Improving Nutritional Status in Children With Obesity and Asthma May Improve Clinical Outcomes

Improving nutritional status in obese children with asthma may improve clinical outcomes, according to a cross-sectional, observational study published in Clinical & Experimental Allergy.¹

Asthma and obesity are common pediatric health problems that disproportionately affect minority children, particularly those who are African American and Hispanic.^2,3 Obesity is an independent risk factor for asthma,^4,5 and conditions such as insulin resistance and vitamin D deficiency are more common in obese children and are associated with worse pulmonary function, suggesting that dietary intake and metabolic measures are associated with obesity-related asthma.^6,7 Thus, researchers sought to quantify nutritional status, defined as concentrations of serum carotenoids and n-3 fatty acids, and its association with pulmonary function and metabolic markers among 158 urban minority adolescents (39 obese patients with asthma, 39 healthy weight patients with asthma, 38 obese control patients, and 42 healthy weight control patients).¹ They found that mean total carotenoids were lowest in obese children with asthma, lower than both healthy weight patients with asthma and obese control patients. In addition, total carotenoids positively correlated, and the n-6/n-3 polyunsaturated fatty acid ratio inversely correlated, with the forced expiratory volume in 1 second, only in obese patients with asthma.

This was the first study to evaluate the associations among serum carotenoid and fatty acid concentrations, metabolic markers, and pulmonary function in obese-related asthma in children. “In summary, we found that in obese asthmatic children, serum carotenoids were positively correlated with pulmonary function and metabolic measures, while the n-6/n-3 [polyunsaturated fatty acid] ratio was negatively associated with pulmonary function,” concluded the authors.¹ Thus, diet modification may help to address pediatric obesity-related asthma, and future studies are needed to determine the mechanisms behind the associations among obesity-related asthma, carotenoids, and n-3 fatty acids.

References

1. Tobias TAM, Wood LG, Rastogi D. Carotenoids, fatty acids, and disease burden in obese minority adolescents with asthma [published online March 25, 2019]. Clin Exp Allergy. doi:10.1111/cea.13391
2. Akinbami LJ, Simon AE, Rossen LM. Changing trends in asthma prevalence among children. Pediatrics. 2016;137(1):e20152354.
3. Ogden CL, Carroll MD, Lawman HG. Trends in obesity prevalence among children and adolescents in the United States, 1988-1994 through 2013-2014. JAMA. 2016;315:2292-2299.
4. Gold DR, Damokosh AI, Dockery DW, Berkey CS. Body-mass index as a predictor of incident asthma in a prospective cohort of children. Pediatr Pulmonol. 2003;36:514-21.
5. Chen YC, Dong GH, Lin KC, Lee YL. Gender difference of childhood overweight and obesity in predicting the risk of incident asthma: a systematic review and meta-analysis. Obes Rev. 2013;14:222-231.
6. Rastogi D, Fraser S, Oh J, et al. Inflammation, metabolic dysregulation and pulmonary function among obese asthmatic urban adolescents. Am J Resp Crit Care Med. 2015;191:149-160.
7. Lautenbacher LA, Jariwala SP, Markowitz ME, Rastogi D. Vitamin D and pulmonary function in obese asthmatic children. Pediatr Pulmonol. 2016;51:1276-1283.