Being Overweight or Obese and the Development of Asthma

Abstract

Adult obesity is linked to asthma cases and is estimated to lead to 250 000 new cases yearly. Similar incidence and attributable risk (AR) estimates have not been developed for children. We sought to describe the relationship between overweight and obesity and incident asthma in childhood and quantify AR statistics in the United States for overweight and obesity on pediatric asthma. METHODS: The PEDSnet clinical data research network was used to conduct a retrospective cohort study (January 2009-December 2015) to compare asthma incidence among overweight and/or obese versus healthy weight 2-to 17-year-old children. Asthma incidence was defined as ≥2 encounters with a diagnosis of asthma and ≥1 asthma controller prescription. Stricter diagnostic criteria involved confirmation by spirometry. We used multivariable Poisson regression analyses to estimate incident asthma rates and risk ratios and accepted formulas for ARs. RESULTS: Data from 507 496 children and 19 581 972 encounters were included. The mean participant observation period was 4 years. The adjusted risk for incident asthma was increased among children who were overweight (relative risk [RR]: 1.17; 95% confidence interval [CI]: 1.10-1.25) and obese (RR: 1.26; 95% CI: 1.18-1.34). The adjusted risk for spirometry-confirmed asthma was increased among children with obesity (RR: 1.29; 95% CI: 1.16-1.42). An estimated 23% to 27% of new asthma cases in children with obesity is directly attributable to obesity. In the absence of overweight and obesity, 10% of all cases of asthma would be avoided. CONCLUSIONS: Obesity is a major preventable risk factor for pediatric asthma.

Obesity is linked to increased asthma risk in children, finds study

“…Obese children have nearly a one third higher risk of developing asthma compared with children of healthy weight, a retrospective US study1 has found.…”

Pediatric obesity‐related asthma: A prototype of pediatric severe non‐T2 asthma

“…An increase in the prevalence of childhood obesity over the past several decades has identified its myriad effects and contribution to chronic pediatric diseases, including asthma. While initial cross‐sectional studies identified an association between obesity and asthma, prospective studies, and more recently, meta‐analyses, have consistently found obesity to be an independent predictor of asthma . Overweight/obese children have a relative risk of 1.2 to 1.8 for incident asthma .…”

“…While initial cross‐sectional studies identified an association between obesity and asthma, prospective studies, and more recently, meta‐analyses, have consistently found obesity to be an independent predictor of asthma . Overweight/obese children have a relative risk of 1.2 to 1.8 for incident asthma . This association varies by sex .…”

“…1 Overweight/obese children have a relative risk of 1.2 to 1.8 for incident asthma. [1][2][3][4][5][6] This association varies by sex. 7,8 Moreover, the association between asthma and obesity appears to be bidirectional, since asthma increases the relative risk for obesity by 1.5-1.7-fold.…”

“…Although obesity-related asthma, a type of pediatric non-T2 asthma, is often less responsive to medications, 13,14 and therefore classified as severe asthma, not all obese children with asthma have severe disease. There is also a lack of consensus on the association between obesity and asthma; although several studies have supported the association, [1][2][3][4][5][6] others have failed to find an association, [15][16][17] and a meta-analysis reported a weak association of obesity with asthma exacerbations and none with poor asthma control. 18 In addition, a few studies have linked obesity with allergic/Th2mediated asthma, particularly in girls.…”