Effects of dietary induced weight loss on exercise-induced bronchoconstriction in overweight and obese children
Janneke C van Leeuwen1, Mira Hoogstrate, Eric J Duiverman
1Department of Pediatrics, Medisch Spectrum Twente, Enschede, The Netherlands; University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Department of Pediatric Pulmonology, GRIAC Research Institute, Groningen, The Netherlands.
Insights
Weight loss through diet significantly reduces exercise-induced bronchoconstriction (EIB) severity in obese children with asthma. This improvement in EIB is linked to reduced BMI, enhancing their quality of life.
Area of Science:
- Pediatric Pulmonology
- Obesity Medicine
- Clinical Nutrition
Background:
- Obesity in asthmatic children correlates with more severe exercise-induced bronchoconstriction (EIB).
- This study examines the impact of weight loss interventions on EIB in overweight and obese pediatric asthma patients.
Purpose of the Study:
- To investigate the effect of a 6-week dietary intervention on EIB severity in overweight and obese children with asthma.
- To assess the relationship between weight loss and improvements in EIB, lung function, and quality of life.
Main Methods:
- An intervention study involving 20 overweight/obese children (aged 8-18) with EIB, following a 6-week healthy diet.
- Exercise challenge tests in cold air were conducted pre- and post-intervention to measure FEV1 (forced expiratory volume in 1 second).
- Secondary outcomes included FeNO, AUC for FEV1 recovery, PAQLQ, and ACQ scores.
Main Results:
- Significant reductions in weight (-2.6%) and BMI (-1.5 kg/m²) were observed (P<0.01).
- A significant improvement in the percentage exercise-induced fall in FEV1 (30.6% to 21.8%, P<0.01) and PAQLQ scores occurred.
- Reduced BMI z-score strongly correlated with decreased EIB severity (r=0.53, P=0.03).
Conclusions:
- Diet-induced weight loss effectively reduces EIB severity in overweight and obese children with asthma.
- Improvements in EIB are significantly associated with BMI reduction, leading to enhanced quality of life.
Rationale:
Previous studies showed that obesity in asthmatic children is associated with more severe exercise-induced bronchoconstriction (EIB), compared with non-obese asthmatic children. This study investigates the effect of weight loss on EIB in overweight and obese asthmatic children.
Methods:
In this intervention study, children aged 8-18 years with EIB and moderate to severe overweight, followed a diet based on healthy daily intake for 6 weeks. Before and after the diet period they underwent an exercise challenge test in cold air. Primary outcome was change in exercise-induced fall in FEV1 and relation between weight loss and EIB. Secondary outcomes were changes in recovery of FEV1 ("area under the curve"; AUC), fraction of exhaled nitric oxide (FeNO) and scores of the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) and Asthma Control Questionnaire (ACQ).
Results:
Twenty children completed the study. After the diet period, weight, and body mass index (BMI) were significantly reduced (changes respectively -2.6% and -1.5 kg/m(2), P < 0.01). There was a significant improvement of the percentage exercise-induced fall in FEV1 (30.6% vs. 21.8%, P < 0.01), AUC and PAQLQ score. The reduction in BMI z-score was significantly related to the reduction in the percentage exercise-induced fall in FEV1 in children that lost weight (r = 0.53, P = 0.03). There were no changes in FeNO and ACQ.
Conclusions:
Dietary induced weight loss in overweight and obese asthmatic children leads to significant reduction in severity of EIB and improvement of the quality of life. The reduction in BMI z-score is significantly related to the improvement of EIB.
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