The Growing Threat of Asthma and Obesity
by Dr. M. Myrtha Gregoire-Bottex
Obesity has quickly become one of the most pressing threats to public health in the United States. In 2009, 30% of adults and about 12% of youth in Michigan were obese. Obesity increases the risk of chronic diseases like asthma: 13% of obese adults say they have asthma versus about 8% of non-obese adults in Michigan. Though this link between asthma and obesity has been shown in many studies, the reason for it, and obesity's specific effect on asthma, is not yet understood.
There are a number of ideas that may explain the connection between asthma and obesity, but it is likely due to more than one cause. The inflammation throughout the body from obesity may increase the risk of asthma. Eating processed food high in calories and fat may add to obesity and asthma. This kind of diet may also be low in fruit, vegetables, vitamins and antioxidants (which can protect cells from breaking down) that can help prevent asthma and obesity. Poor diet is a risk factor that children and adults are exposed to every day, but even a mother's poor diet during pregnancy may increase her child's risk of asthma. A lack of physical activity, often seen with obesity, is also a risk factor for asthma. Certain genes, found more often in obese patients, may affect the pathway that leads to inflammation and asthma. More research is being done to better understand the link between obesity and asthma.
Asthma care providers must think about how obesity affects asthma when treating patients. Obesity does not appear to lead to a higher risk for severe asthma. Care providers should also expect normal lung function in obese patients. There is also little proof that obesity leads to more allergic airway inflammation. A key difference, however, is that obese patients may not respond as strongly to asthma control medicine. Treatment plans and follow-up care need to address this reduced response.
Obese asthmatics should follow the same asthma treatment guidelines
as lean asthmatics, but with the addition of weight management. An effective asthma care plan for obese asthmatics involves weight loss and exercise. This plan should involve repeated education on asthma control, proper inhaler use, avoiding asthma triggers, a healthy diet, and exercise. Patients with poor symptom control should be urged to adopt a diet with the right amount of vitamins A, C, E, D, and antioxidants. With new ways of treating asthma and obesity, asthma care providers can help patients lead a healthier life.
Based on Obesity, Nutrition, and Asthma in Children, Jason E. Lang, M.D., Pediatric Allergy, Immunology, and Pulmonology, Volume 25, Number 2, 2012
M. Myrtha Gregoire-Bottex, MD is an Assistant Professor of Pediatrics at Michigan State University where she is the Director of Pediatric Pulmonology and the Cystic Fibrosis Center.