Obesity and Asthma

Overview

Journal J Allergy Clin Immunol

Specialty Allergy & Immunology

Date 2018 Apr 9

PMID 29627041

Citations 307

Authors

Ubong Peters

Anne E Dixon

Erick Forno

Affiliations

Soon will be listed here.

Abstract

Obesity is a vast public health problem and both a major risk factor and disease modifier for asthma in children and adults. Obese subjects have increased asthma risk, and obese asthmatic patients have more symptoms, more frequent and severe exacerbations, reduced response to several asthma medications, and decreased quality of life. Obese asthma is a complex syndrome, including different phenotypes of disease that are just beginning to be understood. We examine the epidemiology and characteristics of this syndrome in children and adults, as well as the changes in lung function seen in each age group. We then discuss the better recognized factors and mechanisms involved in disease pathogenesis, focusing particularly on diet and nutrients, the microbiome, inflammatory and metabolic dysregulation, and the genetics/genomics of obese asthma. Finally, we describe current evidence on the effect of weight loss and mention some important future directions for research in the field.

Citing Articles

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Pescari D, Mihuta M, Bena A, Stoian D Nutrients. 2025; 17(5).

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Application of Impulse Oscillometry Combined with Fractional Exhaled Nitric Oxide in Monitoring Asthma Control Levels in Children.

Hu J, Fan Y, Luo R, Li Q, Ai T, Wang L J Asthma Allergy. 2025; 18:391-402.

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Protective effect of dietary phosphorus intake on cardiovascular mortality in asthma: evidence from NHANES 1999-2018.

Yang S, Chen H, Xie C, Zhang N Front Nutr. 2025; 12:1533514.

PMID: 40070480 PMC: 11893399. DOI: 10.3389/fnut.2025.1533514.

The relationship between energy intake and asthma in Americans aged 1-18 years: a cross-sectional study.

Du L, Che C, Liu Q, Zhang X, Feng N, Chen L BMC Pediatr. 2025; 25(1):180.

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Chronic Inflammation in Asthma: Looking Beyond the Th2 Cell.

Olsthoorn S, van Krimpen A, Hendriks R, Stadhouders R Immunol Rev. 2025; 330(1):e70010.

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References

Strunk R, Colvin R, Bacharier L, Fuhlbrigge A, Forno E, Arbelaez A . Airway Obstruction Worsens in Young Adults with Asthma Who Become Obese. J Allergy Clin Immunol Pract. 2015; 3(5):765-71.e2. PMC: 4568157. DOI: 10.1016/j.jaip.2015.05.009. View

Ma J, Strub P, Xiao L, Lavori P, Camargo Jr C, Wilson S . Behavioral weight loss and physical activity intervention in obese adults with asthma. A randomized trial. Ann Am Thorac Soc. 2014; 12(1):1-11. PMC: 4342805. DOI: 10.1513/AnnalsATS.201406-271OC. View

Flaherman V, Rutherford G . A meta-analysis of the effect of high weight on asthma. Arch Dis Child. 2006; 91(4):334-9. PMC: 2065974. DOI: 10.1136/adc.2005.080390. View

Aragona E, El-Magbri E, Wang J, Scheckelhoff T, Scheckelhoff T, Hyacinthe A . Impact of Obesity on Clinical Outcomes in Urban Children Hospitalized for Status Asthmaticus. Hosp Pediatr. 2016; 6(4):211-8. DOI: 10.1542/hpeds.2015-0094. View

Ho W, Lin Y, Caffrey J, Lin M, Hsu H, Myers L . Higher body mass index may induce asthma among adolescents with pre-asthmatic symptoms: a prospective cohort study. BMC Public Health. 2011; 11:542. PMC: 3142515. DOI: 10.1186/1471-2458-11-542. View

Marsland B, Gollwitzer E . Host-microorganism interactions in lung diseases. Nat Rev Immunol. 2014; 14(12):827-35. DOI: 10.1038/nri3769. View

Jensen M, Gibson P, Collins C, Hilton J, Wood L . Diet-induced weight loss in obese children with asthma: a randomized controlled trial. Clin Exp Allergy. 2013; 43(7):775-84. DOI: 10.1111/cea.12115. View

Earthman C, Beckman L, Masodkar K, Sibley S . The link between obesity and low circulating 25-hydroxyvitamin D concentrations: considerations and implications. Int J Obes (Lond). 2011; 36(3):387-96. DOI: 10.1038/ijo.2011.119. View

Nakajima K, Kubouchi Y, Muneyuki T, Ebata M, Eguchi S, Munakata H . A possible association between suspected restrictive pattern as assessed by ordinary pulmonary function test and the metabolic syndrome. Chest. 2008; 134(4):712-718. DOI: 10.1378/chest.07-3003. View

10.

Forno E, Young O, Kumar R, Simhan H, Celedon J . Maternal obesity in pregnancy, gestational weight gain, and risk of childhood asthma. Pediatrics. 2014; 134(2):e535-46. PMC: 4187236. DOI: 10.1542/peds.2014-0439. View

11.

Mead J, Takishima T, Leith D . Stress distribution in lungs: a model of pulmonary elasticity. J Appl Physiol. 1970; 28(5):596-608. DOI: 10.1152/jappl.1970.28.5.596. View

12.

Zhang Z, Lai H, Roberg K, Gangnon R, Evans M, Anderson E . Early childhood weight status in relation to asthma development in high-risk children. J Allergy Clin Immunol. 2010; 126(6):1157-62. PMC: 2998556. DOI: 10.1016/j.jaci.2010.09.011. View

13.

Wood L, Garg M, Gibson P . A high-fat challenge increases airway inflammation and impairs bronchodilator recovery in asthma. J Allergy Clin Immunol. 2011; 127(5):1133-40. DOI: 10.1016/j.jaci.2011.01.036. View

14.

Maniscalco M, Paris D, Melck D, DAmato M, Zedda A, Sofia M . Coexistence of obesity and asthma determines a distinct respiratory metabolic phenotype. J Allergy Clin Immunol. 2016; 139(5):1536-1547.e5. DOI: 10.1016/j.jaci.2016.08.038. View

15.

Trompette A, Gollwitzer E, Yadava K, Sichelstiel A, Sprenger N, Ngom-Bru C . Gut microbiota metabolism of dietary fiber influences allergic airway disease and hematopoiesis. Nat Med. 2014; 20(2):159-66. DOI: 10.1038/nm.3444. View

16.

Suratt B, Ubags N, Rastogi D, Tantisira K, Marsland B, Petrache I . An Official American Thoracic Society Workshop Report: Obesity and Metabolism. An Emerging Frontier in Lung Health and Disease. Ann Am Thorac Soc. 2017; 14(6):1050-1059. PMC: 5802569. DOI: 10.1513/AnnalsATS.201703-263WS. View

17.

Peterson C, Su H, Thomas D, Heo M, Golnabi A, Pietrobelli A . Tri-Ponderal Mass Index vs Body Mass Index in Estimating Body Fat During Adolescence. JAMA Pediatr. 2017; 171(7):629-636. PMC: 5710345. DOI: 10.1001/jamapediatrics.2017.0460. View

18.

Lang J, Hossain J, Dixon A, Shade D, Wise R, Peters S . Does age impact the obese asthma phenotype? Longitudinal asthma control, airway function, and airflow perception among mild persistent asthmatics. Chest. 2011; 140(6):1524-1533. DOI: 10.1378/chest.11-0675. View

19.

Wang L, Murk W, DeWan A . Genome-Wide Gene by Environment Interaction Analysis Identifies Common SNPs at 17q21.2 that Are Associated with Increased Body Mass Index Only among Asthmatics. PLoS One. 2015; 10(12):e0144114. PMC: 4684413. DOI: 10.1371/journal.pone.0144114. View

20.

Gilliland F, Berhane K, Islam T, McConnell R, Gauderman W, Gilliland S . Obesity and the risk of newly diagnosed asthma in school-age children. Am J Epidemiol. 2003; 158(5):406-15. DOI: 10.1093/aje/kwg175. View