Early Weight Gain Asthma and Atopy in Children
Early Weight Gain Asthma and Atopy in Children
Purpose of review To provide perspective to the most recent evidence regarding the association between early weight gain in infancy and the development of asthma and atopy during childhood, and highlight the potential mechanisms involved.
Recent findings Recently, several birth cohort studies involving more than 25 000 children have found a consistent association between early weight gain in the first 2 years of life and incident asthma during school age. Methodology differs substantially between the studies and complicates the establishment of definite conclusions. Specific mechanisms for this association have been proposed, including impairment in lung development and elevated levels of growth factors and cytokines associated with airway inflammation and remodeling. A limited number of studies indicate that early weight gain in infancy is also associated with recurrent wheezing during preschool age but not with the development of atopy.
Summary A consistent association between early weight gain in infancy and incident asthma during school age has been observed in several cohort studies. The identification of this modifiable risk factor for the development of asthma opens the possibility of preventive intervention. Additional studies are necessary to clarify the involved mechanisms and some pending questions, such as the influence of early weight gain in asthma phenotypes and severity.
Both developed and nonaffluent countries clearly face epidemics of an overweight and obese populace. The WHO estimates that 35% of adults aged 20 or more have weight above expected. Overweight status and obesity frequently starts early in life and it is estimated that more than 40 million children under the age of 5 years are overweight.
The parallel increases in the prevalence of both asthma and obesity observed during the last decades suggest a potential causal link and some shared environmental or genetic factor(s). At least two cross-sectional studies in children and adolescents show a positive relationship between these two conditions. Obesity specifically has been associated with higher risk for the development of asthma, severe asthma, greater lung function impairment, and impaired response to asthma treatment.
Research on the relationship between somatic growth and asthma has focused largely on the associations with fetal growth and birth weight. Recently, early-life events, particularly early nutrition and lifestyle factors, have been connected with later susceptibility to several chronic diseases. Rapid weight gain at an early age has been consistently associated with subsequent risk of obesity in later life and has also been related to hypertension, coronary heart disease, and type 2 diabetes mellitus.
The relationship between early weight gain and the development of asthma and atopy has received more attention in the last few years with an increasing number of prospective studies. The objective of this article is to provide perspective to the most recent evidence regarding these associations.
Abstract and Introduction
Abstract
Purpose of review To provide perspective to the most recent evidence regarding the association between early weight gain in infancy and the development of asthma and atopy during childhood, and highlight the potential mechanisms involved.
Recent findings Recently, several birth cohort studies involving more than 25 000 children have found a consistent association between early weight gain in the first 2 years of life and incident asthma during school age. Methodology differs substantially between the studies and complicates the establishment of definite conclusions. Specific mechanisms for this association have been proposed, including impairment in lung development and elevated levels of growth factors and cytokines associated with airway inflammation and remodeling. A limited number of studies indicate that early weight gain in infancy is also associated with recurrent wheezing during preschool age but not with the development of atopy.
Summary A consistent association between early weight gain in infancy and incident asthma during school age has been observed in several cohort studies. The identification of this modifiable risk factor for the development of asthma opens the possibility of preventive intervention. Additional studies are necessary to clarify the involved mechanisms and some pending questions, such as the influence of early weight gain in asthma phenotypes and severity.
Introduction
Both developed and nonaffluent countries clearly face epidemics of an overweight and obese populace. The WHO estimates that 35% of adults aged 20 or more have weight above expected. Overweight status and obesity frequently starts early in life and it is estimated that more than 40 million children under the age of 5 years are overweight.
The parallel increases in the prevalence of both asthma and obesity observed during the last decades suggest a potential causal link and some shared environmental or genetic factor(s). At least two cross-sectional studies in children and adolescents show a positive relationship between these two conditions. Obesity specifically has been associated with higher risk for the development of asthma, severe asthma, greater lung function impairment, and impaired response to asthma treatment.
Research on the relationship between somatic growth and asthma has focused largely on the associations with fetal growth and birth weight. Recently, early-life events, particularly early nutrition and lifestyle factors, have been connected with later susceptibility to several chronic diseases. Rapid weight gain at an early age has been consistently associated with subsequent risk of obesity in later life and has also been related to hypertension, coronary heart disease, and type 2 diabetes mellitus.
The relationship between early weight gain and the development of asthma and atopy has received more attention in the last few years with an increasing number of prospective studies. The objective of this article is to provide perspective to the most recent evidence regarding these associations.
Source...