Lung function and overweight in school aged children after early childhood wheezing

Abstract

Background and purpose Recently, obesity has been connected with wheezing, asthma and reduced lung function. Most previous studies have been cross‐sectional. The aim of the present follow‐up study was to evaluate the association of preceding or current overweight or obesity with lung function at early and late school age after early childhood wheezing. Material and methods From the 100 children hospitalized for infection associated wheezing at <24 months of age, 83 attended the control visit at 4.0 years, 82 at 7.2 years and 81 at 12.3 years of age. Flow‐volume spirometry was performed in 79 children at 7.2 years and in 80 children at 12.3 years of age. The weight status was assessed by calculating body mass index (BMI) at all visits. Age‐ and gender‐specific BMI standard deviation scores (BMI–SDS) of >1.3 SD and >2.0 SD were defined to mean overweight and obesity, respectively. Results Overweight at both 7.2 and 12.3 years of age was associated with decreased FEV1/FVC (forced expiratory volume in 1 sec/forced vital capacity). Overweight and obesity at 7.2 years of age were associated with decreased FEV1/FVC and MEF50 (maximal expiratory flow at 50% of FVC) at 12.3 years of age. The results were similar by continuous and categorized analyses, being robust to adjustments for viral findings during early childhood wheezing and asthma maintenance medication at school age. Conclusion Overweight and obesity are significant risk factors for reduced lung function at school age after early childhood wheezing. Thus, early‐life wheezers should avoid excessive weight gain during childhood. Pediatr. Pulmonol. 2011; 46:435–441. © 2010 Wiley‐Liss, Inc.

Overweight does not increase asthma risk but may decrease allergy risk at school age after infantile bronchiolitis

“…Second, no association was found between previous or current overweight or obesity and asthma or BHR at 7.2 or 12.3 years of age. However, overweight at 7.2 and 12.3 years of age was associated with decreased FEV 1 /FVC (forced vital capacity), and overweight and obesity at 7.3 years of age were predictive for decreased FEV 1 /FVC at 12.3 years of age in the same cohort, as published recently (25). And third, preliminary evidence was found that obesity (BMI >2.0 SD corresponding BMI >30 in young adults) may decrease the risk of allergy at late school age.…”

“…In conclusion, no evidence was found for an association between previous or current overweight and asthma in former bronchiolitis patients at school age, although overweight in the same cohort was associated with reduced lung function (25). Obesity may even decrease the risk of allergy and atopic sensitization at late school age.…”

Prevalence of malnutrition and obesity among cystic fibrosis patients

“…Interestingly, no overweight/obese patient in the present study had any characteristics of metabolic syndrome. In contrast, obesity in CF appears to exert a positive effect on lung function contrary to what is known about its role in non‐CF subjects . Nevertheless, according to certain reports, this positive association between NS and pulmonary function is limited to adult BMI below 23 kg/m 2 ; therefore counseling for weight management is advisable for this patient group as well .…”

“…In contrast, obesity in CF appears to exert a positive effect on lung function contrary to what is known about its role in non-CF subjects. 36 Nevertheless, according to certain reports, this positive association between NS and pulmonary function is limited to adult BMI below 23 kg/m 2 ; therefore counseling for weight management is advisable for this patient group as well. 17 The question whether overweight or obesity is also associated with improved clinical outcome is one that warrants further investigation.…”

Weight gain in infancy and post‐bronchiolitis wheezing

“…There is increasing evidence that overweight and obesity may increase asthma risk in children at school age (3,22). Excessive weight gain seems to be associated with asthma symptoms, treatments and diagnoses (22), and even with decreased lung function (23), but not with bronchial hyper‐responsiveness (22). We found some evidence that an excessive weight gain assessed by WFL, in line with three other studies applying length‐related weight gains for infants (4,5,9), increases the risk of wheezing in early years.…”