Association between obesity and asthma in 4-11 year old children in the UK

Abstract

Background-There is evidence of a positive association between asthma and obesity in adults and in children. We investigated, in a large sample of English and Scottish primary school children, whether there is a consistent association between fatness and asthma symptoms in Britain. Methods-A cross sectional analysis was made of 18 218 children aged 4-11 years who participated in the 1993 or 1994 surveys of the National Study of Health and Growth (NSHG). Children belonged either to English or Scottish representative samples, or an English inner city sample. Asthma attacks in the previous year, occasional wheeze, or persistent wheeze were the symptoms used in the analysis. Body mass index (BMI) and the sum of triceps and subscapular skinfolds converted to standard deviation scores (SDS) were used to assess levels of fatness. Results-A total of 14 908 children (81.8%) were included in the analysis. In the multiple logistic analysis BMI and asthma (asthma attacks or wheeze) were associated in the representative sample (OR for the comparison of the 10th and 90th centiles of BMI 1.28, 95% CI 1.11 to 1.48), but sum of skinfolds was unrelated to asthma symptoms in most analyses. The association between asthma and BMI was stronger in girls than in boys in the inner city sample, but less convincingly in the representative sample. Conclusions-Levels of obesity are associated with asthma symptoms regardless of ethnicity. The association is more consistent for BMI than for sum of skinfolds, partly because obese children are more advanced in their maturation than other children. There is some evidence that, as in adults, the association is stronger in girls than in boys, but only in the multiethnic inner city sample. (Thorax 2001;56:133-137)

Quality of Life and Health Outcomes in Overweight and Non-Overweight Children With Asthma

“…In another study examining ethnicity, Figueroa-Munoz, Chinn, & Rona (2001), examined 4-11 year old children in the United Kingdom and found that obesity, measured using BMI values, was associated with asthma regardless of ethnicity. They found this association to be strongest among inner-city girls.…”

“…However, whether this relationship is a direct or indirect one has yet to be fully determined. One theory proposed, which supports the view that asthma causes obesity, is that parents of asthmatic children may restrict their child's activity level for fear of inducing an asthma exacerbation, which would put them at increased risk for obesity due to a more sedentary lifestyle (Figueroa-Munoz et al, 2001). While a number of individuals with asthma might avoid vigorous activity and thus put on weight, this would seem, at best, an incomplete explanation for asthma causing obesity (Shaheen, 1999).…”

“…Studies examining both obesity and asthma together have relied on self-reported asthma symptoms and/or self-reported height and weight Figueroa-Munoz et al, 2001). Self-report is unreliable.…”

Childhood Asthma and Extreme Values of Body Mass Index: The Harlem Children’s Zone Asthma Initiative

“…4 A growing body of literature has reported a relationship between asthma and obesity among adults. 5,6 Studies conducted among children, [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] however, have produced conflicting results thus far, and further elucidation is necessary of how an association between asthma and body mass index (BMI) may differ by population characteristics, such as age, gender, and race/ethnicity. In addition, many studies among children have failed to assess the potential effect across the full range of BMI percentiles, including those who are underweight.…”

Nutritional status and childhood wheezing in rural Bangladesh

“…Previous studies reported that higher BMI and being overweight were risk factors for asthma/wheezing and allergic diseases in children from Japan, Taiwan and the UK, countries where childhood obesity is an increasing public health concern (7)(8)(9)(10) . Little evidence exists, however, on the potential association between undernutrition and current wheezing/ asthma and allergic diseases.…”