Lung function, obesity and physical fitness in young children: The EXAMIN YOUTH study

Köchli, Sabrina; Endes, Katharina; Bartenstein, Tim; Usemann, Jakob; Schmidt‐Trucksäss, Arno; Frey, Urs; Zahner, Lukas; Hanssen, Henner

doi:10.1016/j.rmed.2019.105813

Cited by 18 publications

(21 citation statements)

References 34 publications

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“…Children considered overweight or obese have higher values for both FEV1 and FVC, particularly for FVC, so that the FEV1/FVC ratio is lower than for normal weight children [37,38]. This aligns with our findings and may be due to asymmetric lung growth (i.e., increased dysanapsis) for children considered overweight and obese [9].…”

Section: Comparison With Other Studiessupporting

confidence: 88%

Age and body mass index affect fit of spirometry GLI references in schoolchildren

Mozún

Ardura‐Garcia

Pedersen

et al. 2021

Preprint

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Background: References from the Global Lung Function Initiative (GLI) are widely used to interpret children's spirometry results. We assessed fit for healthy schoolchildren. Methods: LuftiBus in the school (LUIS) is a population-based study done from 2013-2016 in the canton of Zurich, Switzerland. Parents and children aged 6-17 years answered questionnaires about respiratory symptoms and lifestyle. Children underwent spirometry in a mobile lung function lab. We calculated GLI-based z-scores for FEV1, FVC, FEV1/FVC, and FEF25-75 for healthy White participants. We defined appropriate fit to GLI references by mean values +/-0.5 z-scores. We assessed if fit varied by age, body mass index, height, and sex using linear regression models. Results: We analysed cross-sectional data from 2036 children with valid FEV1 measurements of which 1762 also had valid FVC measurements. The median age was 12.2 years. Fit was appropriate for children aged 6-11 years for all indices. In adolescents aged 12-17 years, fit was appropriate for FEV1/FVC (mean: 0.09; SD: 1.02) z-scores, but not for FEV1 (mean: 0.62; SD: 0.98), FVC (mean: 0.60; SD: 0.98), and FEF25-75 (mean: 0.54; SD: 1.02). FEV1, FVC, and FEF25-75 z-scores fitted better in children considered overweight (means: 0.25, 0.13, 0.38) than normal weight (means: 0.55, 0.50, 0.55; p-trend: <0.001, 0.014, <0.001). FEV1, FVC, and FEF25-75 z scores depended on both age and height (p interaction: 0.034, 0.019, <0.01). Conclusion: GLI-based FEV1, FVC, and FEF25-75 z-scores do not fit White Swiss adolescents well. This should be considered when using reference equations for clinical decision making, research and international comparison.

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Section: Comparison With Other Studiessupporting

confidence: 88%

Age and body mass index affect fit of spirometry GLI references in schoolchildren

Mozún

Ardura‐Garcia

Pedersen

et al. 2021

Preprint

Self Cite

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“…The pattern in children seems to be different and, although there is also a fall that correlates to BMI in FRC and RV, the most relevant characteristic is the decline in the FEV1/FVC ratio without a loss in FVC, which in fact even increased [40]. A broad study involving more than 1200 respiratory function studies in non-asthmatic children between the ages of six and eight years, showed a significant increase in FEV1 and FVC with the increase in BMI, but both increments were not parallel: there was a disproportionate increase in FVC compared to FEV1, so the FEV1/FVC ratio decreases with the increase in BMI; with childhood obesity being associated with lower FEV1/FVC because of a disproportional increase of FVC with respect to FEV1 with increasing BMI [41]. Similar results have been replicated in another wide-ranging study that evaluated the effect of overweight on lung function in 1717 children aged five to 18 years; they also found a positive association between the BMI z-score and FVC and FEV1 but, conversely, a negative association with FEV1/FVC and these lung function alterations presented independently of whether the child was atopic or not [42].…”

Section: Changes In Lung Functionmentioning

confidence: 99%

Nutrition, Obesity and Asthma Inception in Children. The Role of Lung Function

Sánchez-Solís

García‐Marcos

2021

Nutrients

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Obesity is an important public health problem. WHO estimates that about 39 million children younger than 5 years of age are overweighted or obese. On the other hand, asthma is the most prevalent chronic disease in childhood, and thus, many children share those two conditions. In the present paper we review the epidemiology of children with asthma and obesity, as well as the consequences of being obese on the respiratory system. On the one hand obesity produces an underlying T-helper 2 (TH2) low inflammation state in which numerous cytokines, which could have an impact in the respiratory system play, a role. On the other hand, some respiratory changes have been described in obese children and, specially, the development of the so called “dysanapsis” (the disproportionate scaling of airway dimensions to lung volume) which seems to be common during the first stages of life, probably related to the early development of this condition. Finally, this review deals with the role of adipokines and insulin resistance in the inception and worsening of asthma in the obese child.

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“… 43 Normal respiratory physiology is usually impaired in obese patients, including children and adolescents. 64 As the lung is one of the main targets and leads to greater risks for patients with COVID-19, this aspect must always be considered. In fact, hematosis is impaired in obesity, which becomes even more relevant when the exchange areas are reduced due to coronavirus action.…”

Section: Pathophysiology Of Obesity and Its Relationship With Covid-1mentioning

confidence: 99%

COVID-19 and obesity in childhood and adolescence: a clinical review

Nogueira‐de‐Almeida

Ciampo

Ferraz

et al. 2020

Jornal de Pediatria

177

136

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Objective To identify factors that contribute to the increased susceptibility and severity of COVID-19 in obese children and adolescents, and its health consequences. Sources Studies published between 2000 and 2020 in the PubMed, MEDLINE, Scopus, SciELO, and Cochrane databases. Summary of findings Obesity is a highly prevalent comorbidity in severe cases of COVID-19 in children and adolescents; social isolation may lead to increase fat accumulation. Excessive adipose tissue, deficit in lean mass, insulin resistance, dyslipidemia, hypertension, high levels of proinflammatory cytokines, and low intake of essential nutrients are factors that compromise the functioning of organs and systems in obese individuals. These factors are associated with damage to immune, cardiovascular, respiratory, and urinary systems, along with modification of the intestinal microbiota (dysbiosis). In severe acute respiratory syndrome coronavirus 2 infection, these organic changes from obesity may increase the need for ventilatory assistance, risk of thromboembolism, reduced glomerular filtration rate, changes in the innate and adaptive immune response, and perpetuation of the chronic inflammatory response. Conclusions The need for social isolation can have the effect of causing or worsening obesity and its comorbidities, and pediatricians need to be aware of this issue. Facing children with suspected or confirmed COVID-19, health professionals should 1) diagnose excess weight; 2) advise on health care in times of isolation; 3) screen for comorbidities, ensuring that treatment is not interrupted; 4) measure levels of immunonutrients; 5) guide the family in understanding the specifics of the situation; and 6) refer to units qualified to care for obese children and adolescents when necessary.

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Lung function, obesity and physical fitness in young children: The EXAMIN YOUTH study

Cited by 18 publications

References 34 publications

Age and body mass index affect fit of spirometry GLI references in schoolchildren

Age and body mass index affect fit of spirometry GLI references in schoolchildren

Nutrition, Obesity and Asthma Inception in Children. The Role of Lung Function

COVID-19 and obesity in childhood and adolescence: a clinical review

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