Relationship of body mass index with asthma indicators in Head Start children

Department of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock 72202-3591, USA.
Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology (Impact Factor: 2.6). 08/2007; 99(1):22-8. DOI: 10.1016/S1081-1206(10)60616-3
Source: PubMed


To examine the relationship of body mass index (BMI) and asthma indicators on children with asthma in a Head Start (HS) program.
In this cross-sectional study (November 18, 2000, to December 12, 2003) of children aged 3 to 5 years with asthma, we compared the BMI data of HS asthmatic patients (n = 213) with the data of peer control subjects from a sample (n = 816) of the National Health and Nutrition Examination Survey aged 3 to 5 years and with children in prekindergarten in Arkansas public schools (n = 1,024). Parental reports of asthma symptoms, health care use, medication use, school days missed, and quality of life were used as indicators of asthma morbidity. Categorical analysis and chi2 tests were performed to examine the relationship between BMI and asthma morbidity.
The prevalence of overweight (> or =95th percentile) was significantly higher in HS children with asthma compared with the National Health and Nutrition Examination Survey children (P < .001) and Arkansas prekindergarten children (P = .05). Compared with HS asthmatic children with a BMI less than the 85th percentile, HS asthmatic patients with a BMI of the 85th percentile or greater reported significantly more school days missed (P = .02), lifetime hospitalizations (P = .04), emergency department visits (P = .02), and activity limitations (P = .03) and fewer oral corticosteroid bursts (P = .04). There was also a trend for more daytime symptoms (P = .05) and lower quality of life (P = .06). No differences were observed in rescue (P = .28) or controller (P = .47) medications, environmental tobacco smoke exposure (P = .47), positive allergy test results (P = .85), and nighttime symptoms (P > .99).
Having an increased BMI was associated with more asthma morbidity in this group of HS asthmatic patients. Despite the lack of a clear explanation for the link between asthma and BMI, our data suggest that an increased BMI significantly affects the well-being of young asthmatic patients and should be further addressed.

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    • "AHR) (Bibi et al. 2004) or serum lipid profile and IgE level (Leung et al. 2009). In addition, some studies gathered indicators representing asthma severity such as emergency room visits; school days missed, or rescue medication usage to capture a more thorough picture of the children's asthma severity (Belamarich et al. 2000, Bibi et al. 2004, Vargas et al. 2007, Jacobson et al. 2008). Though there was heterogeneity regarding the definition of childhood obesity across reviewed studies, half of them agreed that the 85th and 95th BMI percentiles were applicable cut-off points to identify overweight/obese children. "
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    ABSTRACT: AIM: To provide a comprehensive integration of contemporary studies focusing on the relationship between obesity and asthma in paediatric populations. BACKGROUND: The simultaneous increase in asthma and obesity prevalence has been widely discussed over the past 20 years. Although studies have discovered a positive correlation between the two, evidence-based findings are needed to develop nursing interventions. DESIGN: A quantitative systematic review on the literature was conducted from June-December 2011. DATA SOURCES: An electronic database search was conducted for studies published between January 1966-May 2011. Additional articles were identified through the reference lists of reviewed papers. REVIEW METHODS: Inclusion/exclusion criteria and quality appraisal were applied to ensure research primarily designed to study the relationship between obesity and asthma in children was included. RESULTS: The majority of studies support a positive association between obesity and asthma in children. Among correlates recognized as important effect modifiers, gender was the most prominent, with obese girls more likely to have asthma diagnoses than obese boys. Scrutinization of covariates in selected studies revealed that most related to children's demographic characteristics and were inconsistent across the studies. CONCLUSIONS: This review was designed to integrate contemporary scientific findings on the association between obesity and asthma by including a large number of studies with variant research designs. To identify high-risk groups and develop nursing interventions to help children affected by both epidemics, more interdisciplinary and well-designed investigations focusing on an expanded spectrum of correlates including demographic and behavioural factors are warranted.
    Journal of Advanced Nursing 04/2013; 69(7). DOI:10.1111/jan.12129 · 1.74 Impact Factor
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    • "Additionally, regulatory genes for ORMDL3 [8] and IL12B [9] have been associated with asthma severity. Environmental exposures have also been associated with asthma severity and include tobacco smoke[10] and outdoor air pollution[11]; there is also evidence of increased asthma severity in association with obesity[12] and reduced dietary antioxidants[13]. Whilst gene-environment interactions are described for asthma causation in children [14,15] there is also the potential for such interactions to explain why asthma severity varies within a population[16]. "
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    ABSTRACT: Gene-environment interactions are likely to explain some of the heterogeneity in childhood asthma. Here, we describe the methodology and experiences in establishing a database for childhood asthma designed to study gene-environment interactions (PAGES--Paediatric Asthma Gene Environment Study). Children with asthma and under the care of a respiratory paediatrician are being recruited from 15 hospitals between 2008 and 2011. An asthma questionnaire is completed and returned by post. At a routine clinic visit saliva is collected for DNA extraction. Detailed phenotyping in a proportion of children includes spirometry, bronchodilator response (BDR), skin prick reactivity, exhaled nitric oxide and salivary cotinine. Dietary and quality of life questionnaires are completed. Data are entered onto a purpose-built database. To date 1045 children have been invited to participate and data collected in 501 (48%). The mean age (SD) of participants is 8.6 (3.9) years, 57% male. DNA has been collected in 436 children. Spirometry has been obtained in 172 children, mean % predicted (SD) FEV1 97% (15) and median (IQR) BDR is 5% (2, 9). There were differences in age, socioeconomic status, severity and %FEV1 between the different centres (p≤0.024). Reasons for non-participation included parents not having time to take part, children not attending clinics and, in a small proportion, refusal to take part. It is feasible to establish a national database to study gene-environment interactions within an asthmatic paediatric population; there are barriers to participation and some different characteristics in individuals recruited from different centres. Recruitment to our study continues and is anticipated to extend current understanding of asthma heterogeneity.
    BMC Medical Research Methodology 12/2010; 10(1):107. DOI:10.1186/1471-2288-10-107 · 2.27 Impact Factor
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    • "Escore Z: (altura/idade; peso/idade) IMC Não houve comprometimento da altura e do peso corporal nas crianças e adolescentes que usaram corticoesteróídes inalatórios mais de 1 ano e em doses recomendadas para o tratamento da asma. Carroll et al.,2006 16 n=209 crianças admitidas na UTI com asma Peso corporal Peso normal (<95% do peso para idade percentil) Obeso (> 95% do peso para idade) 45 (22%) eram obesos Brockmann et al.,2007 17 n=40 crianças asmáticas n=41 controlos IMC Questionário para actividade física 15 crianças asmáticas obesas/sobrepeso; 11 crianças controlos obesas/sobrepeso; As asmáticas realizam menos actividade física comparadas com as controlos Vargas et al., 2007 18 n=213 crianças asmáticas n=816 controlos. 03 a 05 anos IMC A prevalenca de baixo peso (percentil ≥ 95) foi mais signifi cativa nas crianças com asma "
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    ABSTRACT: Asthma is a chronic inflammatory disease of high prevalence, considered a public health problem and is thought to be one cause of low birth weight and growth retardation. The purpose of this article was to review in literature the effects of asthma on the nutritional status in children. A systematic review was made by searching for articles in PubMed, SciELO and LILACS databases. Review articles, studies with adults or research that did not evaluate the effects of asthma in children were excluded. Hence original articles in humans were included. In the systematic review we found 901 articles in MEDLINE (1966-1996), 47 in LILACS and SciELO in the 16 - Brazil, totaling 964 articles. Of these, 17 articles were selected. Evidence that asthma interferes in nutritional status can not be proven in this study.
    Revista portuguesa de pneumologia 08/2010; 16(4):617-26. · 1.17 Impact Factor
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