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Diet-induced weight loss in obese children with asthma: a randomized controlled trial.
Clin Exp Allergy 2013; 43(7):775-84CE

Abstract

BACKGROUND

Obesity is highly prevalent in asthmatic children and associated with worse clinical outcomes. Energy restriction to induce weight loss in asthmatic children has not been investigated in a randomized controlled trial (RCT).

OBJECTIVE

To assess if (1) weight loss can be achieved in obese asthmatic children using a dietary intervention; and (2) changes in asthma outcomes occur following diet-induced weight loss.

METHODS

In a 10-week pilot RCT, obese asthmatic children, aged 8-17 years, were randomized to a wait-list control (WLC) (n = 15) or dietary-intervention group (DIG) (n = 13). Lung function, Asthma Control Questionnaire (ACQ) score, and sputum and systemic inflammation were assessed at baseline and post-intervention. (Australian New Zealand Clinical Trials Registry: ACTRN12610000955011).

RESULTS

Body mass index (BMI) z-score reduced significantly in the DIG vs. the WLC (-0.2 [-0.4, -0.1] vs. 0.0 [-0.1, 0.0], P = 0.014). Expiratory reserve volume (ERV) increased significantly within the DIG, but not compared to the WLC (0.7 [0.0, 1.0] L vs. 0.3 [0.0, 0.8] L, P = 0.355). ACQ improved significantly in the DIG, compared to the WLC (-0.4 [-0.7, 0.0] vs. 0.1 [0.0, 0.6], P = 0.004). Airway and systemic inflammation did not change within the DIG. In comparison, C-Reactive Protein (CRP) increased significantly in the WLC (-0.4 [-0.5, 0.4] vs. 0.7 [-0.1, 1.9], P = 0.037). Change (∆) in BMI z-score correlated with ∆CRP (r = 0.47, P = 0.012) and ∆exhaled nitric oxide (eNO) (r = 0.46, P = 0.034), and ∆ACQ was associated with ∆CRP (r = 0.43, P = 0.029).

CONCLUSION AND CLINICAL RELEVANCE

Dietary intervention can induce acute weight loss in obese asthmatic children with subsequent improvements in static lung function and asthma control. Systemic and airway inflammation did not change following weight loss. However, changes in BMI z-score were associated with changes in airway and systemic inflammation and this requires further investigation in a larger RCT. This is the first weight loss RCT conducted in obese asthmatic children. Diet-induced weight loss can achieve significant improvements in clinical outcomes for obese children with asthma.

Authors+Show Affiliations

Centre for Asthma and Respiratory Diseases, University of Newcastle, Newcastle, NSW, Australia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23786284

Citation

Jensen, M E., et al. "Diet-induced Weight Loss in Obese Children With Asthma: a Randomized Controlled Trial." Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, vol. 43, no. 7, 2013, pp. 775-84.
Jensen ME, Gibson PG, Collins CE, et al. Diet-induced weight loss in obese children with asthma: a randomized controlled trial. Clin Exp Allergy. 2013;43(7):775-84.
Jensen, M. E., Gibson, P. G., Collins, C. E., Hilton, J. M., & Wood, L. G. (2013). Diet-induced weight loss in obese children with asthma: a randomized controlled trial. Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, 43(7), pp. 775-84. doi:10.1111/cea.12115.
Jensen ME, et al. Diet-induced Weight Loss in Obese Children With Asthma: a Randomized Controlled Trial. Clin Exp Allergy. 2013;43(7):775-84. PubMed PMID: 23786284.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diet-induced weight loss in obese children with asthma: a randomized controlled trial. AU - Jensen,M E, AU - Gibson,P G, AU - Collins,C E, AU - Hilton,J M, AU - Wood,L G, PY - 2012/12/10/received PY - 2013/02/18/revised PY - 2013/02/20/accepted PY - 2013/6/22/entrez PY - 2013/6/22/pubmed PY - 2014/1/18/medline SP - 775 EP - 84 JF - Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology JO - Clin. Exp. Allergy VL - 43 IS - 7 N2 - BACKGROUND: Obesity is highly prevalent in asthmatic children and associated with worse clinical outcomes. Energy restriction to induce weight loss in asthmatic children has not been investigated in a randomized controlled trial (RCT). OBJECTIVE: To assess if (1) weight loss can be achieved in obese asthmatic children using a dietary intervention; and (2) changes in asthma outcomes occur following diet-induced weight loss. METHODS: In a 10-week pilot RCT, obese asthmatic children, aged 8-17 years, were randomized to a wait-list control (WLC) (n = 15) or dietary-intervention group (DIG) (n = 13). Lung function, Asthma Control Questionnaire (ACQ) score, and sputum and systemic inflammation were assessed at baseline and post-intervention. (Australian New Zealand Clinical Trials Registry: ACTRN12610000955011). RESULTS: Body mass index (BMI) z-score reduced significantly in the DIG vs. the WLC (-0.2 [-0.4, -0.1] vs. 0.0 [-0.1, 0.0], P = 0.014). Expiratory reserve volume (ERV) increased significantly within the DIG, but not compared to the WLC (0.7 [0.0, 1.0] L vs. 0.3 [0.0, 0.8] L, P = 0.355). ACQ improved significantly in the DIG, compared to the WLC (-0.4 [-0.7, 0.0] vs. 0.1 [0.0, 0.6], P = 0.004). Airway and systemic inflammation did not change within the DIG. In comparison, C-Reactive Protein (CRP) increased significantly in the WLC (-0.4 [-0.5, 0.4] vs. 0.7 [-0.1, 1.9], P = 0.037). Change (∆) in BMI z-score correlated with ∆CRP (r = 0.47, P = 0.012) and ∆exhaled nitric oxide (eNO) (r = 0.46, P = 0.034), and ∆ACQ was associated with ∆CRP (r = 0.43, P = 0.029). CONCLUSION AND CLINICAL RELEVANCE: Dietary intervention can induce acute weight loss in obese asthmatic children with subsequent improvements in static lung function and asthma control. Systemic and airway inflammation did not change following weight loss. However, changes in BMI z-score were associated with changes in airway and systemic inflammation and this requires further investigation in a larger RCT. This is the first weight loss RCT conducted in obese asthmatic children. Diet-induced weight loss can achieve significant improvements in clinical outcomes for obese children with asthma. SN - 1365-2222 UR - https://www.unboundmedicine.com/medline/citation/23786284/Diet_induced_weight_loss_in_obese_children_with_asthma:_a_randomized_controlled_trial_ L2 - https://doi.org/10.1111/cea.12115 DB - PRIME DP - Unbound Medicine ER -