Early childhood weight status in relation to asthma development in high-risk children

Abstract

Background: Obesity has been proposed to be a risk factor for the development of childhood asthma.

Objective: We sought to examine weight status from birth to age 5 years in relation to the occurrence of asthma at ages 6 and 8 years.

Methods: Two hundred eighty-five full-term high-risk newborns with at least 1 asthmatic/atopic parent enrolled in the Childhood Origin of Asthma project were studied from birth to age 8 years. Overweight was defined by weight-for-length percentiles of greater than the 85th percentile before the age of 2 years and a body mass index percentile of greater than the 85th percentile at ages 2 to 5 years.

Results: No significant concurrent association was found between overweight status and wheezing/asthma occurrence at each year of age. In contrast, longitudinal analyses revealed complex relationships between being overweight and asthma. Being overweight at age 1 year was associated with a decreased risk of asthma at age 6 (odds ratio [OR], 0.32; P = .02) and 8 (OR, 0.35; P = .04) years, as well as better lung function. However, being overweight beyond infancy was not associated with asthma occurrence. In fact, only children who were overweight at age 5 years but not at age 1 year had an increased risk of asthma at age 6 years (OR, 5.78; P = .05).

Conclusion: In children genetically at high risk of asthma, being overweight at age 1 year was associated with a decreased risk of asthma and better lung function at ages 6 and 8 years. However, being overweight beyond infancy did not have any protective effect and even could confer a higher risk for asthma.

Figure 1

Prevalence of overweight and wheezing/asthma during the first 8 years of life. Asthma diagnosis was not available for age 5 years or younger. Therefore, the prevalence of wheezing was plotted. At age 6 and 8 years, the prevalence of asthma was plotted.