Nutrition, Obesity and Asthma Inception in Children. The Role of Lung Function

Bariatric surgery and diabetes: Current challenges and perspectives

Diabetes mellitus (DM) and obesity have become public issues of global concern. Bariatric surgery for the treatment of obesity combined with type 2 DM has been shown to be a safe and effective approach; however, there are limited studies that have systematically addressed the challenges of surgical treatment of obesity combined with DM. In this review, we summarize and answer the most pressing questions in the field of surgical treatment of obesity-associated DM. I believe that our insights will be of great help to clinicians in their daily practice.

Exploring the Link between Oxidative Stress, Selenium Levels, and Obesity in Youth

Obesity is a worldwide increasing concern. Although in adults this is easily estimated with the body mass index, in children, who are constantly growing and whose bodies are changing, the reference points to assess weight status are age and gender, and need corroboration with complementary data, making their quantification highly difficult. The present review explores the interaction spectrum of oxidative stress, selenium status, and obesity in children and adolescents. Any factor related to oxidative stress that triggers obesity and, conversely, obesity that induces oxidative stress are part of a vicious circle, a complex chain of mechanisms that derive from each other and reinforce each other with serious health consequences. Selenium and its compounds exhibit key antioxidant activity and also have a significant role in the nutritional evaluation of obese children. The balance of selenium intake, retention, and metabolism emerges as a vital aspect of health, reflecting the complex interactions between diet, oxidative stress, and obesity. Understanding whether selenium status is a contributor to or a consequence of obesity could inform nutritional interventions and public health strategies aimed at preventing and managing obesity from an early age.

Exploring the Impact of Adequate Energy Supply on Nutrition, Immunity, and Inflammation in Elderly Patients with Chronic Obstructive Pulmonary Disease

Background

Chronic Obstructive Pulmonary Disease (COPD) progression in the elderly is notably influenced by nutritional, immune, and inflammatory status. This study aimed to investigate the impact of adequate energy supply on these indicators in COPD patients.

Methods

COPD patients meeting specific criteria were recruited and categorized into energy-adequate and energy-deficient groups based on their energy supply. Comparable demographic factors such as age, gender, smoking and drinking history, COPD duration, inhaled drug classification, and home oxygen therapy application were observed. Notable differences were found in BMI and inhaled drug use between the two groups.

Results

The energy-adequate group exhibited significant improvements in various health indicators, including lymphocyte count, hemoglobin, CRP, total cholesterol, prealbumin, albumin, PNI, SII, SIRI, CAR, and CONUT scores in the secondary auxiliary examination. These positive changes suggest a notable enhancement in nutritional, immune, and inflammatory status.

Conclusion

This research highlights the substantial benefits of adequate energy supply in elderly COPD patients. The observed improvements in nutritional, immune, and inflammatory markers underscore the importance of addressing energy needs to positively influence disease-related outcomes in this population. These findings have implications for developing targeted interventions to optimize the well-being of elderly individuals with COPD.

Multivitamin consumption and childhood asthma: a cross-sectional study of the NHANES database

BACKGROUND

Dietary intakes of vitamins are associated with asthma. However, previous studies mainly explored the association between a single vitamin intake and asthma, which did not take the multivitamins into consideration. Herein, this study aims to explore the overall effect of dietary multivitamins consumption on childhood asthma.

METHODS

Data of children and adolescents (aged 2-17 years old) were extracted from the National Health and Nutrition Examination Survey (NHANES) database in 2015-2018 in this cross-sectional study. Weighted univariate logistic regression analysis was used to screen covariates. The association between multivitamins (including vitamin A, C, D, E, B1, B2, B6, B12, K, niacin, folic acid, and choline) and childhood asthma was explored using univariate and multivariate logistic regression analyses. The evaluation indexes were odds ratio (OR) and 95% confidence interval (CI). We further introduced the Bayesian kernel machine regression (BKMR) to assess the joint effect of the twelve vitamins on childhood asthma, the impact of an individual vitamin as part of a vitamin mixture, and the potential interactions among different vitamins.

RESULTS

Among 4,715 eligible children and adolescents, 487 (10.3%) had asthma. After adjusting for covariates including race, family history of asthma, pregnant smoking, BMI Z-score, energy intake, breast feeding, and low birth weight, we found that for each 1-unit increase in vitamin K consumption, the odds of childhood asthma decreased 0.99 (P=0.028). The overall effect analysis reported a trend of negative relationship between the multivitamins and childhood asthma, especially at the 75th percentile and over. According to the BKMR models, when other vitamins are fixed at the median level, the odds of childhood asthma increased along with the elevated vitamin D (VD) and vitamin B2 (VB2), whereas along with the depressed vitamin C (VC). In addition, no potential interaction has been found between every two vitamins of multivitamins on childhood asthma.

CONCLUSION

Among children and adolescents who have high-risk of asthma, it may be beneficial to increase dietary consumption of multivitamins. Our findings recommended that children and adolescents should increase the intake of VC-rich foods, whereas control the dietary consumption of VD and VB2 in daily life.

Obesity-related asthma and its relationship with microbiota

Obesity and asthma are global public health problems. Obesity-related asthma is a special phenotype of asthma with a complex pathogenesis. Its occurrence and development are related to mechanical compression, inflammatory response, metabolic regulation, gene regulation, and vitamin D deficiency. Different treatment strategies used in the process of weight loss have a beneficial impact on asthma. Alterations in gut and airway microbial community structure and their metabolites may also contribute to obesity-related asthma. The role of the Th17/Treg balance in the gut microbiota regulating the immune responses and host metabolism is important. Therapeutic measures associated with the gut microbiota variety may contribute to improving chronic inflammation associated with obesity by regulating the Th17/Treg balance. An early reduction in microbial diversity can predict the development of asthma and lead to allergy through an imbalance of Th2/Th1 responses. Short-chain fatty acids (SCFAs) regulate the differentiation and activation of regulatory T cells, thereby regulating immune homeostasis in the lung to suppress allergic inflammation and weight gain. Therefore, clarifying the microbial mechanism of obesity-related asthma has important guiding significance for clinical treatment. In this review, we used the following terms: "asthma and obesity" and "obesity-related asthma", combining "phenotype", "airway inflammation" and "lung function", and reviewed the characteristics and pathogenesis of obesity-related asthma, the relationship between the gut and airway microbiota and obesity-related asthma, and the current treatment measures for the disease.

Management of comorbidities in difficult and severe asthma

Difficult-to-treat and severe asthma are challenging clinical entities. In the face of suboptimal asthma control, the temptation for clinicians is to reflexively escalate asthma-directed therapy, including increasing exposure to corticosteroids and commencement of costly but potent biologic therapies. However, asthma control is objectively and subjectively assessed based on measurable parameters (such as exacerbations or variability in pulmonary physiology), symptoms and patient histories. Crucially, these features can be confounded by common untreated comorbidities, affecting clinicians' assessment of asthma treatment efficacy.

Obesity and Selected Allergic and Immunological Diseases-Etiopathogenesis, Course and Management

Obesity is a global problem. It affects every age group and is associated with many negative health effects. As an example, there is a relationship between obesity and allergic and immunological diseases, such as asthma, psoriasis, food allergies, allergic rhinitis and atopic dermatitis. Obesity undeniably affects their development. In addition, it causes adverse changes in the course and response to therapy in relation to patients without excessive body weight. The treatment of diseases associated with obesity is difficult; drugs are less effective and must be used in higher doses, and their use in patients with obesity is often associated with higher risks. The main form of treatment of all obesity-related diseases is a change in eating habits and increased physical activity, which leads to a decrease in body fat mass. The positive effect of reducing BMI has been confirmed in many independent studies. This paper reviews various types of research documents published since 2019. It aims to systematize the latest knowledge and highlight the need for further research for effective and sustainable treatment options for obesity, its complications and obesity-related diseases.

Using the theory of planned behavior to predict factors influencing fast-food consumption among college students

PURPOSE

The purpose of this research is to examine the behavioral factors that impact fast food consumption (FFC) among college students in Pakistan by applying the theory of planned behavior (TPB).

METHODS

Cross-sectional survey was distributed to college students in Pakistan. The questionnaire examines the factors associated with six categories: demographics, FFC pattern, intention for FFC, attitudes toward FFC, Subjective Norms (SN), and Perceived Behavioral Control (PBC). Data analysis was conducted using SPSS and SPSS AMOS software using descriptive statistics, inferential statistics (chi-square, t-test, Pearson correlation, and multiple regression analysis), and structural equation modeling (SEM) Analysis.

RESULTS

A total of 220 questionnaires were completed (97 males and 123 females). There were significant differences in FFC association with gender. Among the constructs of TPB, behavioral intention (BI) and SN are the strongest predictors of the FFC (p < .05). TPB has significantly predicted FFC behavior with a variance of R² 0.603. The SEM analysis shows that the data collected were incompatible with the theoretical TPB model, making it unfeasible to test our five hypotheses or interpret the results due to the poor fit of the model with the data.

CONCLUSIONS

To ensure a good fit of the data with the specified TPB model in SEM analysis, the number of indicators should be limited (≤ 30), or the sample size should be greater (N ≥ 500). Pakistani college students' FFC is mainly influenced by friends and the increased popularity of fast food, despite their knowledge of its negative health effects. Educational programs should target specific harmful effects of fast food, and SN and BI are the strongest predictors of FFC among TPB constructs. These findings can be useful for developing targeted interventional health strategies and future research.

Prevalence and Impact of Asthma and Allergy on Daily Life, Health Outcomes and Use of Healthcare Services in Children: A Population-Based Study

INTRODUCTION

Studies on the prevalence of asthma and allergies often lack representation of the pediatric population, and their impact has not been examined using children without these diseases as a reference group. This study aimed to determine the prevalence of asthma and allergies in children under 14 years old in Spain and their impact on health-related quality of life, activities, healthcare utilization, and environmental and household exposure risk factors.

METHODS

Data came from a Spanish population-based representative survey of children aged <14 years (N=6297). A sample of controls (1:4) from the same survey was matched using propensity score matching. Logistic regression models and population-attributable fractions were calculated to determine the impact of asthma and allergy.

RESULTS

The population prevalence of asthma was 5.7% (95% CI: 5.0%, 6.4%), and of allergy was 11.4% (95% CI: 10.5%, 12.4. In children with lower percentiles of health-related quality of life (≤20th), 32.3% (95% CI, 13.6%, 47.0%) was attributed to asthma and 27.7% (95% CI: 13.0%, 40.0%) to allergy. Forty-four percent of restrictions in usual activity were attributed to asthma (OR: 2.0, p-value: <0.001), and 47.9% to allergy (OR: 2.1, p-value: <0.001). 62.3% of all hospital admissions were attributed to asthma (OR: 2.8, p-value: <0.001), and 36.8% (OR: 2.5, p-value: <0.001) of all specialist consults to allergy.

CONCLUSIONS

The high prevalence of atopic disease and its impact on daily life and healthcare utilization call for an integrated healthcare system focused on children and caregivers' needs with continuity of care across education and healthcare settings.

Obesity affects pulmonary function in Japanese adult patients with asthma, but not those without asthma

Obesity is associated with the severity of asthma, which is characterized by airway obstruction. Pulmonary function testing is one of the important examinations for evaluating airway obstruction. However, the impact of obesity on pulmonary function in patients with asthma is not fully understood. A total of 193 patients with asthma and 2159 patients without asthma who visited Saga University Hospital were investigated retrospectively. Obesity was defined as a body mass index (BMI) greater than 25 kg/m². Pulmonary functions including forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV₁) were compared between patients with and without asthma, focusing especially on obesity. FVC percent predicted and FEV₁ percent predicted were significantly lower in patients with asthma than in those without asthma (p = 0.03, < 0.01 respectively). In patients with asthma, FVC percent predicted and FEV₁ percent predicted were significantly lower in patients with obesity than in those without obesity (all p < 0.01). In addition, BMI was negatively correlated with FEV₁ (r =- 0.21, p = 0.003) and FVC (r = - 0.15, p = 0.04), along with the percent predicted. On multivariate analysis in patients with asthma, FVC (β [95% confidence interval] 0.12 [0.02-0.22], p = 0.02) and FEV₁ (0.13 [0.05-0.22], p < 0.01) were still significantly different between patients with and without obesity. However, these obesity-associated differences were not observed in patients without asthma. Obesity reduces pulmonary function, including FVC and FEV₁, in patients with asthma, but not in those without asthma.

Impact of Obesity on Lung Function in Cats with Bronchoconstriction

Obesity is a nutritional disorder commonly diagnosed in adult cats that has been associated with an increased risk of different chronic diseases including respiratory diseases. The main objective of this study is to define if there is a relation between lung function measured by barometric whole-body plethysmography and obesity in cats with bronchoconstriction. Fifty-three cats were included in the study. All animals presented a bronchoconstriction status diagnosed with an Enhanced Pause (Penh) value higher than the reference range. Based on a standardized 9-point body condition scale, 36 cats were normal-weight cats (with BCS < 6), and 17 cats were considered overweight or obese cats (with BCS ≥ 6). Overweight cats were mainly male cats and older, and presented lower tidal volume values, lower minute volume values, and lower peak inspiratory and expiratory flows than normal-weight cats. According to the results of the present study, overweight cats showed a more compromised lung function parameters related to restrictive pattern compared with normal-weight cats. However, overweight cats did not show a higher bronchoconstriction level compared with normal-weight cats.