Posted by: Indonesian Children | April 15, 2010

Obesity and the Risk of Newly Diagnosed Asthma in School-age Children


Obesity and the Risk of Newly Diagnosed Asthma in School-age Children

Frank D. Gilliland , Kiros Berhane, Talat Islam, Rob McConnell, W. James Gauderman, Susan S. Gilliland, Edward Avol and John M. Peters

From the Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA.

To determine the relation between obesity and new-onset asthma among school-age children, the authors examined longitudinal data from 3,792 participants in the Children’s Health Study (Southern California) who were asthma-free at enrollment. New cases of physician-diagnosed asthma, height, weight, lung function, and risk factors for asthma were assessed annually at five school visits between 1993 and 1998. Incidence rates were calculated, and proportional hazards regression models were fitted to estimate the adjusted relative risks of new-onset asthma associated with percentile of body mass index (weight (kg)/height (m)2) and indicators of overweight (>85th body mass index percentile) and obesity (>95th body mass index percentile). The risk of new-onset asthma was higher among children who were overweight (relative risk (RR) = 1.52, 95% confidence interval (CI): 1.14, 2.03) or obese (RR = 1.60, 95% CI: 1.08, 2.36). Boys had an increased risk associated with being overweight (RR = 2.06, 95% 1.33, 3.18) in comparison with girls (RR = 1.25, 95% CI: 0.83, 1.88). The effect of being overweight was greater in nonallergic children (RR = 1.77, 95% CI: 1.26, 2.49) than in allergic children (RR = 1.16, 95% CI: 0.63, 2.15). The authors conclude that being overweight is associated with an increased risk of new-onset asthma in boys and in nonallergic children.

allergy and immunology; asthma; body mass index; body weight; child; obesity

Abbreviations: Abbreviations: BMI, body mass index; CI, confidence interval; ETS, environmental tobacco smoke; RR, relative risk.


  1. Redd SC. Asthma in the United States: burden and current theories. Environ Health Perspect 2002;110(suppl 4):557–60.[Medline]
  2. Asher MI, Barry D, Clayton T, et al. The burden of symptoms of asthma, allergic rhinoconjunctivitis and atopic eczema in children and adolescents in six New Zealand centres: ISAAC Phase One. N Z Med J 2001;114:114–20.[ISI][Medline]
  3. Peters JM, Avol E, Navidi W, et al. A study of twelve Southern California communities with differing levels and types of air pollution. I. Prevalence of respiratory morbidity. Am J Respir Crit Care Med 1999;159:760–7.[Abstract/Free Full Text]
  4. ISAAC Steering Committee. Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Lancet 1998;351:1225–32.[CrossRef][ISI][Medline]
  5. Mannino DM, Homa DM, Redd SC. Involuntary smoking and asthma severity in children: data from the Third National Health and Nutrition Examination Survey. Chest 2002;122:409–15.[CrossRef][ISI][Medline]
  6. Pekkanen J, Xu B, Jarvelin MR. Gestational age and occurrence of atopy at age 31—a prospective birth cohort study in Finland. Clin Exp Allergy 2001;31:95–102.[CrossRef][ISI][Medline]
  7. Pearce N, Pekkanen J, Beasley R. How much asthma is really attributable to atopy? Thorax 1999;54:268–72.[Free Full Text]
  8. Pearce N, Douwes J, Beasley R. Is allergen exposure the major primary cause of asthma? Thorax 2000;55:424–31.[Abstract/Free Full Text]
  9. Committee on the Assessment of Asthma and Indoor Air, National Academy of Sciences. Clearing the air: asthma and indoor exposures. Washington, DC: National Academy Press, 2000.
  10. Carter S, Platts-Mills T. Searching for the cause of the increase in asthma. Curr Opin Pediatr 1998;10:594–9.[Medline]
  11. Martinez FD, Wright AL, Taussig LM, et al. Asthma and wheezing in the first six years of life. The Group Health Medical Associates. N Engl J Med 1995;332:133–8.[Abstract/Free Full Text]
  12. Gold DR, Burge HA, Carey V, et al. Predictors of repeated wheeze in the first year of life: the relative roles of cockroach, birth weight, acute lower respiratory illness, and maternal smoking. Am J Respir Crit Care Med 1999;160:227–36.[Abstract/Free Full Text]
  13. Platts-Mills TA, Carter MC, Heymann PW. Specific and nonspecific obstructive lung disease in childhood: causes of changes in the prevalence of asthma. Environ Health Perspect 2000;108(suppl 4):725–31.[Medline]
  14. von Mutius E, Schwartz J, Neas LM, et al. Relation of body mass index to asthma and atopy in children: The National Health and Nutrition Examination Study III. Thorax 2001;56:835–8.[Abstract/Free Full Text]
  15. Oddy WH, de Klerk NH, Sly PD, et al. The effects of respiratory infections, atopy, and breastfeeding on childhood asthma. Eur Respir J 2002;19:899–905.[Abstract/Free Full Text]
  16. Wright AL, Taussig LM. Lessons from long-term cohort studies: childhood asthma. Eur Respir J Suppl 1998;27:17s–22s.[CrossRef][Medline]
  17. Peat JK, Mellis CM. Early predictors of asthma. Curr Opin Allergy Clin Immunol 2002;2:167–73.[Medline]
  18. Ball TM, Castro-Rodriguez JA, Griffith KA, et al. Siblings, day-care attendance, and the risk of asthma and wheezing during childhood. N Engl J Med 2000;343:538–43.[Abstract/Free Full Text]
  19. Stein RT, Sherrill D, Morgan WJ, et al. Respiratory syncytial virus in early life and risk of wheeze and allergy by age 13 years. Lancet 1999;354:541–5.[CrossRef][ISI][Medline]
  20. Tantisira KG, Weiss ST. Childhood infections and asthma: at the crossroads of the hygiene and Barker hypotheses. Respir Res 2001;2:324–7.[CrossRef][ISI][Medline]
  21. McConnell R, Berhane K, Gilliland F, et al. Asthma in exercising children exposed to ozone: a cohort study. Lancet 2002;359:386–91.[CrossRef][ISI][Medline]
  22. Figueroa-Munoz J, Chinn S, Rona R. Association between obesity and asthma in 4–11 year old children in the UK. Thorax 2001;56:133–7.[Abstract/Free Full Text]
  23. Camargo CA Jr, Weiss ST, Zhang S, et al. Prospective study of body mass index, weight change, and risk of adult-onset asthma in women. Arch Intern Med 1999;159:2582–8.[Abstract/Free Full Text]
  24. Tantisira KG, Weiss ST. Complex interactions in complex traits: obesity and asthma. Thorax 2001;56(suppl 2):ii64–73.[Medline]
  25. Castro-Rodriguez JA, Holberg CJ, Morgan WJ, et al. Increased incidence of asthmalike symptoms in girls who become overweight or obese during the school years. Am J Respir Crit Care Med 2001;163:1344–9.[Abstract/Free Full Text]
  26. Beckett WS, Jacobs DR Jr, Yu X, et al. Asthma is associated with weight gain in females but not males, independent of physical activity. Am J Respir Crit Care Med 2001;164:2045–50.[Abstract/Free Full Text]
  27. Chen Y, Dales R, Krewski D, et al. Increased effects of smoking and obesity on asthma among female Canadians: The National Population Health Survey, 1994–1995. Am J Epidemiol 1999;150:255–62.[Abstract/Free Full Text]
  28. Celedon JC, Palmer LJ, Litonjua AA, et al. Body mass index and asthma in adults in families of subjects with asthma in Anqing, China. Am J Respir Crit Care Med 2001;164:1835–40.[Abstract/Free Full Text]
  29. Moudgil H. Prevalence of obesity in asthmatic adults. (Letter). BMJ 2000;321:448.[Free Full Text]
  30. Redd SC, Mokdad AH. Invited commentary: obesity and asthma—new perspectives, research needs, and implications for control programs. Am J Epidemiol 2002;155:198–202.[Free Full Text]
  31. National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. BMI: body mass index. Atlanta, GA: Centers for Disease Control and Prevention, 2002. (World Wide Web URL:
  32. Peters JM, Avol E, Gauderman WJ, et al. A study of twelve Southern California communities with differing levels and types of air pollution. II. Effects on pulmonary function. Am J Respir Crit Care Med 1999;159:768–75.[Abstract/Free Full Text]
  33. Chen Y, Dales R, Tang M, et al. Obesity may increase the incidence of asthma in women but not in men: longitudinal observations from the Canadian National Population Health Surveys. Am J Epidemiol 2002;155:191–7.[Abstract/Free Full Text]
  34. Grad R. Risk of asthma in children with exposure to mite and cat allergens. Lancet 2000;356:1369–70.[Medline]
  35. Peat J. Prevention of asthma. Eur Respir J 1996;9:1545–55.[Abstract]
  36. Litonjua AA, Sparrow D, Celedon JC, et al. Association of body mass index with the development of methacholine airway hyperresponsiveness in men: The Normative Aging Study. Thorax 2002;57:581–5.[Abstract/Free Full Text]
  37. Stenius-Aarniala B, Poussa T, Kvarnstrom J, et al. Immediate and long term effects of weight reduction in obese people with asthma: randomized controlled study. BMJ 2000;320:827–32.[Abstract/Free Full Text]
  38. Gokbel H, Atas S. Exercise-induced bronchospasm in nonasthmatic obese and nonobese boys. J Sports Med Phys Fitness 1999;39:361–4.[ISI][Medline]
  39. Huang SL, Shiao G, Chou P. Association between body mass index and allergy in teenage girls in Taiwan. Clin Exp Allergy 1999;29:323–9.[CrossRef][ISI][Medline]
  40. Kaplan TA, Montana E. Exercise-induced bronchospasm in nonasthmatic obese children. Clin Pediatr (Phila) 1993;32:220–5.[Abstract/Free Full Text]
  41. Broder I, Higgins MW, Mathews KP, et al. Epidemiology of asthma and allergic rhinitis in a total community, Tecumseh, Michigan. IV. Natural history. J Allergy Clin Immunol 1974;54:100–10.[CrossRef][ISI][Medline]
  42. Dodge RR, Burrows B. The prevalence and incidence of asthma and asthma-like symptoms in a general population sample. Am Rev Respir Dis 1980;122:567–75.[ISI][Medline]
  43. Yunginger JW, Reed CE, O’Connell EJ, et al. A community-based study of the epidemiology of asthma: incidence rates, 1964–1983. Am Rev Respir Dis 1992;146:888–94.[ISI][Medline]
  44. Ownby DR, Johnson CC, Peterson EL. Incidence and prevalence of physician-diagnosed asthma in a suburban population of young adults. Ann Allergy Asthma Immunol 1996;77:304–8.[ISI][Medline]
  45. Basagana X, Sunyer J, Zock JP, et al. Incidence of asthma and its determinants among adults in Spain. Am J Respir Crit Care Med 2001;164:1133–7.[Abstract/Free Full Text]
  46. Lombardi E, Morgan WJ, Wright AL, et al. Cold air challenge at age 6 and subsequent incidence of asthma: a longitudinal study. Am J Respir Crit Care Med 1997;156:1863–9.[Abstract/Free Full Text]
  47. Anderson HR, Pottier AC, Strachan DP. Asthma from birth to age 23: incidence and relation to prior and concurrent atopic disease. Thorax 1992;47:537–42.[Abstract/Free Full Text]
  48. Strachan DP, Butland BK, Anderson HR. Incidence and prognosis of asthma and wheezing illness from early childhood to age 33 in a national British cohort. BMJ 1996;312:1195–9.[Abstract/Free Full Text]
  49. Ronmark E, Jonsson E, Platts-Mills T, et al. Incidence and remission of asthma in schoolchildren: report from the obstructive lung disease in northern Sweden studies. Pediatrics 2001;107:E37.[CrossRef][Medline]
  50. Norrman E, Nystrom L, Jonsson E, et al. Prevalence and incidence of asthma and rhinoconjunctivitis in Swedish teenagers. Allergy 1998;53:28–35.[ISI][Medline]
  51. Larsson L. Incidence of asthma in Swedish teenagers: relation to sex and smoking habits. Thorax 1995;50:260–4.[Abstract/Free Full Text]
  52. Sunyer J, Anto JM, Tobias A, et al. Generational increase of self-reported first attack of asthma in fifteen industrialized countries. European Community Respiratory Health Study (ECRHS). Eur Respir J 1999;14:885–91.[Abstract/Free Full Text]
  53. Burr ML. Diagnosing asthma by questionnaire in epidemiological surveys. Clin Exp Allergy 1992;22:509–10.[CrossRef][ISI][Medline]
  54. Samet JM. Epidemiologic approaches for the identification of asthma. Chest 1987;91(suppl):74S–8S.
  55. Troiano R, Flegal K. Overweight children and adolescents: description, epidemiology, and demographics. Pediatrics 1998;101:497–504.[Abstract/Free Full Text]


Provided by

children’s ALLERGY CENTER online


PHONE : (021) 70081995 – 5703646

email :\ 





Information on this web site is provided for informational purposes only and is not a substitute for professional medical advice. You should not use the information on this web site for diagnosing or treating a medical or health condition. You should carefully read all product packaging. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider. 

Copyright © 2010, Children Allergy Center Information Education Network. All rights reserved



  1. […] Obesity and the Risk of Newly Diagnosed Asthma in School-age Children […]

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s


%d bloggers like this: