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Obesity major preventable risk factor for child asthma

Study finds 23%-27% of incident asthma in obese children in US directly attributable to obesity

Louise Prime

Tuesday, 27 November 2018

Obesity is a major preventable risk factor for paediatric asthma, with an estimated 23% to 27% of new asthma cases in obese children in the US directly attributable to obesity, the authors of a large study* have concluded in Pediatrics. They called for prioritisation of action to address child obesity, to reduce its onset and “significantly lower the public health burden of asthma”.

A team of researchers from across the US set out to describe the relationship between overweight and obesity and incident asthma in childhood and quantify attributable risk statistics for overweight and obesity on paediatric asthma in the US. They used the PEDSnet clinical data research network (a multi-specialty network that conducts observational research and clinical trials across eight of the US’s largest children’s health systems) to conduct a retrospective cohort study from January 2009 to December 2015 and compare asthma incidence among overweight and/or obese versus healthy weight 2- to 17-year-old children, none of whom had a history of asthma. Their data covered 507,496 children and 19,581,972 encounters; asthma incidence was defined as at least two encounters with a diagnosis of asthma and at least one asthma controller prescription.

They found that the adjusted risk for incident asthma was significantly increased among children who were overweight (relative risk, RR 1.17) and obese (RR 1.26), and that the adjusted risk for spirometry-confirmed asthma was increased among children with obesity (RR 1.29).

They calculated that an estimated 23% to 27% of new asthma cases in children with obesity are directly attributable to obesity, and noted: “In the absence of overweight and obesity, 10% of all cases of asthma would be avoided. … Obesity is a major preventable risk factor for paediatric asthma.”

They commented: “There are few preventable risk factors to reduce the incidence of asthma, but our data show that reducing the onset of childhood obesity could significantly lower the public health burden of asthma. Addressing childhood obesity should be a priority to help improve the quality of life of children and help reduce paediatric asthma.”

The author of a commentary** accompanying the study said it had many strengths including its “stringent analysis of asthma diagnosis using different definitions routinely used in asthma research”, and welcomed the fact that it had addressed the gaps in knowledge relating to incidences of the two mechanistically distinct types of paediatric obesity-related asthma – one in which asthma precedes obesity and the other in which obesity precedes asthma.


* Lang JE, Bunnell HT, Hossain MJ, et al. Being overweight or obese and the development of asthma. Pediatrics Published Online November 26, 2018 doi: 10.1542/peds.2018-2119.

** Rastogi D. Quantifying the contribution of obesity to incident childhood asthma: it’s about time. Pediatrics Published Online November 26, 2018 doi: 10.1542/peds.2018-2979.

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