February 01, 2017
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Children with asthma more likely to become obese

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Children with asthma may be at greater risk of developing obesity later in childhood or adolescence than children who do not have asthma, according to a recent study published in the American Journal of Respiratory and Critical Care Medicine.

“Although longitudinal studies have documented obesity as a risk factor for asthma incidence, it is unclear whether children with asthma are at higher risk for the development of obesity,” Zhanghua Chen, PhD, from the department of preventive medicine at the Keck School of Medicine of USC, and colleagues wrote. “If asthma increases the risk for developing obesity, then a portion of the obesity epidemic in children may be related to the increased occurrence of asthma or the effects of a common etiologic factor.”  

To investigate whether asthma contributes to the childhood obesity epidemic, the researchers assessed the effects of asthma and asthma medication use on the development of obesity in children and adolescents. Chen and colleagues enrolled 2,171 nonobese children aged 5 to 8 years at study inception and followed these children for up to 10 years in the Southern California Children’s Health Study (CHS). At study enrollment, 13.5% of the children had asthma.

In an independent sample, they performed a replication analysis to confirm study results in a different group of 2,684 CHS children followed from roughly age 10 to 18 years. The investigators measured height and weight annually to group children into normal, overweight and obese categories. Using cox proportional hazards model, they compared associations of asthma history with obesity incidence during follow-up.

After adjusting for cofounding factors, the analysis revealed that children with asthma at study entry were at 51% increased risk of developing obesity during childhood and adolescence compared with children without asthma (HR [95% CI] = 1.51; 1.08, 2.10). Investigators saw that the risk of developing obesity lessened by 43% when children used asthma rescue medication (HR [95% CI] = 0.57; 0.33, 0.96). These results were replicated in the independent CHS sample, confirming the notable association between asthma history and increased risk of children becoming obese.

“In addition to excess caloric intake and lack of physical activity, our findings suggest that childhood asthma also contributes to the development of childhood obesity,” Chen and colleagues wrote. “Early interventions for children with asthma and/or wheezing may be warranted to prevent a vicious cycle of worsening obesity and asthma that could contribute to the development of other metabolic diseases including prediabetes and type 2 diabetes in later life.” – by Savannah Demko

Disclosure: Chen reports the study is funded by the Southern California Environmental Health Sciences Center, the National Institute of Environmental Health Sciences and the Hastings Foundation.