Obese kids with asthma take more medications, find it harder to control their symptoms, have more flare ups, and make more ED visits than children with asthma who are not obese or overweight, researchers from the University of California, San Diego, reported in the Journal of Allergy and Clinical Immunology.

The authors explained that theirs is the first study to take into account race and social factors to show that obese children need more medications to control their asthma flare ups.

The investigators wrote:

“Improving nutritional status, preventing obesity, and stressing the importance of weight loss might improve asthma control and exacerbation risk in children and decrease the incidence of asthma in adults.”

10% of American children today have asthma, and 17% are obese. Obesity and asthma rates have increased significantly since the 1980s.

Previous studies, the authors wrote, had pointed towards an association between obesity and asthma, however, their findings were mainly unclear and sometimes contradictory.

Dr. Kenneth B. Quinto and team gathered data on 41,819 kids in a Kaiser Permanente health plan. All of them had been diagnosed with asthma. 56% were male, 43.5% female. 55.9% of the 13,815 Hispanic children, 50.3% of the 5,736 African-American children and 41.5% of the 9,038 Caucasian kids were overweight/obese.

The fatter children used, on average, 3.1 rescue inhalers each year, compared to 2.8 among the normal-weight children.

Inhaled steroids, such as Flovent or Pulmicort, the mainstays of treatment to control airway inflammation on a daily basis among patients with asthma, were used more often by the heaver children, compared to those of normal-weight.

Emergency department visits were more common among the obese children (9%) compared to the normal weight ones (8.1%). Hospitalization rates were similar, 1.9% for obese, 1.8% for overweight and 1.9% for normal-weight kids.

Even after taking account differences in sex, diabetes, race and socioeconomic levels, the results still stood up, the authors added.

The extra weight on the lungs experienced by obese children may make them feel as if they require more drugs, the researchers suggest. Also, obese children (and adults) do not respond as well to steroids as do children of normal weight. The authors concluded:

“Childhood obesity disproportionately affects certain cultural groups. Obese children experience increased asthma morbidity through ED visits for asthma when compared to normal-weight children.”

Written by Christian Nordqvist