Exercise can bring on attacks in up to 90 percent of asthma sufferers. Indeed, some asthmatics experience asthma only during exercise, which can appear as shortness of breath, wheezing, tightness in the chest or coughing. Rather than advising people who have exercise-induced asthma to take it easy, doctors advise patients to stay physically fit.

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But that sounds like a Catch-22: How can someone keep fit if exercise sets off asthma attacks?

Sports medicine specialists say it's possible if asthmatics use preventive medications wisely and avoid certain triggers that exacerbate attacks. Exercise-induced asthma can be made worse by cold, dry air or air containing, and high levels of pollen or pollutants. The extra effort made to stay fit pays off in fewer or milder asthma attacks overall and a need for less medication.

Respiratory specialists say swimming can be one of the best exercises for people with asthma. "By and large swimming is considered the best exercise for asthmatics," says Dr Jamshed Kanga, chief of paediatric pulmonology at the University of Kentucky medical centre. "In fact many Olympic swimmers have asthma and yet they do quite well."

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