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Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Childhood body mass index trajectories and asthma and allergies: A systematic review
Chia-Lun Chang1, Gulshan Bano Ali1, Jonathan Pham1,2
1Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
Insights
Maintaining a healthy Body Mass Index (BMI) trajectory in childhood may lower asthma risk. Rapid BMI increases in infancy or persistently high BMI in later childhood are linked to increased asthma risk.
Area of Science:
- Pediatric Allergy and Immunology
- Developmental Pediatrics
- Epidemiology
Background:
- Existing research on Body Mass Index (BMI) and allergic diseases often uses single time-point measurements.
- Childhood BMI is dynamic, necessitating studies on longitudinal BMI trajectories.
- Understanding the relationship between changing BMI and allergic disease development is crucial.
Purpose of the Study:
- To systematically review the association between childhood BMI trajectories (ages 0-18) and allergic diseases.
- To synthesize evidence on asthma, eczema, allergic rhinitis, and food allergy outcomes in relation to BMI changes.
Main Methods:
- Systematic review adhering to PRISMA guidelines.
- Inclusion of longitudinal cohort studies examining childhood BMI trajectories and allergic diseases.
- Quality assessment using ROBINS-E and GRADE tools; narrative synthesis due to heterogeneity.
Main Results:
- Eleven studies (37,690 participants) were included, with a focus on asthma outcomes.
- Evidence quality was very low due to high heterogeneity and risk of bias.
- Two consistent findings: persistently high BMI (6-10 years) linked to later asthma; rapid BMI increase (first 2 years) linked to subsequent asthma.
Conclusions:
- Normal BMI trajectories in childhood may reduce asthma risk.
- Further research with robust confounding control and long-term follow-up is required.
- More studies are needed on BMI trajectories and eczema, food allergies, and allergic rhinitis.
Background:
Previous systematic reviews have focused on associations between single time point measures of Body Mass Index (BMI) and asthma and allergic diseases. As BMI changes dynamically during childhood, examination of associations between longitudinal trajectories in BMI and allergic diseases is needed to fully understand the nature of these relationships.
Objective:
To systematically synthesise the association between BMI trajectories in childhood (0-18 years) and allergic diseases (asthma, eczema, allergic rhinitis, or food allergies outcomes).
Design:
We conducted a systematic review following the PRISMA guidelines, and two independent reviewers assessed the study quality using the ROBINS-E and GRADE tools. A narrative synthesis was performed as the statistical heterogeneity did not allow a meta-analysis.
Data Sources:
A search was performed on PubMed and EMBASE databases on 4th January 2023.
Eligibility Criteria:
Longitudinal cohort studies assessing the associations between childhood BMI trajectories and allergic diseases were included.
Results:
Eleven studies met the inclusion criteria with a total of 37,690 participants between 0 and 53 years of age. Ten studies examined asthma outcomes, three assessed association with allergic rhinitis, two assessed eczema, and one assessed food allergy. High heterogeneity and high risk of bias were observed. Overall, the quality of evidence was very low. Nevertheless, two consistent findings were identified: (1) a persistently high BMI between 6 and 10 years of age may be associated with an increased risk of asthma at 18 years and (2) a rapid increase in BMI in the first 2 years of life may be associated with subsequent asthma.
Conclusions:
Maintaining a normal BMI trajectory during childhood may reduce the risk of asthma. Future research that adequately addresses confounding and includes longer-term follow-up is needed. Moreover, additional studies examining potential associations with eczema, food allergies, and allergic rhinitis outcomes are needed.
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