Abstract
The parallel epidemics of childhood asthma and obesity over the past few decades have spurred research into obesity as a risk factor for asthma. However, little is known regarding the role of asthma in obesity incidence. We examined whether early-onset asthma and related phenotypes are associated with the risk of developing obesity in childhood.
This study includes 21 130 children born from 1990 to 2008 in Denmark, France, Germany, Greece, Italy, The Netherlands, Spain, Sweden and the UK. We followed non-obese children at 3–4 years of age for incident obesity up to 8 years of age. Physician-diagnosed asthma, wheezing and allergic rhinitis were assessed up to 3–4 years of age.
Children with physician-diagnosed asthma had a higher risk for incident obesity than those without asthma (adjusted hazard ratio (aHR) 1.66, 95% CI 1.18–2.33). Children with active asthma (wheeze in the last 12 months and physician-diagnosed asthma) exhibited a higher risk for obesity (aHR 1.98, 95% CI 1.31–3.00) than those without wheeze and asthma. Persistent wheezing was associated with increased risk for incident obesity compared to never wheezers (aHR 1.51, 95% CI 1.08–2.09).
Early-onset asthma and wheezing may contribute to an increased risk of developing obesity in later childhood.
Abstract
Children who have asthma or wheezing in early childhood may be at a higher risk of developing obesity http://ow.ly/HfKw30lhF3X
Footnotes
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Author contributions: Z.A. Contreras, T. Roumeliotaki and L. Chatzi had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: L. Chatzi; acquisition of data: all authors; statistical analysis: Z.A. Contreras and T. Roumeliotaki; interpretation of data: all authors; drafting of the manuscript: Z.A. Contreras and L. Chatzi; critical revision of the manuscript for important intellectual content: all authors; study supervision: L. Chatzi.
Conflict of interest: L. Duijts reports grants from European Union's Horizon 2020 co-funded programme ERA-Net on Biomarkers for Nutrition and Health (ERA HDHL) (the ALPHABET project (number 696295; 2017) and ZonMW The Netherlands (number 529051014; 2017)) and grants from the European Union's Horizon 2020 programme (the LIFECYCLE project, grant agreement number 733206; 2016), during the conduct of the study.
Conflict of interest: B. Gerhard reports grants from the EU FP7, during the conduct of the study.
Conflict of interest: H. Inskip reports grants (salary) from the UK Medical Research Council, grants from the British Heart Foundation, the UK Food Standards Agency, the British Lung Foundation, Arthritis Research UK, the NIHR Southampton Biomedical Research Centre and the European Union's Seventh Framework Programme (FP7/2007-2013, project EarlyNutrition under grant agreement number 289346), during the conduct of the study; and members of H. Inskip's team have received funding from Nestec, Abbott Nutrition and Danone Nutricia for various projects to which she is linked, but she has received no direct funding herself.
Conflict of interest: S. Lau reports grants and personal fees (honoraria) from Symbiopharm and Allergopharma, personal fees (honoraria) and non-financial support (advisory board work) from DBV, personal fees from ALK, and non-financial support (advisory board work) from Boehringer and Merck, outside the submitted work.
Conflict of interest: D. Maier reports grants from the European Commission (FP7 MeDALL, 261357), during the conduct of the study.
Support statement: This work was partially supported by the Southern California Environmental Health Sciences Center (grant # P30ES007048) funded by the National Institute of Environmental Health Sciences (PI F. Gilliland). Z.A. Contreras was supported by a grant from the NIH (T32 ES013678). MeDALL and CHICOS Projects: the research leading to these results has received funding from the European Community's Seventh Framework Programme (Health-F2 grant agreements 261357 and 241604). ABCD cohort: data of the Amsterdam Born Children and their Development cohort study used in this research was in part supported by funds from the Netherlands Organisation for Health Research and Development (ZonMw 40-00812-98-11010). The study sponsors had no role in study design, data analysis, interpretation of data, or writing of this report. BAMSE: we acknowledge all funding sources (the Swedish Research Council, the Swedish Heart and Lung Foundation, the Swedish Research Council for Working Life and Social Welfare, the Swedish Asthma and Allergy Association Research Foundation, the Swedish Research Council Formas, Stockholm County Council and the European Commission's Seventh Framework 29 Programme MeDALL under grant agreement number 261357). EDEN: we acknowledge all the funding sources for the EDEN study (the Foundation for Medical Research (FRM), the National Agency for Research (ANR), the National Institute for Research in Public health (IRESP: TGIR cohorte santé 2008 programme), the French Ministry of Health (DGS), the French Ministry of Research, the INSERM Bone and Joint Diseases National Research (PRO-A) and Human Nutrition National Research Programmes, Paris-Sud University, Nestlé, the French National Institute for Population Health Surveillance (InVS), the French National Institute for Health Education (INPES), the European Union FP7 programme (FP7/2007–2013, HELIX, ESCAPE, ENRIECO and MeDALL projects), the Diabetes National Research Program (through a collaboration with the French Association of Diabetic Patients (AFD)), the French Agency for Environmental Health Safety (now ANSES), Mutuelle Générale de l'Education Nationale a complementary health insurance (MGEN), the French national agency for food security and the French speaking association for the study of diabetes and metabolism (ALFEDIAM)). The Generation R Study: the Generation R study is made possible by financial support from the Erasmus Medical Center, Rotterdam, the Erasmus University Rotterdam, the Netherlands Organization for Health Research and Development (ZonMw), the Netherlands Organisation for Scientific Research (NWO), the Ministry of Health, Welfare and Sport and the Ministry of Youth and Families. The project received funding from the European Union's Horizon 2020 research and innovation programme (the LIFECYCLE project, grant agreement number 733206; 2016), the European Research Council (ERC-2014-CoG-648916) and from the cofunded ERA-Net on Biomarkers for Nutrition and Health (ERA HDHL), Horizon 2020 (grant agreement number 696295; 2017), ZonMW The Netherlands (number 529051014; 2017), Science Foundation Ireland (no SFI/16/ERA-HDHL/3360) and the European Union (the ALPHABET project). The researchers are independent from the funders. The study sponsors had no role in study design, data analysis, interpretation of data, or writing of this report. INMA: data used for this research was provided by the INMA-Environment and Childhood Project (www.proyectoinma.org). This study was funded by grants from the Instituto de Salud Carlos III (Red INMA G03/176 and CB06/02/0041), the Spanish Ministry of Health (FIS-PIO41436, PI06/0867, PI081151, and FIS-FEDER 03/1615, 04/1112, 04/1931, 05/1079, 05/1052, 06/1213, 07/0314 and 09/02647), the Generalitat de Catalunya-CIRIT 1999SGR00241, the Conselleria de Sanitat Generalitat Valenciana, the Department of Health of the Basque Government (2005111093 and 2009111069) and the Provincial Government of Gipuzkoa (DFG06/004 and DFG08/001). KOALA: the collection of the data from the KOALA Birth Cohort study used in this analysis was financially supported by Friesland Foods (now FrieslandCampina), the Netherlands Asthma Foundation (grant numbers 3.2.07.022 and 3.2.03.48), the Netherlands Heart Foundation (grant number 2014 T037), the Netherlands Organization for Health Research and Development (ZonMw Prevention Program number 1.210-00-090), the Triodos Foundation, the Phoenix Foundation, the Raphaël Foundation, the Iona Foundation and the Foundation for the Advancement of Heilpedagogie, all in the Netherlands. MAS: the MAS birth cohort was funded by grants from the German Federal Ministry of Education and Research (BMBF; reference numbers 07015633, 07 ALE 27, 01EE9405/5, 01EE9406) and the German Research Foundation (DFG; reference number KE 1462/2-1). PIAMA: the PIAMA study was funded by the Netherlands Organisation for Health Research and Development, the Netherlands Organisation for Scientific Research, the Netherlands Asthma fund, the Netherlands Ministry of Spatial Planning, Housing and the Environment and the Netherlands Ministry of Health, Welfare and Sport. RHEA: the Rhea project was financially supported by European projects (EU FP6-003-Food-3-NewGeneris, contract number 16320; EU FP6 STREP Hiwate, contract number 36224; EU FP7 ENV.2007.1.2.2.2, project number 211250 ESCAPE; EU FP7-2008-ENV-1.2.1.4 Envirogenomarkers, contract number 226756; EU FP7-HEALTH-2009-single stage CHICOS, contract number 241604; EU FP7 ENV.2008.1.2.1.6, proposal number 226285 ENRIECO; EU-FP7, proposal number 264357 MeDALL; EU-FP7-HEALTH-2012, proposal number 308333 HELIX) and the Greek Ministry of Health (Program of Prevention of Obesity and Neurodevelopmental Disorders in Preschool Children, Heraklion District, Crete, Greece: 2011−2014; “Rhea Plus”: Prevention Program of Environmental Risk Factors for Reproductive Health, and Child Health: 2012-2015). ROBBIC: data from the Rome cohort was in part supported by funds from the Italian Ministry of Health (Programma speciale ex art. 12, comma 2, lettera b) del D. Lgs. 502/92, 2001, 2003). SWS: the Southampton Women's Survey is supported by grants from the Medical Research Council, the British Heart Foundation, the Food Standards Agency, the British Lung Foundation, Arthritis Research UK, the NIHR Southampton Biomedical Research Centre, the University of Southampton and University Hospital Southampton NHS Foundation Trust and the European Union's Seventh Framework Programme (FP7/2007−2013, project EarlyNutrition under grant agreement number 289346). Funding information for this article has been deposited with the Crossref Funder Registry.
- Received March 13, 2018.
- Accepted July 30, 2018.
- Copyright ©ERS 2018
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