Being Overweight or Obese and the Development of Asthma

Abstract

Although adult obesity has been associated with 250 000 new cases of asthma annually, the authors attempted to associate overweight and obesity with incident asthma and attributable risk in pediatric asthma in the United States.Subjects were 2- to 17-year-olds who were healthy weight compared with obese or overweight children.The PEDSnet clinical data system was employed to perform a retrospective cohort investigation to compare the incidence of asthma in overweight and/or obese versus healthy-weight 2- to 17-year-old children with asthma. Asthma was defined by ≥2 encounters, ≥1 asthma controller prescription, and/or stricter criteria encompassing spirometry. Multivariable Poisson regression analyses were used to determine incident asthma rates and risk ratio.By using data from >500 000 children with a mean observation period of 4 years, the risk for incident asthma was enhanced in overweight (relative risk [RR]: 1.17; 95% confidence interval [CI]: 1.10–1.25) and obese (RR: 1.26; 95% CI: 1.18–1.34) children. The adjusted risk for asthma diagnosed by spirometry was enhanced among children with obesity (RR: 1.29; 95% CI: 1.16–1.42). Up to 27% of new asthma diagnoses in obese children is estimated to be directly related to obesity. An estimated 10% of all cases of asthma would be eliminated if overweight condition and/or obesity could be prevented.For childhood asthma, obesity is a preventable risk factor accessible to intervention.This study has multiple strengths. The robustness of this study includes rigorous analysis for asthma diagnosis by using 3 standard definitions and pairing children for demographic, insurance, and comorbidity confounders. These strengths are based on clinical and medical claims data, using the PEDSnet system from 8 large pediatric health systems. In summary, the researchers in this study provide abundant data with rigorous analysis of confounders, emphasizing the substantial independent attribution of obesity to incident asthma. With the prevalence of childhood obesity being 20% and obesity contributing to up to 27% of new cases of asthma, addressing this modifiable risk factor can have a significant impact on asthma.