A weight reduction intervention in children with overweight and asthma
Maartje Willeboordse1,6, Kim D.G. van de Kant1, Frans E.S. Tan2, Sandra Mulkens3, Julia Schellings4, Yvonne Crijns4, Liesbeth van de Ploeg5, Onno C.P. van Schayck6 and Edward Dompeling1
1Paediatric Respiratory Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC), Maastricht, Netherlands, 2Methodology and Statistics, CAPHRI, MUMC, Maastricht, Netherlands, 3Clinical Psychological Science, MUMC, Maastricht, Netherlands, 4Physiotherapy, MUMC, Maastricht, Netherlands, 5Dietetics, MUMC, Maastricht, Netherlands, 6Family Medicine, CAPHRI, MUMC, Maastricht, Netherlands
Aim There is increasing evidence that obesity is related to asthma development and severity. In children, it is largely unknown whether weight reduction contributes to improvements in asthma outcomes. We investigated the effects of a multifactorial weight reduction intervention on body weight and clinical asthma characteristics in children with asthma and overweight or obesity.
Methods An 18 month weight reduction RCT was conducted in 87 children with asthma and overweight or obesity. The intervention consisted of an intense programme with sport-, lifestyle-, parental- and individual sessions. Every 6 months, measurements of anthropometry, lung function, lifestyle parameters and inflammatory markers were assessed.
Results After 18 months, BMI-standard deviation score decreased slightly with -0.12±0.32 (p<0.01). However, this decrease was equally present in the intervention and control group. Clinical asthma characteristics (including asthma control, quality of life) and lung function indices (including forced expiratory volume, expiratory reserve volume) improved over time, although equally in the intervention and control group (all parameters p≥0.05). Only changes in forced vital capacity differed significantly between groups (p<0.05), with increases in intervention group of 10.1±8.7%, and in control group of 6.1±8.4%. Inflammatory markers, and most lifestyle parameters (including diet, step count) did not change over time (p≥0.05), or between groups (p≥0.05).
Discussion Our intervention demonstrated limited effects on both weight reduction and lung function. Possible reasons for the low effectiveness are high attrition rates, low intervention compliance, and weight reduction in the control group.