Early-life Weight Gain Worsens Severity of Asthma
A new study revealed that symptoms of asthma may be worse for young children who are overweight.
In a study spearheaded by researchers from Duke Health and collaborators, children ages 2 to 5 who are overweight and weren’t using an inhaler had 70 percent more days with asthma symptoms per year than untreated peers of a healthy weight. This means, these young children suffered 37 more symptom-days – more than five extra weeks – per year.
Researchers also found untreated children who were overweight had more asthma attacks than untreated peers of a healthy weight.
Asthma is one of the most common chronic diseases affecting children. In the United States, asthma affects almost 1 in 10 children and is a leading cause of emergency room visits and hospitalizations in preschoolers.
The Good News!
Though the key finding sounds discouraging, there’s good news for young asthma sufferers. The researchers found that obesity doesn’t seem to lessen the effectiveness of corticosteroid inhalers.
When used daily, inhalers reduced the number of symptom-days and asthma attacks in both healthy and overweight children, and may even be more protective for overweight children, the authors found.
Jason Lang, M.D., a pediatric lung specialist and director of the Duke Children’s Pulmonary Function Laboratory, who led the study, has a good explanation why obesity does not reduce the efficacy of inhalers.
Lang said, “Reports in older children and adults with asthma who are overweight have shown a poor response to inhaled corticosteroids to manage their asthma. This study suggests either pathways of inflammation are a bit different in preschool-aged patients, or that it takes years for obesity to reduce the effectiveness of steroid inhalers.”
To probe further into whether obesity impacts asthma severity and the effectiveness of inhalers in preschoolers, the researchers analyzed data from three randomized, controlled clinical trials. Those trials, conducted between 2001 and 2015 called INFANT, PEAK and MIST, included 736 children. One-third of participants had a BMI above the 84th percentile.
Some trial participants were randomly assigned to use inhalers daily while some used them intermittently; some received placebos and some received no treatment.
Key findings of the study revealed that obesity has a negative impact on young children with asthma. However, being overweight does not affect the effectiveness of inhalers.
Lang said, “This study uses the best, mostly highly controlled data to demonstrate that early-life weight gain does worsen the severity of asthma in the youngest patients. But this study provides clear evidence that maintaining a healthy weight in preschoolers may be an effective strategy for controlling asthma.”