We breathe in and out about 22,000 times a day. When resting, an average adult breathes about 12–20 times per minute. Though it looks small inside our body, when the lung is spread out, its size is actually about half the size of a tennis court. It has 2400 km of airways and up to 500 million alveoli (places where oxygen exchange occurs in the lung). Our lung is very unique in such a way that, though it has left and right sides, both of these are not entirely identical; the left lung is smaller than the right lung, and the left lung has only two lobes while the right lung has three (1).

Amazing, isn’t it? Starting today, let's not take the lung for granted. Now, it is time to find out how to breathe life into the lung.

Smoking and your lung health (2,3)

Among the things that you can start to cultivate in order to take care of your lungs is to stop smoking if you are a smoker. Though it is easier said than done, there are thousands of people who have successfully quit smoking with the correct guidance, motivation, and support. Above all, you must first recognise the factors that influence you to smoke and start to tackle them. As for addiction, it is something that can be worked out with patches, medication, support from your loved ones, and a conducive environment. If you are a passive smoker, it is time for you to take charge of your life. It is time to be stern if the smoker is one of your loved ones; provide them with some rules and regulations for smoking; and if it is in public, avoid places where you know smokers will be there. Remember, you’re saving your lung while doing so!

If you are a passive smoker or you are currently smoking and have yet to quit, you may consider supplements to take care of your lung health while trying to quit smoking. A herbal supplement such as tiger milk mushroom is suitable for smokers, people with breathing problems like cough and cold, senior citizens with weak hearts, and those who are always exposed to harmful smoke, like passive smokers.

Exercise or simply move (4)

Exercise can also help make sure your lung health is tip top! Exercise can be considered any kind of physical activity. It can be structured or planned exercise or simply your daily chores, which require you to move your body and sweat out. With the correct exercise that requires your cardiovascular conditioning, or simply put, exercise that involves your heart and lungs to pump the blood even quicker and to breathe in and out at a much quicker pace, it is considered aerobic exercise or moderate exercise. This includes activities like brisk walking, swimming, running, and cycling. All these activities, if done correctly, will improve your lung capacity, which is good for your lung health as well.

Stay indoors and avoid harmful pollution (3)

Nowadays, with our current transportation system in Malaysia, it is very likely for us to inhale bad air into our lungs. What you can do with regards to this is avoid heavy traffic and clean your house regularly to avoid the buildup of mold, dust, and allergens. You may ventilate your house and workplace frequently as well, so they have a good air circulation system inside. One of the smart ways that you can do before you plan your journey is to check the air quality of the place that you plan to go.

Prevent infection (3,5)

As for infection related to the lung, it can be due to various reasons, but one thing you can do to decrease your risk of getting infected is by frequently washing your hands. Do not touch your face with unwashed hands. Some people even consider getting the flu vaccine. Talk to your doctor to find out whether you should get a flu vaccination.

In conclusion,

It is easy to actually value your lung's worth and take care of it if you are living a mindful life. A simple activity like opting to use stairs instead of an elevator or lift can also benefit your lung. Avoid places with heavy traffic and wear proper personal protective equipment when handling hazardous or harmful chemicals. Making sure your house is properly ventilated can improve indoor air quality. Start now to take care of your lung, or you will regret it!

References

1. The Lung Association. Breathing and Fun Facts about Lung (2016). https://www.lung.ca/lung-health/lung-info/breathing (Accessed on September 30, 2020)
2. Ministry of Health Malaysia (MOH). My Health Portal. Quit Smoking (2012). http://www.myhealth.gov.my/en/quit-smoking-prime-years-2/(Accessed on September 30, 2020)
3. National Institute of Health (NIH). Nationa Heart, Lung, and Blood Institute. Keeping your lung healthy (2019). https://www.nhlbi.nih.gov/health-topics/how-lungs-work (Accessed on September 30, 2020)
4. European Lung Foundation (ELF). Your lung and exercise. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4818249/pdf/EDU-ELF121.pdf (Accessed on September 30, 2020).
5. Five ways to Keep your lung healthy and whole. https://www.healthline.com/health/understanding-idiopathic-pulmonary-fibrosis/ways-to-keep-your-lungs-healthy-and-whole#5.-Breathe-deeply (Accessed on September 30, 2020).

Just as its name implies, folklore tales and Indigenous people believe that the mushroom grows whenever drops of tiger’s milk fall to the ground. The mushroom grows on soil deep in the tropical jungles; they thrive in areas with humidity levels over 80% and grow mainly in Genting Highland and Kuala Lipis in Pahang and in Perak (3).

Tiger Milk Mushroom and its Benefits

The tiger milk mushroom consists of three parts: its cap (pileus), stem (stipe), and tuber (sclerotium). The sclerotium is a compacted mass of fungal mycelium containing food reserves, while the cap and stem are woody. The sclerotium, or tuber, is the part where most of its medicinal properties are stored. The sclerotium is white and yields a milk-like solution that tastes like milk (3).

Since ancient times, tiger milk mushrooms have been used by the indigenous community in Malaysia to treat common colds, coughs, flu, and asthma. A study on rats with asthmatic symptoms found that the usage of tiger milk mushroom extract can improve asthmatic rats TH2 cells, which are important in producing Immunoglobulin E (Ig E). IgE is the antibody that will help to recognise a foreign body or allergen that will cause a reaction in the body and chase it away (3).

Tiger milk mushroom is also found to have some natural anti-coagulant properties. Anticoagulant properties are important during thrombolysis treatment. Thrombolysis is the treatment that is used to dissolve blood clots, either in the brain or an artery. Some of the natural anticoagulant and fibrinolytic agents are also used to treat thrombolytic conditions. Certain studies also found out that ‘wood ear fungus’ (a type of mushroom) is able to produce protease-like fibrinolytic enzymes, which could serve as thrombolytic agents to dissolve blood clots. Since the study found out that tiger milk mushroom also has the same protease enzyme, with this property demonstrated by tiger milk mushroom, it is presumed that it is able to be used for cardiovascular diseases (3).

There are also studies showing the comparison between wild tiger milk mushrooms and cultivated tiger milk mushrooms for their antioxidant properties. The study found that both wild and cultivated tiger milk mushroom extracts are able to scavenge free radicals; hence, it was concluded that they have anti-cancer properties, though the nutritional content of wild and cultivated tiger milk mushrooms differs (4). Wild tiger milk mushrooms contain more insoluble fibre and soluble fibre as compared to cultivated tiger milk mushrooms; cultivated tiger milk mushrooms also have more carbohydrate as compared to wild tiger milk mushrooms (4).

In conclusion…

There are many other studies on tiger milk mushroom, and it is found that it can give various health benefits to the human body; however, as tiger milk mushroom is a herb-based ingredient, its effects may differ from individual to individual, and some individuals may have different experiences with it. The takeaway message with regards to taking tiger milk mushroom supplements is that they have to go hand in hand with healthy lifestyles, such as exercise, since the symptoms you are experiencing need to be alleviated with lifestyle modifications such as exercise and stop smoking as well.

References

1. The Star. Health benefits of Tiger Milk Mushroom (2011). Wong Li Za. https://www.thestar.com.my/lifestyle/features/2011/03/15/health-benefits-of-wild-tigers-milk-mushroom (Accessed on September 8, 2020).
2. Nutraceutical Business Review. Tiger Milk Mushroom: Malaysia Lost Its National Treasure (2015). https://www.nutraceuticalbusinessreview.com/news/article_page/Tiger_milk_mushroom_Malaysias_lost_national_treasure/104531 (Accessed on September 8, 2020).
3. Nallathamby N, Phan CW, Seow SL, Baskaran A, Lakshmanan H, Abd Malek SN, Sabaratnam V. A status review of the bioactive activities of tiger milk mushroom Lignosus rhinocerotis (Cooke) Ryvarden. Frontiers in pharmacology. 2018 Jan 15;8:998.
4. Yap HY, Aziz AA, Fung SY, Ng ST, Tan CS, Tan NH. Energy and nutritional composition of Tiger Milk Mushroom (Lignosus tigris Chon S. Tan) sclerotia and the antioxidant activity of its extracts. International journal of medical sciences. 2014;11(6):602.

 
Consistency is key when it comes to reaping the benefits of most breathing exercises. These exercises can be performed while standing, sitting in a chair with proper lumbar support, or lying down on a bed, yoga mat, or the floor. Ensuring your comfort is paramount; if anything restricts your breathing, adjust it as necessary. When lying down, extend your arms slightly away from your sides, with your palms facing upward, and maintain your legs straight or bend your knees so your feet lie flat on the floor. If you're sitting, rest your arms on the chair's armrests. In both sitting and standing positions, ensure both feet remain flat on the ground, spaced approximately hip-width apart. Inhale gently and steadily, some may find it helpful to count slowly from 1 to 5. Initially, reaching 5 may be challenging, but that's perfectly fine. Inhale through your nose and exhale through your mouth. Allow your breath to penetrate deep into your abdomen, never force it. As you inhale, you'll feel your chest expand, and as you exhale, your abdomen will rise. Practice this for 3 to 5 minutes (1,3).
 

Asthma and Buteyko Breathing

Asthma, a debilitating chronic condition characterized by airway hyper-responsiveness and associated respiratory symptoms, is exceedingly common and often presents as a primary complaint in healthcare clinics, even in Malaysia (3,4).

While there aren't many studies exploring the efficacy of Buteyko breathing exercises in treating asthma, a recent review study from 2018 opted to withdraw due to insufficient studies meeting contemporary scientific standards (3,4). Nevertheless, it's worth noting that researchers did conclude that, although they couldn't draw definitive conclusions regarding the use of breathing exercises in clinical asthma management, there was a promising trend in improved quality of life measures. This implies that individuals with asthma who incorporate Buteyko breathing into their daily routines report a potential enhancement in their quality of life, potentially experiencing fewer or less severe asthma attacks (3,4).

Therefore, individuals with asthma might consider integrating the Buteyko breathing technique into their daily regimen to enhance their overall quality of life. The Buteyko breathing exercise entails the following steps:

Lung Health and Diaphragmatic Breathing
 

Many people inadvertently develop a habit of utilizing neck, shoulder, and back muscles, which significantly impedes the airflow in and out of the lungs. A 2016 research study published in the Journal of Physical Therapy Science investigated the effects of diaphragmatic breathing on respiratory function. It utilized two groups, with one practicing feedback breathing exercises and the other engaging in diaphragmatic breathing. The results indicated an increase in lung capacity among the diaphragmatic breathing group (6).
 

Diaphragmatic breathing effectively strengthens the diaphragm muscle, thereby enhancing the efficiency of lung function. To perform this exercise, focus on breathing from your abdomen, placing one hand on your belly and the other on your chest while inhaling and exhaling. Inhale through the nose for two seconds, and exhale through pursed lips for two seconds. During exhalation, gently press down on your abdomen to ensure proper engagement of your diaphragm muscle (6).
 

In Conclusion
 

Numerous breathing exercises can be found on the internet, but the task at hand is to identify the one suitable for your specific condition and overall well-being. Once you've identified your ideal technique, consistent practice can yield long-term benefits for your overall health. Just as physical activities contribute to better lung health, so do breathing exercises.
 

It's intriguing to note that laughter and singing can also enhance lung health. The movements involved in these activities, particularly those of the lips, facilitate the expulsion of stale air from your lungs, replacing it with a fresh breeze, ultimately increasing lung capacity and benefiting your overall lung health (6).
 

So, the next time you hear someone singing, even if their voice isn't the most melodious, consider supporting them or applauding their contribution to better lung health!
 

References

1. Breathing exercise for stress (2018). National Health Service (NHS). United Kingdom. https://www.nhs.uk/conditions/stress-anxiety-depression/ways-relieve-stress/ (Accessed on October 14, 2020).
2. Resolving mental illness issue in Malaysia (n.d). University Malaya Specialist Centre (UMSC). https://umsc.my/umsc_news/resolving-mental-illness-issues-in-malaysia/ (Accessed on October 14, 2020).
3. Breathing technique for stress relief (1, 2020). WebMD. https://www.webmd.com/balance/stress-management/stress-relief-breathing-techniques#2 (Accessed on October 14, 2020).
4. Bruton A, Lewith GT. The Buteyko breathing technique for asthma: a review. Complementary therapies in medicine. 2005 Mar 1;13(1):41-6.
5. Campbell TG, Hoffmann TC, Glasziou PP. Buteyko breathing for asthma. The Cochrane Database of Systematic Reviews. 2018 Aug;2018(8).
6. Patient Empower Network (PEN). 5 Easy Ways to Improve you Lung Health (2019). https://powerfulpatients.org/2019/09/27/5-easy-ways-to-improve-your-lung-health/#:~:text=Pursed%2Dlip%20breathing%20lung%20exercises,to%20exhale%20for%2010%20seconds.

With the advancement of technology, scientists started to discover the harmful effects of tobacco smoking that are not only limited to the smoker itself but also to those who inhale the cigarette smoke, better known nowadays as passive smokers.

What is passive smoker?

Passive smokers are those who breathe in other people’s tobacco smoke. It can increase a non-smoker’s risk of getting lung cancer and may also increase the risk of other cancers, including laryngeal (voice box) and pharyngeal (upper throat) cancers (nasopharyngeal cancer) (2).

Apart from cancer, the evidence is clear that second-hand smoke or passive smoking can also cause heart disease, stroke, and various complications of lung disease, the most common of which is Chronic Obstructive Pulmonary Disease (COPD) (2). Most harmful tobacco smoke is invisible but travels through the air and lingers; thus, it can also build up on surfaces and clothes, which explains why it is even more dangerous since people cannot see it and thus take no precaution for it when in fact it is still there and harming your body as you inhale it (2).

Passive smokers’ health

The first conclusive evidence on the dangers of passive smoking came from Takeshi Hirayama's 1981 study on lung cancer among non-smoking Japanese women who were married to men who smoked. Whenever passive smokers inhale the smoke from the burning tip of the cigarette (sidestream) and also whenever non-smokers breathe in the smoke that smokers inhale and exhale (mainstream), this will impose a 20–30% risk of getting lung cancer and a 23% higher risk of getting cardiovascular diseases on the non-smoker (3).

The smoke from cigarettes will do even more harm to children and pregnant women as compared to adults. As for children who are exposed to the smoke, they will have a higher risk of sudden and unexpected infant deaths, which include sudden infant death syndrome (SIDS) and fatal sleep accidents. Children who live in a smoking household for the first 18 months of their lives have an increased risk of developing a range of respiratory illnesses, including bronchitis, broncholitis, and pneumonia (4).

Children who are exposed to second-hand smoke are also more likely to get colds, coughs, and glue ear (middle ear infections). Their lungs are weaker and do not grow to their full potential. Which also explains that children who are exposed to second-hand smoke in the home are more likely to develop asthma symptoms, have more asthma attacks, and use asthma medications more often and for a longer period of time. As for the pregnant mother who is exposed to second-hand smoke, they have a higher risk of ectopic pregnancy, giving birth earlier (premature baby), and a lower birthweight (3, 4).

What can be done to improve this situation?

There are many things that can be done in order to improve this. As an example, from the government's and community's point of view, their role is to always create awareness about harmful second-hand smoke so that many more people are aware. The government can also implement health policies, such as in Australia, where it is illegal to smoke in a car with individuals below 18 years old; it is also illegal to smoke in an indoor workplace; and if individuals are to smoke, it has to be four metres away from the gate of a children’s indoor play centre, school, or kindergarten; if it is in an outdoor play park, it has to be 10 metres away from the play space, etc. While in Malaysia, it is illegal to smoke in the hospital area, school area, and certain public places such as restaurants (4).

Apart from this, the individual who is in contact with smokers, be it their family members, friends, housemate, partners, etc., must always voice their discomfort and their right to fresh air.

As for the smoker itself, after knowing the harmfulness of tobacco smoke, one should already try to quit smoking, not only for oneself but also for one's loved ones, for those who live with you and care for you. You may get help from the nearest community clinic for this; every government community clinic in Malaysia has a smoking cessation counsellor, doctor, and nurse who will help you with your addiction.

References

1. World Health Organization (WHO). Passive Smoking Atlas. https://www.who.int/tobacco/en/atlas10.pdf?ua= (Accessed on October 16, 2020)
2. Cancer Research United Kingdom. What is passive smoker? https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/smoking-and-cancer/what-is-passive-smoking (Accessed on October 16, 2020).
3. Bek K, Tomaç N, Delibas A, Tuna F, Teziç HT, Sungur M. The effect of passive smoking on pulmonary function during childhood. Postgraduate medical journal. 1999 Jun 1;75(884):339-41.
4. Victoria State Government. Better Health Channel. Passive Smoking. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/passive-smoking (Accessed on October 16, 2020).

Individuals with long-term conditions may as well exercise, but most people with such conditions feel demotivated to exercise due to the thought that they might quickly be out of breath. However, if individuals with long-term lung problems do less activity over time, they will become less fit, which makes daily activities even harder. It is best to ask for guidance from a doctor or physiotherapist before starting any exercise. This is to ensure that your exercise plans are in line with your capacity and are safe (2).

Generally, what can be practised is that all exercise programmes must be built up over time to allow the body to adapt. It is important that you exercise at your own pace. If you reach a stage where you are too breathless to talk, then slow down the pace or, if necessary, take a short pause (2). Remember, the more you do, the more you will be able to do!

Intermittent exercises can also help you deal with shortness of breath. In this case, you alternate brief exercises lasting 1–2 minutes with moments of rest (or slower exercise). This is called ‘interval training’ (2).

As an example, if you have COPD, you will have damaged airways. This means that when you breathe out, your airways narrow before you have gotten rid of all the air in your lungs. Many people with COPD find that pursing their lips enables them to breathe out more slowly and effectively. You may also find it easier to walk with braced arms (for example, leaning on a shopping stroller or even grasping the belt of your trousers). Patients with severe lung disease can benefit from using a wheeled walking aid (4).

If you suffer from severe COPD, you may have problems bringing enough oxygen into your body. If this is the case, you may need to take supplementary oxygen during your activity. Your doctor will be able to assess this before you begin a training programme (4).

References

1. National Heart, Lung & Blood Institute (NHLBI). U.S. Department of Health & Human Services. How the Lungs Work. https://www.nhlbi.nih.gov/health-topics/how-lungs-work
2. Your lungs and exercise. (2016). Breathe (Sheffield, England), 12(1), 97–100. https://doi.org/10.1183/20734735.ELF121
3. Breathing Exercise to Increase Lung Capacity. https://www.healthline.com/health/how-to-increase-lung-capacity
4. Breathing exercise with COPD. https://www.healthline.com/health/copd/breathing-exercises

Do you know that every food has its own set of nutrients that make it suitable for every specific health problem that we encounter? The only unknown is how much we need it and how it can help, whether as a means to prevent diseases or to alleviate the symptoms of diseases. When it comes to this, whenever you look closely, you will see that animals or even pets such as dogs and cats, whenever they feel uneasy, will eat grass or some plants that possess an antidote to their unwell condition.

As for lung, it also has foods that will benefits it condition but little that we know since there are not many studies conducted specifically for this. Studies shows that vitamin C is good for people who smoke, not to reverse their lung condition but as a ‘cushion’ to the damage on the lung. Which is why, according to United States, National Institute of Health (NIH), smokers are recommended to consume 35 mg more vitamin C as compared to normal adult (1). As for normal adult  in Malaysia recommended vitamin C intake is about 70 mg for both male and female (2). The way in which vitamin C works in this condition is that it will limit the damage effects of free radicals through antioxidant activity, in which this will helps to prevent or delay the development of certain cancers, cardiovascular disease, improved immune function and improved absorption of plant based iron (non-heme iron) (1).

Apart from vitamin C, studies also established that smokers have fewer carotenoid levels in their bodies as compared to non-smokers. Carotenoids are a type of antioxidant; they include beta-carotene, lycopene, lutein, and zeaxanthin. Beta-carotene is the most common one used, especially for studies related to lung health. There is a study concluding that the consumption of beta-carotene supplementation among smokers will improve their pulmonary (lung) function (3). However, there are also studies (intervention trials) reporting that supplementing with large doses of beta-carotene has an adverse effect on the incidence of lung cancer in smokers and workers exposed to asbestos. Until the efficacy and safety of taking supplements containing these nutrients can be determined, the current dietary recommendation is to consume a diet high in beta-carotene (4,5).

Interestingly, there is also a study examining the relationship between curry intake and lung health! The longitudinal study that was conducted for a year among older adults in Singapore found that individuals who consume more curcumin-rich (turmeric-rich)  curry have better lung health. The study also compares smokers who consume more curry to those who consume less curry. These results suggest that the antioxidant and anti-inflammatory actions of curcumins in curry might be particularly effective in protecting against pulmonary damage caused by smoking (6). However, the study does not assess the cholesterol level and does not mention how the curry is usually prepared in Singapore. If the same study were to be conducted in Malaysia, perhaps one thing to consider is the amount of cholesterol since curry uses coconut milk, which has high saturated fat and thus might increase the cholesterol level.

As for non-smokers, there are also guidelines on foods that can help with lung health. According to the American Lung Association, the consumption of complex carbohydrates such as whole grain bread and limiting simple carbohydrates helps to maintain lung health, especially for individuals with chronic obstructive pulmonary disease (COPD). Consumption of 20–30 g of fibre from fruits and vegetables and a good source of protein, such as lean meat and low-fat milk, helps with lung health. While consumption of fat from monounsaturated (MUFA) and polyunsaturated (PUFA) sources will also help with lung health,

Basically, consumption of a healthy diet helps with not gaining extra weight, which can load the lungs even more. Other than the previous, dietary habits such as those listed below will also help with lung conditions:

• Rest just before eating.

• Eat more food early in the morning if you’re usually too tired to eat later in the day.

• Avoid foods that cause gas or bloating. They tend to make breathing more difficult.

• Eat 4 to 6 small meals a day. This enables your diaphragm to move freely and lets your lungs fill with air and empty out more easily.

• If drinking liquids with meals makes you feel too full to eat, limit liquids with meals; drink an hour after meals.

• Consider adding a nutritional supplement at night to avoid feeling full during the day.

In conclusion, for non-smokers and smokers, consumption of a healthy diet and having good diet habits help with lung health as well. Even though certain foods have nutrients that may help with certain body conditions, it is still best to consume food in moderation, variety, and balance. Always try to cut back on the habit of smoking. This is advisable for smokers.

References

1. United States. National Health Institute (NIH). Office of Dietary Supplement (ODS). Vitamin C https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/

2. Ministry of Health Malaysia (MOH). Recommended Nutrient Intake (RNI) (2017). A Report of Technical Working Group of on Nutritional Guideline. National Coordinating Committee on Food and Nutrition.

3. Thyagarajan, B., A Meyer, K., Smith, L. J., Beckett, W. S., Williams, O. D., Gross, M. D., & Jacobs, D. R., Jr (2011). Serum carotenoid concentrations predict lung function evolution in young adults: the Coronary Artery Risk Development in Young Adults (CARDIA) study. The American journal of clinical nutrition, 94(5), 1211–1218. https://doi.org/10.3945/ajcn.111.019067

4. Committee on the Public Health Implications of Raising the Minimum Age for Purchasing Tobacco Products; Board on Population Health and Public Health Practice; Institute of Medicine; Bonnie RJ, Stratton K, Kwan LY, editors. Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products. Washington (DC): National Academies Press (US); 2015 Jul 23. 4, The Effects of Tobacco Use on Health. Available from: https://www.ncbi.nlm.nih.gov/books/NBK310413/

5. Johnson EJ. The role of carotenoids in human health. Nutr Clin Care. 2002 Mar-Apr;5(2):56-65. doi: 10.1046/j.1523-5408.2002.00004.x. PMID: 12134711.

6. Ng, T. P., Niti, M., Yap, K. B., & Tan, W. C. (2012). Curcumins-rich curry diet and pulmonary function in Asian older adults. PloS one, 7(12), e51753. https://doi.org/10.1371/journal.pone.0051753