PURPOSE OF THE STUDY.
The goal of this study was to determine if a supervised normocaloric diet would help improve asthma-related quality of life (AR-QoL) in obese prepubertal adolescents with asthma.
Fifty-one children between 12 and 16 years of age diagnosed with stable allergy-induced asthma and obesity (BMI >95th percentile of the Centers for Disease Control and Prevention BMI-for-age growth charts) were recruited from an allergy clinic in Guadalajara, Mexico.
Children were randomized to undergo a 28-week dietary program consisting of a monitored normocaloric diet (n = 26) and matched to a control group who had no dietary restrictions (n = 25). AR-QoL questionnaires and pulmonary function test results were recorded before and after the intervention period.
Energy and macronutrient intake were significantly different in the test group compared with control subjects (2231 ± 231 vs 3243 ± 278 kcal/d; P = .001) with increased consumption of carbohydrates, fat, and saturated fat among the control subjects’ diet. Although the mean BMI z score significantly declined in the test group, the mean BMI z score remained unchanged in the control group. There was significant improvement in AR-QoL scores in the dietary intervention group compared with control subjects (P < .001). They also reported fewer episodes of asthma rescue inhaler use (17 vs 39; P < .02), as well as fewer nighttime awakenings (11 vs 2; P < .001). There seemed to be more improvement in forced expiratory volume in 1 second values among the study group, but the results were not statistically significant.
The normocaloric dietary intervention was associated with improved AR-QoL and some asthma control. Dietary programs may serve as a complementary nonpharmacologic therapeutic strategy in obese adolescents who have asthma.
Asthma and obesity are 2 chronic conditions that are becoming more prevalent in children today. Moreover, there is often a direct relationship between the 2 factors; increased BMI is associated with dose-dependent increases in asthma incidence and severity. The authors were able to limit their study subjects to obese prepubertal children, providing a clearer picture of how emphasizing a normocaloric diet not only can contribute to a decreased BMI but also to improved AR-QoL. Although many allergy practices have incorporated asthma educational strategies at diagnosis and follow-up, perhaps it is time to also include standardized nutritional recommendations. Encouraging our youngest patients with asthma to maintain a normal BMI may not only help reduce exacerbations and potential for steroid adverse effects but also contribute to optimal lung development during this critical growth period.
- Copyright © 2014 by the American Academy of Pediatrics