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Association between obesity and asthma in 4-11 year old children in the UK
J I Figueroa-Muñoz1, S Chinn, R J Rona
1Department of Public Health Sciences, King's College, 5th Floor, Capital House, 42 Weston Street, London SE1 3QD, UK. jose.figueroa-munoz@kcl.ac.uk
Insights
Childhood obesity is linked to asthma symptoms. This study found body mass index (BMI) is a more consistent indicator of this association than skinfold measurements in British children.
Area of Science:
- Pediatric Health
- Epidemiology
- Public Health
Background:
- Growing evidence links childhood obesity to asthma.
- This study examines the association between fatness and asthma symptoms in a large cohort of British children.
Purpose of the Study:
- To investigate the relationship between obesity indicators and asthma symptoms in English and Scottish primary school children.
- To determine if measures of fatness, such as Body Mass Index (BMI) and skinfold thickness, are consistently associated with asthma symptoms.
Main Methods:
- Cross-sectional analysis of 14,908 children aged 4-11 years from the National Study of Health and Growth (1993-1994).
- Assessed asthma symptoms (attacks, wheeze) and fatness using Body Mass Index (BMI) and skinfold sum (standard deviation scores).
- Analyzed data from representative English/Scottish samples and an English inner-city sample.
Main Results:
- A significant association was found between higher Body Mass Index (BMI) and asthma symptoms in the representative sample (OR 1.28).
- The sum of skinfolds was generally unrelated to asthma symptoms.
- The BMI-asthma link was stronger in girls than boys in the inner-city sample, but less clear in the representative sample.
Conclusions:
- Obesity, particularly indicated by BMI, is associated with asthma symptoms in children, irrespective of ethnicity.
- BMI is a more reliable indicator of this association than skinfold measurements, potentially due to maturation differences.
- The stronger association in girls observed in the inner-city sample warrants further investigation.
Background:
There is evidence of a positive association between asthma and obesity in adults and in children. We investigated, in a large sample of English and Scottish primary school children, whether there is a consistent association between fatness and asthma symptoms in Britain.
Methods:
A cross sectional analysis was made of 18 218 children aged 4-11 years who participated in the 1993 or 1994 surveys of the National Study of Health and Growth (NSHG). Children belonged either to English or Scottish representative samples, or an English inner city sample. Asthma attacks in the previous year, occasional wheeze, or persistent wheeze were the symptoms used in the analysis. Body mass index (BMI) and the sum of triceps and subscapular skinfolds converted to standard deviation scores (SDS) were used to assess levels of fatness.
Results:
A total of 14 908 children (81.8%) were included in the analysis. In the multiple logistic analysis BMI and asthma (asthma attacks or wheeze) were associated in the representative sample (OR for the comparison of the 10th and 90th centiles of BMI 1.28, 95% CI 1.11 to 1.48), but sum of skinfolds was unrelated to asthma symptoms in most analyses. The association between asthma and BMI was stronger in girls than in boys in the inner city sample, but less convincingly in the representative sample.
Conclusions:
Levels of obesity are associated with asthma symptoms regardless of ethnicity. The association is more consistent for BMI than for sum of skinfolds, partly because obese children are more advanced in their maturation than other children. There is some evidence that, as in adults, the association is stronger in girls than in boys, but only in the multiethnic inner city sample.