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Updated: Jun 5, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Obesity at the age of 4-5 related to asthma diagnosis in later childhood: A longitudinal study using linked routinely
Waleed Mohamed Abdeldayem1, Jo Davies1, Lucy Jane Griffiths1
1Swansea University Medical School, Swansea, UK.
Insights
Childhood obesity at age 4-5 significantly increases the risk of developing asthma. Early weight management interventions may help reduce asthma incidence in children.
Area of Science:
- Pediatric Health
- Epidemiology
- Public Health Surveillance
Background:
- Childhood obesity and asthma are prevalent, with increasing incidence over recent decades.
- Cross-sectional studies suggest a positive association between childhood obesity and asthma.
- Longitudinal data examining the temporal relationship between these conditions is limited.
Purpose of the Study:
- To investigate the association between body mass index (BMI) in early childhood and the subsequent risk of developing bronchial asthma.
- To determine if obesity at school-starting age predicts later childhood asthma diagnosis.
Main Methods:
- Utilized longitudinal data from a national surveillance program in Wales, linking anthropometric measurements (age 4-5) with clinical and administrative datasets.
- Employed the Secure Anonymised Information Linkage (SAIL) databank for data analysis over a nine-year follow-up period.
- Defined obesity using BMI Z-score (≥98th Centile) and analyzed the risk of recorded asthma diagnoses.
Main Results:
- The study included 22,790 children; 7% received an asthma diagnosis during follow-up.
- Obese children (BMI Z-score ≥98th Centile) exhibited a 41% increased risk of asthma diagnosis (aOR: 1.41; 95% CI: 1.17-1.7).
- Females showed a 26% lower likelihood of asthma diagnosis after adjusting for weight and deprivation (aOR: 0.74; 95% CI: 0.67-0.82).
Conclusions:
- Childhood obesity at ages 4-5 is a significant risk factor for developing asthma.
- Population-level surveillance programs providing anthropometric data are crucial for such research.
- Expanding surveillance programs and implementing lifestyle interventions for weight management may reduce asthma risk.
Introduction:
Obesity and asthma are two of the most common childhood conditions and their prevalence have increased over the last decades. Several cross-sectional studies provide strong evidence for a positive association between these two conditions. However, few longitudinal studies have examined the temporal relationship between them.
Objective:
To examine the relationship between body mass index (BMI) at school starting age and the risk of developing bronchial asthma later in childhood.
Methods:
We used anthropometric measurements of children aged 4 to 5 years, obtained as part of a national surveillance programme in Wales, linked to multiple population-level longitudinal administrative and clinical datasets within a trusted research environment provided by the Secure Anonymised Information Linkage (SAIL) databank to examine whether obesity at age 4 to 5 years was associated with increased risk of having a recorded diagnosis of asthma during a nine year follow-up period.
Results:
Out of 22,790 children included in the study, 7% had a recorded diagnosis of asthma during the nine years following anthropometric measurement. Children who were classified as obese (Body Mass Index [BMI] Z-score ≥98th Centile) had a 41% increased risk of having a recorded diagnosis of asthma (adjusted odds ratio [aOR]: 1.41; 95% confidence interval [CI]: 1.17-1.7). Females were 26% less likely to have a recorded diagnosis of asthma after adjusting for weight status and deprivation index (aOR: 0.74; 95% CI: 0.67-0.82).
Conclusion:
Obesity in children aged 4 to 5 years carries an increased risk of developing asthma. Anthropometric measurements obtained through standardised population-level surveillance programmes enable important research which would not be possible otherwise and expanding these programmes to older age groups is recommended. Lifestyle interventions aimed at weight loss may have a role in decreasing the risk of developing asthma.
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