Summary:
Asthma and obesity are among the most common chronic conditions in children worldwide. Excess weight increases asthma risk, with overweight children having a 20% higher risk and obese children up to twice the risk. Obesity also worsens asthma severity, leading to poorer control, more frequent exacerbations, higher morbidity, and lower quality of life. Mechanisms linking asthma and obesity may include inflammation, immune dysregulation, metabolic changes, sedentary behavior, and diet. Diet plays a key role in both conditions. Western-style diets, high in processed foods, sugar, and saturated fat and low in fruits, vegetables, and whole grains, promote weight gain and nutrient deficiencies. Certain nutrients, such as vitamin D, omega-3 fatty acids, and antioxidants, have anti-inflammatory effects and may reduce asthma risk or severity. This cross-sectional study included 100 children aged 6-17 years, divided into four groups: normal weight with asthma, overweight/obese with asthma, normal weight without asthma, and overweight/obese without asthma. Dietary intake was recorded via 3-day food diaries, and diet quality was assessed. Associations between nutrient intake, lung function, and inflammatory markers were examined. Fatty acids were the main dietary factors linked to asthma outcomes. In normal-weight children with asthma, omega‑3 fatty acids were associated with improved lung volumes and lower inflammatory markers, while soluble fiber was linked to better airway function. In overweight or obese children with asthma, omega‑6 and omega‑3 fatty acids, along with vitamin E, were associated with higher lung capacity and reduced airway obstruction. These results suggest that dietary components may affect asthma differently depending on body weight. BMI-specific dietary interventions could potentially improve asthma outcomes in children. Randomized controlled trials are needed to confirm these findings and guide clinical recommendations.
Abstract:
Background and aims: Evidence suggests that diet influences the pathophysiology of asthma, but its role in pediatric obesity-related asthma is unclear. This case–control study aimed to explore the relationships between nutrient intake and the pathophysiology of asthma in children who are overweight or obese. Methods: Participants of the Sphingolipids in Childhood Asthma and Obesity study (100 children aged 6–17 years) were divided into four groups: normal weight with asthma (NW-A, n = 16); overweight or obese with asthma (OO-A, n = 26); normal weight (NW, n = 33); overweight or obese (OO, n = 25). Dietary intake was recorded via 3-day food diaries. Diet quantity and quality were assessed using UK Government Dietary Recommendations and dietary inflammatory index (DII) scores. Nutrient intake was compared across groups, and regression analyses were applied to identify the top contributors to asthma and obesity-associated asthma. Correlation analyses were used to assess the associations between the most important nutrients and clinical parameters. Results: Fatty acids (FAs), including saturated, monounsaturated, and polyunsaturated FAs, were identified as the most significant contributors to asthma and obesity-associated asthma, followed by several vitamins, fibers, and sugars. The relationships between nutrients and clinical parameters showed different patterns in the NW-A and OO-A groups. In NW-A, intakes of saturated, monounsaturated, and polyunsaturated FAs, including α-linolenic acid (PUFA 18:3, n-3), were positively associated with vital capacity and total lung capacity and inversely related to plasma levels of interleukin (IL)-10; while soluble fiber intake was negatively correlated with lung clearance index. In OO-A, FAs, including linoleic acid (PUFA 18:2, n-6) and α-linolenic acid, and vitamin E isoforms were positively associated with vital capacity, total lung capacity, inspiratory capacity, and forced vital capacity, and negatively associated with lung clearance index and forced expiratory volume in 1 s. Multiple saturated FA intakes were negatively associated with levels of IL-10, IL-17A, and IL-2. Conclusion: This study suggests that certain dietary components, such as FAs and fiber, may have different effects on asthma in overweight or obese children compared to normal weight children. Thus, tailored dietary modifications, guided by body mass index, could improve asthma symptoms. Randomized controlled trials are needed to confirm these associations and guide dietary recommendations.
Article Publication Date: 3/11/2025
DOI: 10.3389/fnut.2025.1687082
