Weight loss reduces pediatric exercise-induced bronchoconstriction

A study has found that weight loss in overweight and obese children with exercise-induced bronchoconstriction (EIB) leads to a significant reduction in symptom severity and improved quality of life.

Lead author Janneke van Leeuwen (University of Groningen, the Netherlands) and team say their findings show that “even a small reduction in BMI [body mass index] following a diet based on healthy daily intake can improve severity of EIB in overweight and obese asthmatic children.”

They studied 20 overweight or obese children aged 8–18 years who were diagnosed with asthma and who had a post-exercise fall in forced expiratory volume in 1 second (FEV1) of at least 10%.

Following a 6-week dietary intervention in which the children followed a strict written nutritional plan approved by a dietician, weight, BMI, and BMI z-score were all significantly reduced – from 58.6 kg to 56.8 kg, 25.7 kg/m2 to 24.2 kg/m2, and 2.2 to 2.0, respectively.

These changes were accompanied by a significant decrease in the maximum exercise-induced fall in FEV1, at 21.8% compared with 30.6% at baseline, as well as a reduced FEV1 recovery time. And, in the 17 children who lost weight during the intervention, the reduction in BMI z-score correlated significantly with the fall in FEV1.

Additionally, median scores on the Pediatric Asthma Quality of Life Questionnaire significantly improved, from 6.2 to 6.5 after the diet – a clinically relevant change – as did those for the individual domains of symptoms (5.9 vs 6.6) and activity limitations (5.8 vs 6.2).

“This improvement could be due to both weight loss and reduction in the severity of EIB, as excessive body weight is associated with an additional decrease in quality of life in children with asthma,” comment van Leeuwen and colleagues.

However, there was no significant change in Asthma Control Questionnaire scores or fraction exhaled nitric oxide values.

Writing in Pediatric Pulmonology, the authors say the study highlights the potential importance of dietary intervention and weight management for overweight and obese children with asthma.

“Moreover, dietary induced weight loss is associated with improved quality of life, which is valuable to patients with low self-esteem as a result of overweight and EIB,” they add.

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