The Relationship between Asthma and Obesity in Urban Early Adolescents

Abstract

Asthma and obesity, which have reached epidemic proportions, impact urban youth to a great extent. Findings are inconsistent regarding their relationship; no studies have considered asthma management. We explored the association of obesity and asthma-related morbidity, asthma-related health care utilization, and asthma management in urban adolescents with uncontrolled asthma. We classified 373 early adolescents (mean age = 12.8 years; 82% Hispanic or Black) from New York City public middle schools into 4 weight categories: normal (body mass index [BMI] < 85th percentile); overweight (85th percentile £ BMI < 95th percentile); obese (95th percentile £ BMI < 97th percentile); and very obese (BMI ‡ 97th percentile). We compared sample obesity prevalence to national estimates, and tested whether weight categories predicted caregiver reported asthma outcomes, adjusting for age and race/ethnicity. Obesity prevalence was 37%, with 28% of the sample being very obese; both rates were significantly higher than national estimates. We found no significant differences in asthma-related health care utilization or asthma management between weight categories, and a few differences in asthmarelated morbidity. Relative to normal weight and obese youth, overweight youth had higher odds of never having any days with asthma-related activity limitations. They also had higher odds of never having asthmarelated school absences compared with obese youth. Overweight youth with asthma-related activity limitations had more days with limitations compared with normal weight youth. Overweight, but not obese youth, missed more school due to asthma than normal weight youth. Overweight and obesity prevalence was very high in urban, Hispanic, and Black adolescents with uncontrolled asthma, but not strongly associated with asthmarelated morbidity, asthma-related health care utilization, or asthma management practices.

Normocaloric Diet Improves Asthma-Related Quality of Life in Obese Pubertal Adolescents

“…It is now well recognized that asthma and obesity share some aspects in their pathophysiology, and that elevated body mass index (BMI) is associated with the dose-dependent increase in asthma incidence and severity, particularly in the young Hispanic population [2,3,4]. The main international guidelines for the management of asthma recognize the impact of obesity on asthma from the clinical and pathophysiological perspectives [5,6].…”

Highlights from This Issue

“…6 Original research in this issue includes an analysis by Jay et al Using data from a New York City school-based asthma intervention study, the impact of obesity on asthma morbidity is examined. 7 Besides the alarmingly high rate of obesity observed (56%) in this sample with asthma, those with obesity did not have increased asthma morbidity. This suggests that although obesity is associated with increased asthma prevalence, it does not appear to impact adversely the distribution of asthma severity among school-age children with asthma.…”

Clinical features of obesity in children with bronchial asthma

“…Похожие результаты были получены и в других исследовани-ях, хотя частота ожирения у детей с бронхиальной астмой варьировала от 16,9 до 37%, что, вероятнее всего, связано с использованием разных критериев диагностики ожирения [17][18][19][20] Ожирение I степени диагностировано у 19 (42,2%) больных основной группы, II степени -у 12 (26,7%), III степени -у 12 (26,7%) и IV степени -у 2 (4,4%). При анализе распределения по степени ожирения у детей с бронхиальной астмой и группы сравне-ния статистически значимых различий не выявлено (рис.…”