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Physical activity, restrictions in activity, and body mass index among urban children with persistent asthma.

ABSTRACT: Asthma and obesity are public health problems that disproportionately affect underserved children. Urban children with asthma may be limited in their participation in physical activity, further increasing their risk for overweight.To determine the prevalence of overweight and obesity among high-risk children with persistent asthma, to assess physical activity and activity restrictions by level of asthma control, and to evaluate whether activity is associated with weight status.We analyzed baseline data from 324 urban children with poorly controlled asthma (3-10 years old) enrolled in the School-Based Telemedicine Enhanced Asthma Management program in Rochester, New York. Caregivers reported their child's asthma symptoms, physical activity, and activity limitation, and height and weight were measured.Most children were black (59%), and 69% had Medicaid. Almost half (47%) of children had symptoms that indicated poorly controlled asthma, 15% were overweight, and 31% were obese. Few children (39%) participated in 1 or more hour of physical activity per day. In addition, most (85%) did not walk to and from school, 38% did not have any recess in school, and 35% reported no safe place to exercise. More children with very poorly controlled asthma symptoms, compared with children with more mild symptoms, reported limitation in gym class (58% vs 43%, P = .01) and even in mild activities (28% vs 14%, P = .004). Children with activity limitation were at significantly greater odds of being overweight or obese (odds ratio, 2.1; 95% confidence interval, 1.2-3.8).Many children with persistent asthma are overweight or obese, have limited opportunity for activity, and experience activity limitations. Efforts are needed to optimize asthma control and provide opportunity for increased physical activity in and outside school.ClinicalTrials.gov Identifier: NCT01650844.

SUBMITTER: Holderness H

PROVIDER: S-EPMC5385295 | biostudies-literature | 2017 Apr

REPOSITORIES: biostudies-literature

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Physical activity, restrictions in activity, and body mass index among urban children with persistent asthma.

Holderness Heather H Chin Nancy N Ossip Deborah J DJ Fagnano Maria M Reznik Marina M Halterman Jill S JS

Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology 20170306 4

<h4>Background</h4>Asthma and obesity are public health problems that disproportionately affect underserved children. Urban children with asthma may be limited in their participation in physical activity, further increasing their risk for overweight.<h4>Objective</h4>To determine the prevalence of overweight and obesity among high-risk children with persistent asthma, to assess physical activity and activity restrictions by level of asthma control, and to evaluate whether activity is associated ...[more]

PMID: 28268134

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Project description:BackgroundAlthough obesity has been hypothesized to worsen asthma, data from studies of subjects with well-characterized asthma are lacking.ObjectiveWe sought to evaluate the relationship between body mass index (BMI), asthma impairment, and response to therapy.MethodsBMI (in kilograms per meter squared) and asthma phenotypic and treatment response data were extracted from Asthma Clinical Research Network studies. The cross-sectional relationship between BMI and asthma impairment was analyzed, as was the longitudinal relationship between BMI and response to asthma controller therapies.ResultsOne thousand two hundred sixty-five subjects with mild-to-moderate persistent asthma were evaluated. Analyses of lean versus overweight/obese asthmatic subjects demonstrated small differences in FEV1 (3.05 vs 2.91 L, P = .001), FEV1/forced vital capacity ratio (mean, 83.5% vs 82.4%; P = .01), rescue albuterol use (1.1 vs 1.2 puffs per day, P = .03), and asthma-related quality of life (5.77 vs 5.59, P = .0004). Overweight/obese asthmatic subjects demonstrated a smaller improvement in exhaled nitric oxide levels with inhaled corticosteroid (ICS) treatment than did lean asthmatic subjects (3.6 vs 6.5 ppb, P = .04). With ICS/long-acting beta-agonist treatment, overweight/obese asthmatic subjects demonstrated smaller improvements in lung function than lean asthmatic subjects, with an 80 mL (P = .04) and 1.7% (P = .02) lesser improvement in FEV1 and FEV1/forced vital capacity ratio, respectively. Significant differences in therapeutic response to leukotriene modifiers between BMI categories were not observed.ConclusionsIncreased BMI is not associated with clinically significant worsening of impairment in subjects with mild-to-moderate persistent asthma. There is a modest association between increased BMI and reduced therapeutic effect of ICS-containing regimens in this patient population. Prospective studies evaluating the effect of being overweight or obese on treatment response in asthma are warranted.

Dataset Information

Physical activity, restrictions in activity, and body mass index among urban children with persistent asthma.

Publications

Physical activity, restrictions in activity, and body mass index among urban children with persistent asthma.

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