Pediatric Obesity-Related Asthma: The Role of Nutrition and Nutrients in Prevention and Treatment

Abstract

Childhood obesity rates have dramatically risen in numerous countries worldwide. Obesity is likely a factor in increased asthma risk, which is already one of the most widespread chronic respiratory pathologies. The pathogenic mechanism of asthma risk has still not yet been fully elucidated. Moreover, the role of obesity-related inflammation and pulmonary overreaction to environmental triggers, which ultimately result in asthma-like symptoms, and the importance of dietary characteristics is well recognized. Diet is an important adjustable element in the asthma development. Food-specific composition of the diet, in particular fat, sugar, and low-quality nutrients, is likely to promote the chronic inflammatory state seen in asthmatic patients with obesity. An unbalanced diet or supplementation as a way to control asthma more efficiently has been described. A personalized dietary intervention may improve respiratory symptoms and signs and therapeutic response. In this narrative review, we presented and discussed more recent literature on asthma associated with obesity among children, focusing on the risk of asthma among children with obesity, asthma as a result of obesity focusing on the role of adipose tissue as a mediator of systemic and local airway inflammation implicated in asthma regulation, and the impact of nutrition and nutrients in the development and treatment of asthma. Appropriate early nutritional intervention could possibly be critical in preventing and managing asthma associated with obesity among children.

Benefits of Physical Exercise as Approach to Prevention and Reversion of Non-Alcoholic Fatty Liver Disease in Children and Adolescents with Obesity

“…Childhood obesity is at the root of multiple systemic comorbidities. These include, among others, unbalances in the endo-metabolic system (e.g., type 2 diabetes mellitus, dyslipidemia), respiratory system (e.g., obstructive sleep apnea, asthma), and gastrointestinal system including NAFLD and its evolutions as well as at the cardiovascular and musculoskeletal systems [ 16 , 17 , 18 , 19 , 20 ] ( Figure 1 ). The severity of these comorbidities increases proportionally to the degree of obesity [ 21 ].…”

An Overview of the Obese-Asthma Phenotype in Children

“…There is evidence that Mediterranean diet rich in fruit, vegetable and n-3 polyunsaturated fatty acids is protective for asthma development, exacerbations and asthma symptoms due to the positive impacts on inflammation, oxidation and microbial composition. Conversely, the Western diet—rich in saturated fatty acids and low in antioxidants—stimulates inflammation and may increase the risk of preschool wheezing and asthma with a negative effect on lung function [ 40 ]. In addition, childhood asthma may be influenced by maternal diet during pregnancy, particularly by the intake of certain foods such as fish or fruits and vegetables, and nutrients such as vitamin E, vitamin D, zinc or polyunsaturated fatty acids).…”

Perimenstrual Asthma in Adolescents: A Shared Condition in Pediatric and Gynecological Endocrinology

“…Epidemiologic evidences have shown that the overall prevalence and incidence of asthma are increased in obese individuals, and obesity is a risk factor for airway inflammation [ 32 , 38 , 39 , 40 , 41 , 42 ]. A recent meta-analysis, including six prospective cohort studies on the effect of body weight on future asthma risk, found a twice-higher risk in obese children compared with normal-weight ones, suggesting that obesity is an independent asthma risk factor for the youngest [ 43 , 44 ].…”

“…Visceral obesity is responsible for a picture of mechanical obstruction in the lungs, resulting in airflow obstruction and altered lung volumes [ 43 ]. The relationship between obesity and asthma is complex [ 38 , 52 ]. In the Severe Asthma Research Program, an age/phenotype-dependent association was found: children with early onset asthma became obese, whereas there was no significant relationship between overweight/obesity and asthma duration in cases of late-onset asthma [ 32 , 53 ].…”