pediatrics
December 2017, VOLUME140 /ISSUE Supplement 3

Effects of Childhood Asthma on the Development of Obesity Among School-Aged Children

Z Chen, MT Salam, TL Alderete. Am J Respir Crit Care Med. 2017;195(9):11811188
  1. Justin M. Skripak, MD
  1. Oradell, NJ

PURPOSE OF THE STUDY.

To determine what effect asthma has on the development of obesity.

STUDY POPULATION.

A total of 3474 children from 8 different southern California communities were enrolled and followed prospectively. A total of 2706 of these children were nonobese at study entry and were included in the primary analysis.

METHODS.

Nonobese children were followed and examined annually or biannually from kindergarten or first grade through high school. Questionnaires were completed periodically by parents until study year 5, then by the children until completion of the study. Children were classified as having asthma if they reported being diagnosed with asthma by a physician.

RESULTS.

Children with asthma at baseline were 51% more likely to develop obesity than children without asthma (HR, 1.51; 95% CI, 1.08–2.10), even when controlling for multiple variables. However, new-onset asthma during the study was not found to be associated with increased risk of obesity (HR, 0.90; 95% CI, 0.52–1.55). The use of asthma rescue mediations at baseline was associated with a reduced risk of obesity (HR, 0.57; 95% CI, 0.33–0.96). Conversely, the use of any controller medications was not associated with incidence of obesity (inhaled corticosteroid: HR, 0.97; 95% CI, 0.49–1.93) (nonsteroid controller: HR, 1.34; 95% CI, 0.35–4.97).

CONCLUSIONS.

Asthmatic children may be at increased risk of developing obesity. The use of asthma rescue medications may be helpful in reducing that risk.

REVIEWER COMMENTS.

There are multiple studies that have suggested that obese children are more likely to have asthma and severe asthma symptoms. However, it is unclear whether children with asthma are at higher risk for obesity. This prospective study followed nonobese children for up to 10 years and found a higher incidence of obesity in asthmatics compared with nonasthmatics. This risk was found to be maintained even when controlling for physical activity level. The authors do acknowledge that details collected regarding physical activity were limited. A better understanding of the interplay between asthma and obesity as well as early identification and management of asthma and obesity risk may be helpful in reducing morbidity.