Book: ADVANCES IN HEALTH AND DISEASE
Maria Michelle Papamichael, Bircan Erbas, Dimitris Tsoukalas, Catherine Itsiopoulos and Charis Katsardis, La Trobe University, School of Allied Health, Human Services & Sport, Department of Dietetics, Human Nutrition & Sport, Melbourne, Australia, La Trobe University, School of Psychology and Public Health, Department of Public Health, Melbourne, Australia, National & Kapodistrian University of Athens, Athens, Greece, European Institute of Nutritional Medicine, Rome, Italy
ABSTRACT
The global surge in pediatric obesity and asthma are two disorders requiring urgent attention in public health and account for significant patient, familial and societal economic burden including school and employment absentees, hospital care and pharmaceutical expenditures. Overweight and obesity as measured by body mass index (BMI) is a risk factor for many conditions including pediatric asthma, that has immediate and long-term negative impact on children’s health physically, psychologically, socially as well as on academic performance. The obese-asthma phenotype in children is more difficult to treat, is related to increased and more severe exacerbations, need for hospitalization, days absent from school, impaired lung function, reduced medication response, poor asthma control and quality of life compared to normo-weight peers. Despite the growing evidence on the obese-asthmatic phenotype, little is known about its specific characteristics in children. The purpose of this chapter is to critically appraise the current literature and summarize the evidence on the impact of excess body fat on the pulmonary system in pediatric asthma patients. Possible mechanisms are also discussed.
In conclusion, paediatric obesity remains a growing global issue with significant detrimental health impact for paediatric respiratory health. Effective public health strategies focusing on reducing the increasing obesity trend, have the potential to reduce asthma risk, patient burden and overall cost. The findings of this review highlight the complexity and heterogeneity of asthma in children and imply that deficits observed in lung function of pediatric asthma patients might be due to obesity-related systemic inflammation, mechanical overload, metabolic dysfunction, oxidative stress and hormonal effects of excess body fat including disproportionate lung growth. Childhood may represent a critical window of opportunity to intervene and prevent long term consequences. Phenotyping and lifestyle interventions promoting a healthy diet, daily physical exercise and outdoor play combined with asthma therapy should be considered key points in the management of obesity in pediatric asthma patients. Future longitudinal studies are recommended to determine the mechanisms underlying the obese-asthma phenotype in children.
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1.Health & Disease Vol 33 E book Ch 1 NOVA publications 13.4.21
