The Journal of Allergy and Clinical Immunology
Volume 123, Issue 6 , Pages 1312-1318.e2, June 2009

Overweight and changes in weight status during childhood in relation to asthma symptoms at 8 years of age

  • Salome Scholtens, PhD

      Affiliations

    • Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
    • Corresponding Author InformationReprint requests: Salome Scholtens, PhD, National Institute for Public Health and the Environment (RIVM), Centre for Prevention and Health Services Research (pb 101), P.O. Box 1, 3720 BA Bilthoven, The Netherlands.
  • ,
  • Alet H. Wijga, PhD

      Affiliations

    • Center for Prevention and Health Services Research, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
  • ,
  • Jacob C. Seidell, PhD

      Affiliations

    • Institute of Health Sciences, Vrije Universiteit, Amsterdam, The Netherlands
  • ,
  • Bert Brunekreef, PhD

      Affiliations

    • Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
    • Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
  • ,
  • Johan C. de Jongste, MD, PhD

      Affiliations

    • Department of Pediatrics, Division of Respiratory Medicine, Erasmus Medical Center–Sophia, Rotterdam, The Netherlands
  • ,
  • Ulrike Gehring, PhD

      Affiliations

    • Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
  • ,
  • Dirkje S. Postma, MD, PhD

      Affiliations

    • Department of Pulmonology, University Medical Centre Groningen, Groningen, The Netherlands
  • ,
  • Marjan Kerkhof, MD, PhD

      Affiliations

    • Department of Epidemiology and Bioinformatics, University of Groningen, Groningen, The Netherlands
  • ,
  • Henriette A. Smit, PhD

      Affiliations

    • Center for Prevention and Health Services Research, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
    • Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands

Received 15 July 2008; received in revised form 19 February 2009; accepted 20 February 2009. published online 01 May 2009.

Background

Asthma may be more prevalent in overweight children. However, how early overweight and changes in weight status during childhood affect the asthma risk is unclear.

Objectives

To investigate overweight and changes in overweight status in children age 1 to 8 years in relation to asthma symptoms in childhood.

Methods

We studied 3756 children who participated in a large birth cohort study. The parents reported their children's weight and height, and wheeze, dyspnea, and prescription of inhaled corticosteroids in yearly questionnaires. Sensitization to inhalant allergens and bronchial hyperresponsiveness (BHR) were determined at 8 years.

Results

At 8 years, 275 children (7.3%) wheezed, 361 (9.6%) had dyspnea, and 268 (7.1%) had a prescription of inhaled corticosteroids in the preceding year. Children who had a persistent high body mass index (BMI, weight/height2) during childhood or a high BMI at 6 to 7 years had a significantly increased risk of dyspnea (adjusted odds ratio, 1.68; 95% CI, 1.18-2.39, for a high BMI at 6-7 years) and measured BHR (adjusted odds ratio, 1.66; 95% CI, 1.10-2.52) at 8 years. Children with a high BMI at a young age, but who developed a normal BMI at 6 to 7 years, did not have an increased risk of dyspnea or BHR at 8 years. BMI was not associated with sensitization.

Conclusion

Children with a current high BMI are at increased risk to have dyspnea and BHR at 8 years. A high BMI at an earlier age is not related to an increased risk if the child has become normal weight at 6 to 7 years.

Key words: Obesity, body mass index, asthma, child, cohort study

Abbreviations used: BHR, Bronchial hyperresponsiveness, BMI, Body mass index, OR, Odds ratio, PIAMA, Prevention and Incidence of Asthma and Mite Allergy, SDS, SD score (z score)

 

 Supported by the Netherlands Organization for Health Research and Development; the Netherlands Asthma Foundation; the Netherlands Ministry of Health, Welfare and Sport; and Numico Research, The Netherlands.

 Disclosure of potential conflict of interest: J. C. de Jongste has received research support from GlaxoSmithKline, Roche, and Friso. The rest of the authors have declared that they have no conflict of interest.

PII: S0091-6749(09)00353-4

doi:10.1016/j.jaci.2009.02.029

The Journal of Allergy and Clinical Immunology
Volume 123, Issue 6 , Pages 1312-1318.e2, June 2009