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Cahill LM, Fisher KA, Robinson WT, Beiter KJ, Zabaleta J, Tseng TS, Kepper MM, Skizim MK, Griffiths LA, Uddo RB, Pelligrino NE, Maronge JM, Happel K, Scribner R, Sothern MS. Asthma status moderates the relationship between neighbourhood disadvantage and obesity in African American adolescent females. Obes Sci Pract 2019; 5:564-569. [PMID: 31890247 PMCID: PMC6934428 DOI: 10.1002/osp4.370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/24/2019] [Accepted: 07/25/2019] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Significant health disparities exist in asthma and obesity for African American youths. Successful interventions present an opportunity to address these disparities but require detailed study in order to ensure generalizability. This study investigated the intersection of obesity, neighbourhood disadvantage, and asthma. METHODS Data were extracted from 129 African American females ages 13 to 19 years (mean = 15.6 years [SD = 1.9]). Obesity was measured via body mass index (BMI). Asthma status was based on clinical diagnosis and/or results of the International Study of Asthma and Allergies during Childhood (ISAAC) questionnaire. The concentrated disadvantage index (CDI) assessed neighbourhood disadvantage. RESULTS Findings showed that 21.5% (n = 28) of participants were clinically defined as having asthma, 76.2% (n = 99) had obesity, and 24.9% (n = 31) were classified without obesity. The mean BMI was 35.1 (SD = 9.1) and the mean CDI was 1.0 (SD = 0.9). CDI and obesity were significantly associated in participants without asthma, but not in those with asthma. Multivariable linear regression results showed a significant interaction between CDI and asthma (t value = 2.2, P = .03). CONCLUSION In sum, results from this study found that asthma moderated the relationship between neighbourhood disadvantage and obesity.
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Affiliation(s)
- Laura M. Cahill
- Department of Behavioral and Community Health Sciences, School of Public HealthLouisiana State University Health Sciences CenterNew OrleansLouisiana
| | - Kiva A. Fisher
- Department of Behavioral and Community Health Sciences, School of Public HealthLouisiana State University Health Sciences CenterNew OrleansLouisiana
| | - William T. Robinson
- Department of Behavioral and Community Health Sciences, School of Public HealthLouisiana State University Health Sciences CenterNew OrleansLouisiana
| | - Kaylin J. Beiter
- Department of Behavioral and Community Health Sciences, School of Public HealthLouisiana State University Health Sciences CenterNew OrleansLouisiana
| | - Jovanny Zabaleta
- Department of Behavioral and Community Health Sciences, School of Public HealthLouisiana State University Health Sciences CenterNew OrleansLouisiana
- Department of Pediatrics, School of Medicine, Stanley S. Scott Cancer CenterLouisiana State University Health Sciences Center, Louisiana Cancer Research CenterNew OrleansLouisiana
| | - Tung S. Tseng
- Department of Behavioral and Community Health Sciences, School of Public HealthLouisiana State University Health Sciences CenterNew OrleansLouisiana
| | - Maura M. Kepper
- Department of Behavioral and Community Health Sciences, School of Public HealthLouisiana State University Health Sciences CenterNew OrleansLouisiana
- Contextual Risk Factors LaboratoryPennington Biomedical Research CenterBaton RougeLouisiana
| | - Meg K. Skizim
- Cancer Clinical Trials, School of Medicine, Stanley S. Scott Cancer CenterLouisiana State University Health Sciences CenterNew OrleansLouisiana
| | - Lauren A. Griffiths
- Department of Behavioral and Community Health Sciences, School of Public HealthLouisiana State University Health Sciences CenterNew OrleansLouisiana
| | - Robert B. Uddo
- Sanford Stem Cell Clinical CenterUniversity of California San Diego School of MedicineLa JollaCalifornia
| | - Nicole E. Pelligrino
- Department of Behavioral and Community Health Sciences, School of Public HealthLouisiana State University Health Sciences CenterNew OrleansLouisiana
| | | | - Kyle Happel
- Department of Pulmonology/Critical Care Medicine, School of MedicineLouisiana State University Health Sciences Center, Louisiana Cancer Research CenterNew OrleansLouisiana
| | - Richard Scribner
- Department of Epidemiology, School of Public HealthLouisiana State University Health Sciences CenterNew OrleansLouisiana
| | - Melinda S. Sothern
- Department of Behavioral and Community Health Sciences, School of Public HealthLouisiana State University Health Sciences CenterNew OrleansLouisiana
- Department of Pediatrics, School of Medicine, Stanley S. Scott Cancer CenterLouisiana State University Health Sciences Center, Louisiana Cancer Research CenterNew OrleansLouisiana
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Differences in respiratory consultations in primary care between underweight, normal-weight, and overweight children. NPJ Prim Care Respir Med 2019; 29:15. [PMID: 31053706 PMCID: PMC6499776 DOI: 10.1038/s41533-019-0131-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 04/16/2019] [Indexed: 11/08/2022] Open
Abstract
This prospective cohort study investigates whether the suggested association between weight status and respiratory complaints in open populations is also reflected in the frequency of consultations for respiratory complaints at the general practice. Children aged 2–18 years presenting at one of the participating general practices in the Netherlands could be included. Electronic medical files were used to extract data on consultations. Logistic regression analyses and negative binomial regression analyses were used to assess the associations between weight status and the presence, and frequency of respiratory consultations, respectively, during 2-year follow-up. Subgroup analyses were performed in children aged 2–6, 6–12, and 12–18 years old. Of the 617 children, 115 (18.6%) were underweight, 391 (63.4%) were normal-weight, and 111 (18%) were overweight. Respiratory consultations were not more prevalent in underweight children compared to normal-weight children (odds ratio (OR) 0.87, 95% confidence inteval (CI) 0.64–1.10), and in overweight children compared to normal-weight children (OR 1.33, 95% CI 0.99–1.77). Overweight children aged 12–18 years had more respiratory consultations (OR 2.14, 95% CI 1.14–4.01), more asthma-like consultations (OR 3.94, 95%CI 1.20–12.88), and more respiratory allergy-related consultations (OR 3.14, 95% CI 1.25–7.86) than normal-weight children. General practitioners should pay attention to weight loss as part of the treatment of respiratory complaints in overweight and obese children.
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Karunanayake CP, Amin K, Abonyi S, Dosman JA, Pahwa P. Prevalence and determinants of asthma among aboriginal adolescents in Canada. J Asthma 2019; 57:40-46. [PMID: 30628527 DOI: 10.1080/02770903.2018.1541354] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objective: The objective of the study was to determine the prevalence and associated risk factors of asthma in Aboriginal adolescents in Canada based on the Canadian Aboriginal Peoples Survey (APS) 2012. Few studies have investigated the prevalence and risk factors of asthma in Aboriginal adolescents in Canada. Methods: Data from the cross-sectional APS 2012 were analyzed to accomplish the objective. Logistic regression analysis was utilized to determine significant risk factors of lifetime diagnosis of asthma among Aboriginal adolescents. The outcome of interest for adolescents was based on the question: "Do you have asthma that have been diagnosed by a health professional?" Individual, environmental, and contextual factors were tested for an association with lifetime diagnosis of asthma among adolescents. Results: The overall prevalence of lifetime diagnosis of asthma was 16.0%. The prevalence of lifetime diagnosis of asthma was 16.8% for adolescent boys and 15.3% for adolescent girls. Based on multivariable logistic regression analysis, the risk factors of lifetime diagnosis of asthma were: age, income, being overweight, smoking inside the home, having one to two children under 18 years in the household, history of bronchitis, living in an urban residence, education, and geographical location. Female sex was reported to have a protective effect on or reduce risk of the prevalence of lifetime diagnosis of asthma compared to the male sex. Conclusions: Lifetime diagnosis of asthma prevalence appears to be lower in Aboriginal adolescent girls than in adolescent boys. Lifetime diagnosis of asthma prevalence in these adolescents is associated with age, income, education, being overweight, smoking inside the home, history of bronchitis, and location of residence, both geographical region and urban residence. The prevalence of lifetime diagnosis of asthma among Aboriginal adolescent is higher compared to the general adolescent population in Canada.
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Affiliation(s)
- Chandima P Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Khalid Amin
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Sylvia Abonyi
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - James A Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.,Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Punam Pahwa
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.,Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Navya H, Yajurvedi HN. Obesity causes weight increases in prepubertal and pubertal male offspring and is related to changes in spermatogenesis and sperm production in rats. Reprod Fertil Dev 2018; 29:815-823. [PMID: 26876883 DOI: 10.1071/rd15480] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 12/06/2015] [Indexed: 11/23/2022] Open
Abstract
The effect of obesity on testicular activity in prepubertal and pubertal rats was investigated in the present study. Obesity was induced in adult females by feeding a high-calorie diet (HCD). These females were mated with normal males and were fed an HCD during pregnancy and lactation. The male offspring born to obese mothers and fed an HCD after weaning were found to be obese. Seminiferous tubules of offspring from control mothers (OCM) and offspring from HCD-fed mothers (OHCDM) had the same set of germ cells at different age intervals, namely spermatogonia, leptotene spermatocytes, zygotene spermatocytes, pachytene spermatocytes and round and elongated spermatids on postnatal days (PND) 7, 13, 17, 24 and 36, and on the day of preputial separation, respectively. However, there was a significant decrease in round and elongated spermatids and the epididymal sperm count, coupled with a significant decrease in testosterone and an increase in leptin serum concentrations in OHCDM compared with OCM. These results show that obesity in prepubertal rats does not affect the age-dependent appearance of germ cells according to developmental hierarchy, but it does interfere with spermatid formation, resulting in a reduced sperm count, which may be due to a deficiency of testosterone mediated by hyperleptinaemia.
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Affiliation(s)
- Harish Navya
- Department of Zoology, University of Mysore, Manasagangotri, Mysore 570 006, Karnataka, India
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Delaware Survey of Children's Health: Childhood Asthma in Delaware. Dela J Public Health 2017; 3:6-9. [PMID: 34466892 PMCID: PMC8352469 DOI: 10.32481/djph.2017.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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The lipid profile in obese asthmatic children compared to non-obese asthmatic children. Allergol Immunopathol (Madr) 2016; 44:346-50. [PMID: 27112546 DOI: 10.1016/j.aller.2015.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 11/18/2015] [Accepted: 12/03/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND A relationship between asthma and obesity has been documented in children and adolescents. An alternate day calorie restriction diet has been reported to improve asthma symptoms by decreasing levels of serum cholesterol and triglycerides, reducing markers of oxidative stress and increasing levels of the antioxidant uric acid. Therefore, to investigate the lipid profile in asthmatic children may be important in asthma control treatment. MATERIALS AND METHODS One hundred and sixty newly diagnosed persistent asthmatic children were selected to participate in the study. They were divided into four groups based on their body mass index (BMI): Group I normal weight (BMI=20-24.9kg/m(2), n=30); Group II under-weight (BMI<20kg/m(2), n=30); Group III overweight (BMI=25-30kg/m(2), n=25); and Group IV obese (BMI>30kg/m(2), n=25). Fasting blood sugar, fasting insulin, and HbA1c were measured to exclude the possibility of pre-diabetes. Lipid profile measurements included total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), apo-A1, apo-B and triglycerides. RESULTS There were no significant differences in the levels of apo-A1, apo-B, triglycerides, cholesterol and LDL in all four groups. Only the level of HDL was higher in GIV>GIII>GII>GI (75.84±13.95, 68.56±15.28, 64.17±13.93, 63.17±14.34mg/dl, respectively). There were no cases of pre-diabetes in any of the four groups. CONCLUSION Hypercholesterolaemia and hypertriglyceridaemia were not found in any of the persistent asthmatic children, and thus they are not high risk factors for asthma. Similarly, there were no differences in apo-A1 and apo-B between any of the BMI groups. No differences were found in LDL levels, however HDL levels were increased in all four groups, indicating that allergic sensitisation may have occurred. Controlling body weight and restricting calorie intake may be as important as appropriate pharmacological management in controlling asthma.
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Joseph M, Elliott M, Zelicoff A, Qian Z, Trevathan E, Chang JJ. Racial disparity in the association between body mass index and self-reported asthma in children: a population-based study. J Asthma 2016; 53:492-7. [PMID: 26787188 DOI: 10.3109/02770903.2015.1116084] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To examine the racial disparity in the association between obesity and asthma in US children and adolescents. METHODS This study was based on a nationally representative, random-digit-dial sample of US households with children less than 18 years of age from the National Survey of Children's Health in 2011/2012 and 2007. The study sample included 88,668 children ages 10-17 with data on body mass index (BMI), parental reporting of asthma diagnosis, and potential confounders. Multiple logistic regression analysis was performed to estimate the crude and adjusted odds ratios stratified by child race/ethnicity. RESULTS The prevalence of overweight was 15.2% and obesity was 14.1%. Self-reported asthma diagnosis was 16.7% in our study sample. Obese children were 51% more likely to have asthma compared to normal weight children after controlling for child's sex, child age, socioeconomic status, environmental tobacco smoke (ETS), and neighborhood conditions. Our study also shows that the strength of this association varied by race/ethnicity after stratification. Being male, being non-Hispanic Black or Multi-racial, below the Federal Poverty Level, ETS and having detracting neighborhood elements were also significantly associated with higher odds of having a self-reported asthma diagnosis. CONCLUSION We observed a racial difference in the association between BMI and asthma in US children. Our findings have significant public health implications and may help public health practitioners to target children and adolescents at higher risk of prevention and intervention efforts.
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Affiliation(s)
- Michael Joseph
- a Department of Epidemiology , College for Public Health and Social Justice, Saint Louis University , St. Louis, MO , USA and
| | - Michael Elliott
- b Department of Biostatistics , College for Public Health and Social Justice, Saint Louis University , St. Louis, MO , USA
| | - Alan Zelicoff
- a Department of Epidemiology , College for Public Health and Social Justice, Saint Louis University , St. Louis, MO , USA and
| | - Zhengmin Qian
- a Department of Epidemiology , College for Public Health and Social Justice, Saint Louis University , St. Louis, MO , USA and
| | - Edwin Trevathan
- a Department of Epidemiology , College for Public Health and Social Justice, Saint Louis University , St. Louis, MO , USA and
| | - Jen Jen Chang
- a Department of Epidemiology , College for Public Health and Social Justice, Saint Louis University , St. Louis, MO , USA and
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Sex-Based Differences in Asthma among Preschool and School-Aged Children in Korea. PLoS One 2015; 10:e0140057. [PMID: 26441284 PMCID: PMC4595127 DOI: 10.1371/journal.pone.0140057] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 09/20/2015] [Indexed: 11/19/2022] Open
Abstract
The purpose of this study was to explore risk factors related to asthma prevalence among preschool and school-aged children using a representative national dataset from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted from 2009–2011. We evaluated the demographic information, health status, household environment, socioeconomic status, and parents’ health status of 3,542 children aged 4–12 years. A sex-stratified multivariate logistic regression was used to obtain adjusted prevalence odds ratios (ORs) and 95% confidence intervals after accounting for primary sample units, stratification, and sample weights. The sex-specific asthma prevalence in the 4- to 12-year-old children was 7.39% in boys and 6.27% in girls. Boys and girls with comorbid atopic dermatitis were more likely to have asthma than those without atopic dermatitis (boys: OR = 2.20, p = 0.0071; girls: OR = 2.33, p = 0.0031). Boys and girls with ≥1 asthmatic parent were more likely to have asthma than those without asthmatic parents (boys: OR = 3.90, p = 0.0006; girls: OR = 3.65, p = 0.0138). As girls got older, the prevalence of asthma decreased (OR = 0.90, p = 0.0408). Girls residing in rural areas were 60% less likely to have asthma than those residing in urban areas (p = 0.0309). Boys with ≥5 family members were more likely to have asthma than those with ≤3 family members (OR = 2.45, p = 0.0323). The factors related to asthma prevalence may differ depending on sex in preschool and school-aged children. By understanding the characteristics of sex-based differences in asthma, individualized asthma management plans may be established clinically.
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Kitsantas P, Aguisanda F. Association of asthma with obesity among adolescents exposed to environmental tobacco smoke. J Asthma 2015; 53:25-9. [PMID: 26365093 DOI: 10.3109/02770903.2015.1024322] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the association between asthma diagnosis and obesity among adolescents exposed to environmental tobacco smoke (ETS). METHODS The sample included 28,807 adolescents (13-17 years old) from the National Survey of Children's Health (NSCH) (2011-2012). STUDY DESIGN The NSCH is a US cross-sectional telephone survey that included at least one child between the ages of 0 and 17 years residing at a household during the time of the interview. Descriptive statistics were used to describe sample characteristics and assess the prevalence of asthma among adolescents with obesity exposed to ETS. Logistic regression models were built to assess the effect of obesity on asthma diagnosis within the context of ETS exposure. RESULTS The prevalence of asthma among adolescents was 10.4% and the obesity was 13.2%. Adolescents with obesity exposed to ETS within the home were significantly (p < 0.05) more likely to have an asthma diagnosis (23%) compared with non-obese (10.9%) residing in similar households. Adjusted odds ratios showed that adolescents with obesity were 2.07 (95% CI, 1.15, 3.70) times more likely to have asthma if they were exposed to ETS inside their homes. CONCLUSION The findings indicate that adolescents with obesity are more likely to be diagnosed with asthma if they are exposed to ETS in the household. It is important that the association between obesity and asthma is examined within the context of environmental risk factors in future studies, as this may shed some light to underlying mechanisms between these two serious public health issues.
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Affiliation(s)
- Panagiota Kitsantas
- a Department of Health Administration and Policy , George Mason University , Fairfax , VA , USA and
| | - Francis Aguisanda
- b National Center for Advancing Translational Sciences, National Institutes of Health , Rockville , MD , USA
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Groth S, Rhee H, Kitzman H. Relationships among obesity, physical activity and sedentary behavior in young adolescents with and without lifetime asthma. J Asthma 2015; 53:19-24. [PMID: 26288155 PMCID: PMC4827268 DOI: 10.3109/02770903.2015.1063646] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To examine the inter-relationships among body mass index (BMI), physical activity, sedentary behavior and gender in urban, low-income, primarily African American young adolescents with or without lifetime asthma. METHODS Data were collected in 2002-2004 from 626 12-year old adolescents who were children of women who participated in the New Mother's Study in Memphis, TN (1990-1991). Adolescents with and without asthma were compared on BMI, physical activity and sedentary behavior. Multiple linear regression models were used to examine the association of asthma, gender and BMI with physical activity and sedentary behavior. RESULTS Complete data were available for 545 adolescents. Eleven percent of adolescents had lifetime asthma. Asthma and gender were associated with high-intensity physical activity (p < 0.001). Adolescents with asthma participated in less physical activity and girls participated less than boys. Gender was associated with sedentary behavior (p < 0.001): boys used personal computer (pc)/video after school more than girls. Girls with asthma had a higher BMI than girls without asthma (p = 0.027). Boys with asthma were less physically active than boys without asthma (p < 0.05). CONCLUSIONS Adolescents with asthma are less physically active than those without asthma and girls are less active than boys. Clinicians who provide care for adolescents with asthma are encouraged to assess physical activity/sedentary behavior and provide guidance that promotes active lifestyles. A longitudinal study is needed to shed light on the unique contribution of asthma separated from the effects of overweight/obesity on physical activity and sedentary behaviors.
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Affiliation(s)
- Susan Groth
- University of Rochester, 601 Elmwood Ave., Box SON, Rochester, NY 14642, 585-275-8895, Fax: 1-585-273-1270,
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Mebrahtu TF, Feltbower RG, Greenwood DC, Parslow RC. Childhood body mass index and wheezing disorders: a systematic review and meta-analysis. Pediatr Allergy Immunol 2015; 26:62-72. [PMID: 25474092 DOI: 10.1111/pai.12321] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/29/2014] [Indexed: 01/19/2023]
Abstract
BACKGROUND It has been claimed that overweight/obesity, childhood asthma and wheezing disorders are associated, although the results of observational studies have remained inconsistent. We conducted a systematic review and meta-analysis to investigate this. METHODS An online search of published papers linking childhood asthma and wheezing with overweight/obesity up to May 2014 using EMBASE and MEDLINE medical research databases was carried out. Summary odds ratios (OR) were estimated using random-effects models. Subgroup meta-analyses were performed to assess the robustness of risk associations and between-study heterogeneity. RESULTS A total of 38 studies comprising 1,411,335 participants were included in our meta-analysis. The summary ORs of underweight (<5th percentile), overweight (>85th to <95th percentile) and obesity (≥ 95 th percentile) were 0.85 (95% CI: 0.75 to 0.97; p = 0.02), 1.23 (95% CI: 1.17 to 1.29; p < 0.001) and 1.46 (95% CI: 1.36 to 1.57, p < 0.001), respectively. Heterogeneity was significant and substantial in all three weight categories, and not accounted for by pre-defined study characteristics. CONCLUSION Our results suggest that underweight is associated with a reduced risk of childhood asthma, and overweight and obesity are associated with an increased risk of childhood asthma. Although our findings assert that overweight/obesity and childhood asthma are associated, the causal pathway and temporal aspects of this relationship remain unanswered and deserve further epidemiological investigation.
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Affiliation(s)
- Teumzghi F Mebrahtu
- Division of Epidemiology and Biostatistics, School of Medicine, University of Leeds, Leeds, UK
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Black MH, Zhou H, Takayanagi M, Jacobsen SJ, Koebnick C. Increased asthma risk and asthma-related health care complications associated with childhood obesity. Am J Epidemiol 2013; 178:1120-8. [PMID: 23924576 PMCID: PMC3857927 DOI: 10.1093/aje/kwt093] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 04/23/2013] [Indexed: 01/05/2023] Open
Abstract
Asthma is the most common chronic condition of childhood, yet the relationship between obesity and asthma risk and the impact of obesity on clinical asthma outcomes are not well understood. For this population-based, longitudinal study, demographic and clinical data were extracted from administrative and electronic health records of 623,358 patients aged 6-19 years who were enrolled in the Kaiser Permanente Southern California health plan in 2007-2011. Crude asthma incidence ranged from 16.9 per 1,000 person-years among normal-weight youth to 22.3 per 1,000 person-years among extremely obese youth. The adjusted risks of asthma for overweight, moderately obese, and extremely obese youth relative to those of normal weight youth were 1.16 (95% confidence interval: 1.13, 1.20), 1.23 (95% confidence interval: 1.19, 1.28), and 1.37 (95% confidence interval: 1.32, 1.42), respectively (Ptrend < 0.0001). The relationship between obesity and asthma risk was strongest in Asian/Pacific Islanders and in the youngest girls (aged 6-10 years), compared with other groups. Among youth who developed asthma, those who were moderately or extremely obese had more frequent asthma exacerbations requiring emergency department services and/or treatment with oral corticosteroids. In conclusion, obese youth are not only more likely to develop asthma, but they may be more likely to have severe asthma, resulting in a greater need for health care utilization and aggressive asthma treatment.
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Affiliation(s)
- Mary Helen Black
- Correspondence to Dr. Mary Helen Black, Department of Research and Evaluation, Kaiser Permanente Southern California, 100 Los Robles, Second Floor, Pasadena, CA 91101 (e-mail: )
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Childhood overweight/obesity and pediatric asthma: the role of parental perception of child weight status. Nutrients 2013; 5:3713-29. [PMID: 24064571 PMCID: PMC3798930 DOI: 10.3390/nu5093713] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 08/13/2013] [Accepted: 09/04/2013] [Indexed: 01/31/2023] Open
Abstract
Childhood obesity and asthma are on the rise in the U.S. Clinical and epidemiological data suggest a link between the two, in which overweight and obese children are at higher risk for asthma. Prevention of childhood obesity is preferred over treatment, however, in order to be receptive to messages, parents must perceive that their child is overweight. Many parents do not accurately assess their child’s weight status. Herein, the relation between parental perceptions of child weight status, observed body mass index (BMI) percentiles, and a measure of child feeding practices were explored in the context of asthma, food allergy, or both. Out of the children with asthma or food allergy that were classified as overweight/obese by BMI percentiles, 93% were not perceived as overweight/obese by the parent. Mean scores for concern about child weight were higher in children with both asthma and food allergy than either condition alone, yet there were no significant differences among the groups in terms of pressure to eat and restrictive feeding practices. In summary, parents of children with asthma or food allergy were less likely to recognize their child’s overweight/obese status and their feeding practices did not differ from those without asthma and food allergy.
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Prevalence and risk factors of asthma in off-reserve Aboriginal children and adults in Canada. Can Respir J 2013; 19:e68-74. [PMID: 23248805 DOI: 10.1155/2012/753040] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Only a few studies have investigated asthma morbidity in Canadian Aboriginal children. In the present study, data from the 2006 Aboriginal Peoples Survey were used to determine the prevalence and risk factors for asthma in Canadian Aboriginal children six to 14 years of age and adults 15 to 64 years of age living off reserve. The prevalence of asthma was 14.3% in children and 14.0% in adults. Children and adults with Inuit ancestry had a significantly lower prevalence of asthma than those with North American Indian and Métis ancestries. Factors significantly associated with ever asthma in children included male sex, allergy, low birth weight, obesity, poor dwelling conditions and urban residence. In adults, factors associated with ever asthma varied among Aboriginal groups; however, age group, sex and urban residence were associated with ever asthma in all four Aboriginal groups. The prevalence of asthma was lower in Aboriginal children and higher in Aboriginal adults compared with that reported for the Canadian population. Variation in the prevalence of and risk factors for asthma among Aboriginal ancestry groups may be related to genetic and environmental factors that require further investigation.
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Beydon N, Delclaux C. BMI as a comorbidity factor in childhood asthma. Expert Rev Respir Med 2013; 6:569-71. [PMID: 23234442 DOI: 10.1586/ers.12.66] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Liu PC, Kieckhefer GM, Gau BS. A systematic review of the association between obesity and asthma in children. J Adv Nurs 2013; 69:1446-65. [PMID: 23560878 DOI: 10.1111/jan.12129] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2013] [Indexed: 11/29/2022]
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.
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Affiliation(s)
- Pei-Ching Liu
- Department of Nursing, National Taiwan University College of Medicine, Taipei, Taiwan
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Shi X, Tubb L, Fingers ST, Chen S, Caffrey JL. Associations of physical activity and dietary behaviors with children's health and academic problems. THE JOURNAL OF SCHOOL HEALTH 2013; 83:1-7. [PMID: 23253284 DOI: 10.1111/j.1746-1561.2012.00740.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND We examined the associations of physical activities and dietary behaviors with children's health and academic-behavioral problems. METHODS We employed a Community-wide Children's Health Assessment and Planning Survey to examine physical activity, healthy meals, health status, and academic-behavioral problems in 3708 children 7 to 14 years of age. Statistical associations were examined with chi-square test and logistic regression analysis; we calculated odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Among these children, 30.2% were overweight-obese, 11.0% had academic problems, and 7.9% had behavioral problems. Children classified as healthy eaters were more likely to exercise ≥4 days/week (79.1% vs 64.6%, OR: 2.08, 95% CI: 1.14 to 2.49), less likely to be overweight-obese (27.7% vs 44.6%, OR: 0.48, CI: 0.31 to 0.73), less likely to have academic problems (9.1% vs 16.1%, OR: 0.57, 95% CI: 0.41 to 0.79) and behavioral problems (6.9% vs 13.9%, OR: 0.46, 95% CI: 0.32 to 0.66) compared with their less healthy eating peers. Physical activity and healthy meals were associated with an improved health status (p < .001). However, the proportions of children taking unhealthy meals or choosing sedentary lifestyle increased as the cohorts progressed (p < .05) from childhood (7 to 8 years) to adolescence (13 to 14 years). CONCLUSIONS Healthy (or unhealthy) lifestyle behaviors are significantly interrelated. Children who take healthy meals and exercise often are associated with better health and fewer academic and behavioral problems. Unfortunately, taking unhealthy meals and sedentary lifestyle characterize a growing proportion of young adolescents. Thus, curbing unhealthy lifestyle behaviors should start in early childhood.
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Affiliation(s)
- Xiangrong Shi
- Department of Integrative Physiology, Cardiovascular Research Institute and Texas Prevention Institute, UNT Health Science Center, Fort Worth, TX 76107, USA.
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Childhood Overweight/Obesity and Asthma: Is There a Link? A Systematic Review of Recent Epidemiologic Evidence. J Acad Nutr Diet 2013; 113:77-105. [DOI: 10.1016/j.jand.2012.08.025] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2011] [Accepted: 08/22/2012] [Indexed: 11/23/2022]
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Vo P, Makker K, Matta-Arroyo E, Hall CB, Arens R, Rastogi D. The association of overweight and obesity with spirometric values in minority children referred for asthma evaluation. J Asthma 2012. [PMID: 23189981 DOI: 10.3109/02770903.2012.744035] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Overweight, obesity, and asthma are more prevalent in minority children; yet, the association of overweight and obesity with spirometric values in asthmatic minorities is not well characterized. OBJECTIVE To study the relationship between weight, ethnicity, and spirometric values in children referred for asthma evaluation to a large inner-city hospital in Bronx, NY. METHODS Retrospective review of spirometry done at the first pulmonary clinic visit of 980 asthmatic children, aged 7-20 years, was conducted. Linear regression analysis was performed to elucidate the association of overweight and obesity with pulmonary function among Whites, African Americans, and Hispanics compared with their normal weight counterparts. RESULTS More African Americans (58%) and Hispanics (65.4%) were overweight and obese than Whites (51.2%) (p < .05). Compared with their normal weight counterparts, percent forced expiratory volume in the 1st second (FEV(1))/forced vital capacity (FVC) ratio was lower in both overweight and obese African Americans (2.99%, p < .05 and 3.56%, p < .01, respectively) and Hispanics (2.64%, p < .05 and 2.36%, p < .05, respectively); these differences were found in obese (3.73%, p < .05) but not in overweight (0.68%, p = .7) Whites. CONCLUSIONS FEV(1)/FVC ratio was lower in both overweight and obese African American and Hispanic children, while this association was present only among obese Whites compared with their normal weight counterparts. These results suggest that spirometric measures of lower airway obstruction decrease with smaller weight increments in minority children when compared with White children. In the context of the higher prevalence of overweight and obesity among African Americans and Hispanics, our findings offer one potential explanation for increased asthma among minority children.
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Affiliation(s)
- Phuong Vo
- Department of Pediatrics, Children's Hospital, Boston, MA, USA
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Wang HM, Bell JF, Edwards TC, Patrick DL. Weight status, quality of life, and cigarette smoking among adolescents in Washington State. Qual Life Res 2012; 22:1577-87. [DOI: 10.1007/s11136-012-0306-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2012] [Indexed: 11/29/2022]
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Black MH, Smith N, Porter AH, Jacobsen SJ, Koebnick C. Higher prevalence of obesity among children with asthma. Obesity (Silver Spring) 2012; 20:1041-7. [PMID: 22252049 PMCID: PMC3348709 DOI: 10.1038/oby.2012.5] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Accepted: 12/26/2011] [Indexed: 12/02/2022]
Abstract
The aim of this study is to investigate the association between childhood obesity and asthma, and whether this relationship varies by race/ethnicity. For this population-based, cross-sectional study, measured weight and height, and asthma diagnoses were extracted from electronic medical records of 681,122 patients aged 6-19 years who were enrolled in an integrated health plan 2007-2009. Weight class was assigned based on BMI-for-age. Overall, 18.4% of youth had a history of asthma and 10.9% had current asthma. Adjusted odds of current asthma for overweight, moderately obese, and extremely obese youth relative to those of normal weight were 1.22 (95% confidence interval (CI): 1.20, 1.24), 1.37 (95% CI: 1.34, 1.40), and 1.68 (95% CI: 1.64, 1.73), respectively (P trend < 0.001). Black youth are nearly twice as likely (adjusted odds ratio (OR) = 1.93, 95% CI: 1.89, 1.99), and Hispanic youth are 25% less likely (adjusted OR = 0.75, 95% CI: 0.74, 0.77), to have current asthma than to non-Hispanic white youth. However, the relationship between BMI and asthma was strongest in Hispanic and weakest in black youth. Among youth with asthma, increasing body mass was associated with more frequent ambulatory and emergency department visits, as well as increased inhaled and oral corticosteroid use. In conclusion, overweight, moderate, and extreme obesity are associated with higher odds of asthma in children and adolescents, although the association varies widely with race/ethnicity. Increasing BMI among youth with asthma is associated with higher consumption of corticosteroids and emergency department visits.
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Affiliation(s)
- Mary Helen Black
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Ning Smith
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Amy H. Porter
- Kaiser Permanente Medical Center Baldwin Park, Baldwin Park, California, USA
| | - Steven J. Jacobsen
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Corinna Koebnick
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
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Asthma and Association With Obesity and Weight Loss. TOP CLIN NUTR 2012. [DOI: 10.1097/tin.0b013e3182542459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Washington D, Yeatts K, Sleath B, Ayala GX, Gillette C, Williams D, Davis S, Tudor G. Communication and education about triggers and environmental control strategies during pediatric asthma visits. PATIENT EDUCATION AND COUNSELING 2012; 86:63-69. [PMID: 21600721 PMCID: PMC3168678 DOI: 10.1016/j.pec.2011.04.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Revised: 03/08/2011] [Accepted: 04/09/2011] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To determine the extent to which providers, caregivers, and pediatric asthma patients discussed environmental trigger control during primary care visits, and any demographic characteristics associated with having these discussions. METHODS Children ages 8-16 with persistent asthma and their caregivers were recruited at five pediatric practices in non-urban areas of North Carolina. All of the medical visits were audio-tape recorded. We administered questionnaires to the child's caregiver following the visit. RESULTS Two hundred and ninety-six patients had useable audio-tape data. Providers typically discussed at least one type of asthma trigger during these visits (86% of visits). The most common discussions were about exercise (70%), the weather/season (42%), and allergies/pollen (35%). Environmental control strategies were discussed less frequently (27% of visits). Providers educated the patient and their caregiver about environmental control strategies during 14% of the visits. CONCLUSION Although providers frequently discuss some environmental triggers and provide education, there is room for more comprehensive discussions of these issues, which may contribute to decreased asthma exacerbations. PRACTICE IMPLICATIONS Providers, or alternatively, asthma health educators, should devote more time to discussing environmental asthma triggers and control strategies with pediatric asthma patients and their families, as they are important components of overall asthma control.
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Affiliation(s)
- Deidre Washington
- Pharmaceutical Outcomes & Policy, Eshelman School of Pharmacy, University of North Carolina, USA.
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Jiang Y, Risica PM, Arias W, Perry D, Viner-Brown S. Perceived Weight Status Effect on Adolescent Health-Risk Behaviors: Findings from 2007 and 2009 Rhode Island Youth Risk Behavioral Survey. SCHOOL MENTAL HEALTH 2011. [DOI: 10.1007/s12310-011-9068-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Black MH, Anderson A, Bell RA, Dabelea D, Pihoker C, Saydah S, Seid M, Standiford DA, Waitzfelder B, Marcovina SM, Lawrence JM. Prevalence of asthma and its association with glycemic control among youth with diabetes. Pediatrics 2011; 128:e839-47. [PMID: 21949144 PMCID: PMC3387907 DOI: 10.1542/peds.2010-3636] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/16/2011] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE To estimate the prevalence of asthma among youth with types 1 and 2 diabetes and examine associations between asthma and glycemic control. METHODS This was a cross-sectional analysis of data from the SEARCH for Diabetes in Youth study, which included youth diagnosed with type 1 (n = 1683) and type 2 (n = 311) diabetes from 2002 through 2005. Asthma status and medications were ascertained from medical records and self-administered questionnaires, and glycemic control was assessed from hemoglobin A1c measured at the study visit. RESULTS Prevalence of asthma among all youth with diabetes was 10.9% (95% confidence interval [CI]: 9.6%-12.3%). The prevalence was 10.0% (95% CI: 8.6%-11.4%) among youth with type 1 and 16.1% (95% CI: 12.0%-20.2%) among youth with type 2 diabetes and differed according to race/ethnicity. Among youth with type 1 diabetes, those with asthma had higher mean A1c levels than those without asthma, after adjustment for age, gender, race/ethnicity, and BMI (7.77% vs 7.49%; P = .034). Youth with asthma were more likely to have poor glycemic control, particularly those with type 1 diabetes whose asthma was not treated with pharmacotherapy, although this association was attenuated by adjustment for race/ethnicity. CONCLUSIONS Prevalence of asthma may be elevated among youth with diabetes relative to the general US population. Among youth with type 1 diabetes, asthma is associated with poor glycemic control, especially if asthma is untreated. Specific asthma medications may decrease systemic inflammation, which underlies the complex relationship between pulmonary function, BMI, and glycemic control among youth with diabetes.
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Affiliation(s)
- Mary Helen Black
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California 91101, USA
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Stingone JA, Ramirez OF, Svensson K, Claudio L. Prevalence, demographics, and health outcomes of comorbid asthma and overweight in urban children. J Asthma 2011; 48:876-85. [PMID: 21958346 DOI: 10.3109/02770903.2011.616615] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Asthma and overweight are epidemic in urban children but the relationship between these conditions is not fully understood. This study presents demographic and risk profiles of comorbidity for overweight asthmatic children, characterizes morbidity by comparing health outcomes among overweight asthmatics and healthy weight asthmatics, and examines socioeconomic factors associated with comorbidity. OBJECTIVE To construct a demographic profile of overweight asthmatic children in an urban setting and identify factors that contribute to prevalence. METHOD Cross-sectional study of 5250 children in New York City public elementary schools using a parent-report questionnaire on body mass index, socioeconomic status, asthma, and asthma-related outcomes. RESULTS Prevalence of overweight (body mass index ≥ 85th percentile for age and gender) was 50.9%. The prevalence of overweight and ever being diagnosed with asthma was 10.9%. The prevalence of overweight with current asthma was 6.2%. Overweight current asthmatics had more night symptoms, missed school days, and asthma medication use than healthy weight asthmatics. Almost 50% of overweight current asthmatic children reported emergency department visits for asthma compared with 30% of healthy weight asthmatics. Comorbidity was most prevalent among males, Latinos, and children in low-income households, with the highest prevalence among Puerto Ricans. In multivariate analysis stratified by gender, the most significant factors associated with comorbidity among girls were low income and minority race/ethnicity, while among boys significant factors were parental education and parental history of asthma. Interestingly, there were few underweight children (7.8%) but they had high prevalence of asthma (13.8%). CONCLUSIONS The comorbidity of overweight and asthma has a large impact on urban populations, causing greater disease burden than asthma alone. Overweight asthmatics show more uncontrolled asthma, evidenced by emergency department visits, quick-relief medication use, and days with asthma symptoms. The relationship between socioeconomic factors and the asthma-obesity comorbidity may vary by gender and requires further study to identify successful interventions to reduce disease in children.
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Affiliation(s)
- Jeanette A Stingone
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA
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Kheirandish-Gozal L, Dayyat EA, Eid NS, Morton RL, Gozal D. Obstructive sleep apnea in poorly controlled asthmatic children: effect of adenotonsillectomy. Pediatr Pulmonol 2011; 46:913-8. [PMID: 21465680 PMCID: PMC3156307 DOI: 10.1002/ppul.21451] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2010] [Revised: 12/12/2010] [Accepted: 12/13/2010] [Indexed: 12/18/2022]
Abstract
BACKGROUND Asthma and obstructive sleep apnea (OSA) in children share multiple epidemiological risk factors and the prevalence of snoring is higher in asthmatic children, suggesting that the latter may be at increased risk for OSA. Since both asthma and OSA are inflammatory disorders, we hypothesized that polysomnographically demonstrated OSA would be more frequent among poorly controlled asthmatics (PCA), and that treatment of OSA, if present, would ameliorate the frequency of acute asthmatic exacerbations (AAE). METHODS Children with PCA were referred for an overnight sleep study, and adenotonsillectomy (tonsillectomy and adenoidectomy, T&A) was performed if OSA was present. Frequency of asthma symptoms and exacerbations were compared. RESULTS Ninety-two PCA children, ages 3-10 years, with a mean frequency of AAE of 3.4 ± 0.4/year were prospectively referred for a sleep study. OSA (i.e., AHI > 5/hrTST) was present in 58 patients (63.0%; OR: 40.9, 12.9-144.1, P < 0.000001 compared to the prevalence of OSA in a non-asthmatic population). Information at 1-year follow-up was available for 35 PCA children after T&A. The annual frequency of AAE, rescue inhaled use, and asthma symptoms in this sub-group decreased compared to no changes in the group without OSA. CONCLUSIONS The prevalence of OSA is markedly increased among PCA children and treatment of OSA appears to be associated with substantial improvements in the severity of the underlying asthmatic condition.
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Affiliation(s)
- Leila Kheirandish-Gozal
- Sections of Pediatric Pulmonology and Pediatric Sleep Medicine, Department of Pediatrics, University of Chicago, Chicago, Illinois 60637-1470, USA.
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Yeh F, Rhoades ER, Tarpay M, Eichner JE. Advantages of video questionnaire in estimating asthma prevalence and risk factors for school children: findings from an asthma survey in American Indian youth. J Asthma 2010; 47:711-7. [PMID: 20690798 DOI: 10.3109/02770903.2010.485663] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The aims of the present study were to estimate the prevalence and risk factors of asthma among a sample of American Indian youth and to evaluate survey instruments used in determining asthma prevalence and risk factors. METHODS Three hundred and fifty-two adolescents aged 9 to 21 years enrolled in an Indian boarding school completed an asthma screening. The survey instruments were a written questionnaire and a video-illustrated questionnaire prepared from the International Study of Asthma and Allergies in Childhood (ISAAC), school health records, and a health questionnaire. Participants also underwent spirometry testing. RESULTS The prevalence of self-reported asthma varied from 12.7% to 13.4% depending upon the instrument used and the questions asked. A history of hay fever, respiratory infections, and family history of asthma were found to be risk factors for asthma by all instruments. Female gender and living on a reservation were significantly associated with asthma by some, but not all, instruments. Airway obstruction was highly associated with one asthma symptom (wheeze) shown in the video questionnaire. Associations for most risk factors with asthma were strongest for the video questionnaire. CONCLUSIONS The prevalence of self-reported asthma among these American Indian youth was similar to rates reported for other ethnic groups. The video-based questionnaire may be the most sensitive tool for identifying individuals at risk for asthma.
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Affiliation(s)
- Fawn Yeh
- Center for American Indian Health Research, University of Oklahoma Health Sciences Center, College of Public Health, 801 N.E. 13th Street, Oklahoma City, OK 73190, U.S.A.
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Abstract
PRACTICAL RELEVANCE Feline bronchial asthma is one of the most commonly diagnosed respiratory conditions of cats. Clinical signs range from intermittent wheezing and coughing, which can compromise quality of life, to episodes of severe dyspnea that can be life-threatening. CLINICAL CHALLENGES Feline asthma can be easily disregarded as a simplistic condition. However, much about its pathophysiology remains obscure. There is no gold standard method of diagnosis, and current approaches are associated with various limitations. Also, feline asthma is typically treated with long-term glucocorticoid therapy, which can have significant consequences. AUDIENCE Because of its prevalence, general practitioners encounter asthma regularly. Refractory cases are often managed by veterinary internists and pulmonologists. PATIENT GROUP Asthma can be diagnosed in cats of any age but is usually seen in young to middle-aged adults (mean 4 years, range 1-15 years). There is no sex predilection, but the Siamese breed appears to be overrepresented. EVIDENCE BASE While the standard clinical approach to feline asthma has changed little in recent years, new research has provided greater insight into many aspects of this complex disease and new strategies are being studied. This article reviews the current literature in order to raise awareness of how advances in the understanding of the pathophysiology, diagnosis and treatment of feline asthma may be determining the future direction of clinical practice.
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Affiliation(s)
- Christine M Venema
- Department of Small Animal Clinical Sciences, Michigan State University, College of Veterinary Medicine, D211 Veterinary Medical Center, East Lansing, MI 48824, USA.
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