Obesity, sedentary lifestyle, and exhaled nitric oxide in an early adolescent cohort

Abstract

Fractional exhaled nitric oxide (FeNO) is a marker of airway inflammation that is well‐characterized in allergic disease states. However, FeNO is also involved in nonallergic inflammatory and pulmonary vascular mechanisms or responses to environmental stimuli. We sought to determine the extent to which obesity or sedentary lifestyle is associated with FeNO in adolescents not selected on the basis of allergic disease. In Project Viva, a prebirth cohort study, we measured body mass index (BMI), skinfold thicknesses, waist circumference, body fat, hours watching television, hours of physical activity, and heart rate after exercise among 929 adolescents (median age, 12.9). We measured FeNO twice and averaged these as a continuous, log‐transformed outcome. We performed linear regression models, adjusted for child age, sex, height, and race/ethnicity, maternal education and smoking during pregnancy, household income and smoking, and neighbourhood characteristics. In secondary analysis, we additionally adjusted for asthma. More than 2 hours spent watching TV was associated with 10% lower FeNO (95% confidence interval [CI]: −20, 0%). Higher body fat percentage was also associated with lower FeNO. After additional adjustment for asthma, teens who are underweight (BMI <5th %tile, 3%) had 22% lower FeNO (95%CI: −40, 2%) and teens who are overweight (BMI ≥85th %ile, 28%) had 13% lower FeNO (95%CI: −23, −2%). Each of these associations of lifestyle and body weight with lower FeNO were greater in magnitude after adjusting for asthma. In summary, sedentary lifestyle, high and low BMI were all associated with lower FeNO in this adolescent cohort.

Conicity Index as an Anthropometric Index of Central Obesity in the Prediction of Adult Bronchial Asthma; Correlation with Fractional Exhaled Nitrous Oxide Tests

“…Our results are consistent to Flashner et al findings, who showed both high and low BMI were related with lower FENO-values in his cohort 14 . Lang et al, stated that obesity (BMI>95 th centile) had slight effect on symptoms, risk of acute attack or airway-markers among poorly-controlled asthmatic children 1 .…”

Effects of Acute and Chronic Exercises on Executive Function in Children and Adolescents: A Systemic Review and Meta-Analysis

“…A sedentary lifestyle and physical inactivity (insufficient exercises time) are prevalent among children and adolescents (Sisson et al, 2009 ; Qi et al, 2019 ) and are negatively linked with their physical and psycho-cognitive health (Tremblay et al, 2011 ; Flashner et al, 2019 ). Specifically, these unhealthy lifestyle behaviors result in obesity (Rey-Lopez, 2008 ), uncoordinated movements (Ferguson et al, 2014 ; Flashner et al, 2019 ; Kong et al, 2019 ; Riquelme et al, 2019 ), negative emotions (depression, anxiety, suicide attempts) (Berardelli et al, 2018 ; Thivel et al, 2018 ; Padulo et al, 2019 ) and a severe deficit of cognitive functions (Torrens-Burton et al, 2017 ; Koolhaas et al, 2019 ; Loprinzi et al, 2019 ). Among the components of cognitive functioning, inhibitory control, working memory, and cognitive flexibility play a critical role in the development of school-age children and their educational achievement or academic performance (Best, 2010 ; Willoughby et al, 2012 ).…”

Obesity may enhance the adverse effects of NO2 exposure in urban schools on asthma symptoms in children

“…[45][46][47][48] Our data indicate that in obese children with asthma, allergen sensitization is not predictive of elevated FENO and, consequently, eosinophilic lung inflammation. Studies looking at obese adolescents 49 and adults with asthma have shown similar findings whereby increasing BMI is associated with reduced exhaled nitric oxide (NO). 50,51 Lugogo et al 51 reported lower FENO levels and blood eosinophil counts in obese adults with asthma compared with normal weight adults, concluding that conventional biomarkers of inflammation are poorly predictive of eosinophilic airway inflammation in the obese.…”