Ten percent of paediatric asthma cases could be avoided if
childhood obesity were eliminated, according to research led by Nemours
Children’s Health System.  The research, published in Pediatrics, the journal of the American Academy of Pediatrics,
reported on the analysis of medical records of more than 500 000 children. The
study is among the first to use the resources of PEDSnet, a multi-specialty
network that conducts observational research and clinical trials across eight
of the largest children’s health systems in the US.

Paediatric asthma is among the most prevalent childhood
conditions and comes at a high cost to patients, families and the greater
health system. There are few preventable risk factors to reduce the incidence
of asthma, but the data show that reducing the onset of childhood obesity could
significantly lower the public health burden of asthma,” said Terri Finkel, MD,
PhD, Chief Scientific Officer at Nemours Children’s Hospital in Orlando and one
of three Nemours researchers participating in the study. “Addressing childhood
obesity should be a priority to help improve the quality of life of children
and help reduce paediatric asthma.”

 In this retrospective cohort study design, researchers
reviewed de-identified data of patients ages two to 17 without a history of
asthma, receiving care from six paediatric academic medical centres between
2009 and 2015. Overweight or obese patients were matched with normal weight
patients of the same age, gender, race, ethnicity, insurance type, and location
of care. The study included data from 507 496 children and 19 581 972
encounters.

 In their analysis, the researchers found that the
incidence of an asthma diagnosis among children with obesity was significantly
higher than in children in a normal weight range and that 23 to 27% of new
asthma cases in children with obesity are directly attributable to obesity.
Additionally, obesity among children with asthma appears to increase disease
severity. Being overweight was identified as a modest risk factor for asthma,
and the association was diminished when the most stringent definition of asthma
was used.  Other significant risk factors of an asthma diagnosis included
male sex, age of under 5 years old, African-American race, public insurance.

 Several limitations of the study are noted, including
the retrospective design using electronic health data, which prevent the
researchers from drawing absolute conclusions regarding the causal nature of
the association between obesity and asthma. Additionally, while the study
includes data from a large, geographically diverse population of children,
rural children may be underrepresented in the study results.

Source: http://nemours.mediaroom.com/2018-11-26-PEDSnet-Asthma-Obesity

Reference: Lang
JE, Being Overweight or Obese and the Development of Asthma. Pediatrics, November 2018. http://paediatrics.aappublications.org/content/early/2018/11/21/peds.2018-2119