asthma to increase:
- Grean leafy veg
- Olive oil
- Kidney beans
To turn things up another level, add anti-inflammatory and antioxidant superfoods.
Superfoods for asthma to add:
- Sesame seeds
- Pumpkin seeds
- Raw cacao
- Chia seeds
- Flax seeds
- Goji berries
For the most concentrated dose of athletic superfoods, including a big hit of powerful anti-inflammatories and antioxidants, 33's Elite Pre & Post Workout Shakes are just the ticket
Diet for asthma - in summary
- Bin processed foods and dairy
- Cut back on the booze
- Eat more fruit and veg
- Add plenty of tasty superfoods
Now watch your asthma drop, maybe even enough to lose the inhalers altogether thus avoiding all of those nasty side effects.
Can diet really reduce asthma symptoms?
Could this simple advice really beat the marvels of modern medicine, speed up athletes and make the world a healthier place?
Erm, yes, yes, and yes.
For those who think I have taken leave of my senses and am typing this from the comfort of a communal yurt, let me reassure you this is not the woo-woo nonsense you may think.
I’m not anti-inhaler, or anti modern medicine. Quite the opposite.
It was my magical inhalers, taken twice daily for 30 years that let me live a completely normal, active life, while their stronger, injectable counterparts saved my bacon during serious attacks twice. That stuff is good sh*t and without it my quality of life would have been drastically reduced. I might not even be sat here now.
But they’re a sticking plaster and don’t address the root cause.
When I began seriously reworking my diet and going big on the superfoods as we developed 33’s initial formulas in 2012, that root cause WAS addressed for the first time and not only did my ultramarathon performance soar, but my lifelong asthma just… disappeared.
Within a few months I found myself forgetting to take the inhalers. Seven years later I haven’t used an inhaler since.
From lifelong asthma to no asthma. Going big on the superfoods was the turning point for 33Fuel co-founder Warren’s wheezing
Salbutamol, asthma and missing gains at the Tour: conclusion
There’s no guarantee that this approach will work for everyone, and there’s no doubt some asthma won’t respond to dietary changes and may always need pharmaceutical assistance.
But the beauty of this experiment, for anyone who decides to take it on, is it’s free, has no downside, and an unlimited upside. If it were a financial investment people would be queuing around the block for it.
Back at the Tour de France, if riders simply stopped guzzling processed sports nutrition and ate some more fruit, veg and superfoods, maybe they could all go faster while being way healthier.
Just a thought.