Effects of weight loss on dynamic hyperinflation in obese women asthmatics

Abstract

Obese adults with asthma are more likely to develop dynamic hyperinflation (DH) and expiratory flow limitation (EFL) than nonobese asthmatics, and weight-loss seems to improve the breathing mechanics during exercise. However, studies evaluating the effect of weight loss on DH in obese adults with asthma have not been performed. We sought to evaluate the effect of a weight loss program on DH in obese adults with asthma. Forty-two asthma patients were enrolled in a weight loss program (diet, psychological support, and exercise) and were subsequently divided into two groups according to the percentage of weight loss: a ≥5% group ( n = 19) and a <5% group ( n = 23). Before and after the intervention, DH and EFL (constant load exercise), health-related quality of life (HRQoL), asthma control, quadriceps muscle strength and endurance, body composition, and lung function were assessed. Both groups exhibited a decrease of ≥10% in inspiratory capacity (DH) before intervention, and only the ≥5% group showed clinical improvement in DH compared with the <5% group postintervention (−9.1 ± 14.5% vs. −12.5 ± 13.5%, respectively). In addition, the ≥5% group displayed a significant delay in the onset of both DH and EFL and a clinically significant improvement in HRQoL and asthma control. Furthermore, a correlation was observed between reduced waist circumference and increased inspiratory capacity ( r = −0.45, P = 0.05) in the ≥5% group. In conclusion, a weight-loss of ≥5% of the body weight improves DH, which is associated with waist circumference in obese adults with asthma. In addition, the group with greater weight-loss showed a delayed onset of DH and EFL during exercise and improved asthma clinical control and HRQoL. NEW & NOTEWORTHY This is the first study to evaluate dynamic hyperinflation (DH) after a weight loss program in obese patients with asthma. Our results demonstrate that moderate weight loss can improve DH in obese patients with asthma that is associated with a decrease in abdominal fat. Moreover, a minimum of 5% in weight loss delays the onset of DH and expiratory flow limitation besides inducing a clinical improvement in asthma quality of life and clinical control.

Leptin and Asthma: What Are the Interactive Correlations?

“…Thus, more studies are required to explore the interaction between CPAP and leptin levels in OSA patients. Remarkably, weight loss is the effective therapy way for OSA and asthma [ 31 ].…”

Weight Loss for Children and Adults With Obesity and Asthma: Systematic Review

“…After a thorough evaluation of the full-text papers, we ultimately included five papers in the final analysis, consisting of prospective analysis, cross-sectional study, retrospective analysis, experimental study, and secondary analysis to a randomized control trial. In a 2019 prospective study by Silva et al 4 , 51 initially enrolled patients faced various challenges leading to a final cohort of 42 asthma patients. These participants were categorized into two groups, based on their weight loss achievements: those with ≥5% weight loss (n = 19) and those with <5% weight loss (n = 23), exhibiting similar baseline characteristics before the intervention.…”

“…Following the intervention, the ≥5% group experienced a significant increase in tidal volume, with no significant difference in respiratory rates between the two groups. 4 Before the intervention, both groups exhibited similar health-related quality of life (HRQoL) and asthma control. However, the ≥5% group demonstrated substantial improvements in all domains of the Asthma Quality of Life Questionnaire (AQLQ) and the Asthma Control Questionnaire (ACQ) post-intervention, with significant differences in AQLQ domains related to activity limitations, symptoms, and total scores.…”

A Total Diet Replacement Weight Management Program for Difficult-to-Treat Asthma Associated With Obesity

“…The authors correctly question the generalisability based on these limitations. Grandi Silva et al [32] reported a trial of weight loss (nutritional support, psychology input and a varied exercise programme) in women with BMI 35-40kg/m 2 and moderate-to-severe asthma (n=51) to assess the effect on dynamic hyperinflation. Post-hoc analysis showed improvements in ACQ and AQLQ in those that lost 5% weight, though no significant change in ACQ when compared to those that lost <5%.…”