Asthma is a chronic lung disease that causes inflammation and narrowing of the airways. Common asthma triggers include allergens, air pollution, respiratory infections, and exercise. Some people with asthma also report that drinking cold beverages can bring on asthma symptoms like coughing, wheezing, shortness of breath, and chest tightness. But is there any scientific evidence that supports cold drinks as an asthma trigger? Let’s take a closer look.
What happens when you drink something cold?
When you drink a cold beverage, the cold temperature affects your airways in a few key ways:
- It cools the lining of your mouth, throat, and esophagus as you swallow.
- You may inhale some cool air as you drink, which enters your larynx and trachea.
- The cold liquid cools your esophagus as it travels to your stomach.
In people without asthma, these effects are temporary and harmless. But in people with asthma, the cooling and drying effect of cold drinks on the airways could potentially trigger bronchoconstriction – tightening of the bronchial tubes that carry air into and out of the lungs.
Cold temperature as an asthma trigger
Some research suggests that cold air exposure can lead to asthma symptoms like coughing, wheezing, and shortness of breath in people with asthma. According to one study, breathing cold air (below 5°C or 41°F) can cause airway cooling, constriction, and drying of airway surfaces. Another study found that cold air inhalation caused bronchial thermogenesis – heat production in the airways in response to cooling. This thermogenesis leads to neurogenic inflammation that narrows the airways.
Since inhaling cold air and drinking cold liquids have similar effects on the airways, it’s biologically plausible that cold drinks could trigger asthma symptoms in some cases. However, more research is needed to directly investigate the effects of cold beverage consumption on airways in people with asthma.
Anecdotal evidence from asthma patients
While controlled studies are limited, many people with asthma report that drinking cold beverages can trigger their symptoms. Here are some anecdotal reports from asthma patients:
- “I find that drinking anything cold – water, juice, soda, etc triggers my asthma and makes me wheeze. I have to let cold drinks sit out and warm up before drinking them.”
- “About 5-10 minutes after drinking something cold I start wheezing and feel tightness in my chest. I think it has to do with the cold hitting my throat. I try to avoid ice water and icy drinks because of this.”
- “I almost always get asthma flare ups and start coughing if I drink something straight out of the fridge. I now ask for no ice at restaurants and let cold drinks warm up for a bit before drinking.”
While personal accounts don’t prove causation, they suggest that cold beverage consumption is a common asthma trigger among some patients.
Possible mechanisms behind cold drinks triggering asthma
Researchers have proposed a few theories to explain how cold drinks could potentially trigger asthma symptoms:
Bronchoconstriction
Breathing in cold, dry air causes airway cooling and drying, leading to constriction of bronchial smooth muscle. Some experts think drinking cold liquids has similar effects on the throat and esophagus, leading to bronchoconstriction.
Reflex bronchoconstriction
This refers to bronchoconstriction triggered by stimulation of irritant receptors in the esophagus and throat when cold liquid passes through. The nerve impulses travel to the lungs and cause reflex constriction of the airways.
Hyperosmolarity
Hyperosmolarity refers to an abnormally high concentration of molecules in a solution. Some research suggests hyperosmolar fluids can trigger bronchoconstriction. Since many cold drinks like soda and juices have high sugar content, they are hyperosmolar. This means they could potentially cause osmotic stress and dehydration of airway surfaces.
Common asthma triggers in cold drinks
Beyond the temperature, some ingredients commonly found in cold beverages can also trigger asthma symptoms in sensitive individuals, including:
Sulfites
Sulfites are food preservatives used in fruit juices, sodas, wine, and beer to prevent oxidation and browning. Studies show 5-10% of asthmatics are sensitive to sulfites, which can cause bronchospasm minutes after ingestion.
Artificial sweeteners
Artificial sweeteners like aspartame have been linked to asthma attacks in some people. One case report describes a 39-year-old woman who experienced recurrent asthma episodes after consuming artificially sweetened soda.
Other food additives
Sodium benzoate, tartrazine, and monosodium glutamate (MSG) are other additives in cold drinks that may contribute to asthma symptoms in susceptible individuals.
Caffeine
Caffeine is a common trigger of asthma symptoms. Consuming large amounts of caffeine from sodas, energy drinks, or coffee can overstimulate the airways and lead to bronchial constriction in some cases.
Tips for preventing asthma symptoms from cold drinks
If you experience asthma flare-ups after drinking cold beverages, here are some preventive tips:
- Avoid drinking ice-cold beverages. Allow them to sit out and warm up closer to room temperature before drinking.
- Drink through a straw so the liquid bypasses your throat and enters your esophagus directly.
- Avoid drinking large volumes of cold drinks rapidly. Take small sips instead.
- Limit caffeine intake from sodas, teas, and coffees.
- Check ingredients lists and avoid drinks with sulfites, artificial sweeteners, sodium benzoate, and other additives you’re sensitive to.
- Try using an inhaler 5-10 minutes before drinking cold beverages to pre-treat asthma symptoms.
- Warm up cold drinks by holding the glass/bottle in your hands for a few minutes before drinking.
The bottom line
For some people with asthma, drinking cold beverages can potentially trigger asthma symptoms like coughing, wheezing, and shortness of breath. While limited research exists, proposed mechanisms include airway cooling, constriction, and drying from the cold temperature. Ingredients like sulfites, artificial sweeteners, and caffeine may also play a role.
If you experience asthma flare-ups after drinking cold drinks, take preventive measures like avoiding ice-cold beverages, drinking slowly, and limiting additives. However, consult your doctor if cold drinks consistently make your asthma worse, as you may need medication adjustments or further evaluation.
