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Prognosis of asthma in childhood obesity – Prognosis of Asthma in Childhood

Except for children with both asthma and food allergy, the prevalence of obesity, when objectively measured using BMI percentiles, was consistently higher than parental perception.

Matthew Cox
Wednesday, February 24, 2021
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  • They did not find tweeted significant correlation between severity of sleep-disordered breathing and asthma severity or control measures. Create a free personal account to access your subscriptions, sign up for alerts, and more.

  • Van de Griendt E. Figure 1.

  • J Pediatr. Researchers suggest that the antioxidants found in plant foods contribute to reduced airway inflammation and resulting improvements in FEV 1 6364 and FVC.

  • Centers for Disease Control, and Prevention.

  • Aaron, D. The authors recommend that due to the varying response to controller medications, which makes it difficult to know which medication regimen is ideally suited to treat this phenotype, clinicians taking care of patients with asthma should follow the obese asthmatic closely to assess response to medications.

Mechanistic Understanding of the Effect of Obesity on Asthma and Allergy

Bermudez et al suggested that these dietary changes might play a causative role in the increased prevalence of asthma in Latin American countries. Mechanisms of obesity in asthma. Holguin and A. Acute effects of dairy ingestion were examined in a double-blind, placebo-controlled, crossover study. Kermode, S.

The state of childhood asthma, United States, — Pediatrics ; : —9. These differences were not significant. The relation of body mass index to asthma, chronic bronchitis, and emphysema.

At present, the management of asthma in children with obesity, in a step-up strategy, typically requires the use of leukotriene receptor inhibitors and inhaled corticosteroids with long-acting b2-agonsits. Munoz, N. Adipose tissue content and distribution in children and adolescents with bronchial asthma. Obesity and the risk of newly diagnosed asthma in school-age children. Cartier, and B. Boulet and E.

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Early onset allergic asthma is characterized by TH2 driven lymphocytic inflammation with increases in cytokines such as IL-4 and IL-5 that promote airway eosinophilia and IL leading to mucus hypersecretion. Food allergy among children in the United States. However, this study found that families of children with asthma and food allergy had the lowest monitoring scores. Validity of parent-reported height and weight for defining obesity among asthmatic and nonasthmatic schoolchildren. Mayo Clinic does not endorse companies or products.

Show references Asthma in asfhma. In asthmatic patients with obesity, the specific content of the diet, including fats, sugar, and low nutrients, may contribute to the chronic inflammatory state. Flavonoids have been recognized as the major active nutraceutical ingredients in plants, owing to their properties as antioxidants and metal chelators. Lavoie, S. The evaluation of dietary components may constitute an additional therapeutic option for obese asthmatic children. This correlation suggests an ILF—dependent inflammatory pathway might play a mediating role in the development of asthma. Clerisme-Beaty, E.

All participants were 6—16 years old with current asthma and a BMI in the overweight or obesity range without comorbidities such as diabetes or heart diseases. The authors found that obesity was significantly associated with the use of mechanical ventilation and prolonged length of hospital stay among hospitalized children with acute asthma exacerbation. These identified factors can help define a specific phenotype. Sutherland et al.

Vitamin D and inflammatory diseases. Faraone et al. Chu Y. Reduced selenium in asthmatic subjects in New Zealand. Issue Section:. Measurements of exhaled nitric oxide in healthy subjects age 4 to 17 years.

1. Introduction

Fisher L. Asthma is classically described as reversible inflammation of airways, characterized by recurrent attacks of shortness of breath, cough, and wheeze, affecting people of all ages. Acta Paediatr. Japanese guidelines for childhood asthma Results 4.

The role of pro-inflammatory and anti-inflammatory adipokines on exercise-induced bronchospasm in obese adolescents undergoing treatment. After surgery, those undergoing surgery had improved ACT scores compared to the group without surgery In particular, the late-onset obese asthma phenotype seems to be associated with non-Th2 signalling pathways. Stenius-Aarniala, T. Nutr Metab Cardiovasc Dis. Zhang, W.

The complexities of approaching nutrition in inflammatory bowel disease: current recommendations and future iin. Forgione et al. At present, it is difficult to know what role oxidative stress plays in the obese-asthma phenotype. Okubo Y. The researchers suggest measurement through conventional spirometry might lack the sensitivity necessary to detect dairy-induced pulmonary changes. Schwartzman, M.

INTRODUCTION

Suratt, K. A recent meta-analysis that included eleven trials covering patients found that childhoov had a higher mean morning peak expiratory flow PEF rate after treatment with proton pump inhibitory PPI but no significant difference in asthma symptoms score, asthma quality of life questionnaire, evening PEF rate, and FEV1. Get free access to newly published articles.

A systematic review of parental perception of overweight status in children. Validity of parent-reported height and weight for defining obesity among asthmatic and nonasthmatic schoolchildren. A study examining the childhood obesity in obesity among adults, using data from the NHANES I —II —and III obeeityfound that BMI increased universally among adults with asthma and those without; however, the prevalence of obesity rose more in the asthma group Prioritizing comparative-effectiveness research—IOM recommendations. Leptin may have multiple effects on lung development; leptin deficient mice show decreased lung volume and alveolar surface area 55 and decreased proliferation of tracheal epithelium. If your child has asthma, he or she may say things such as, "My chest feels funny" or "I'm always coughing. It would be interesting to account for these factors when exploring parental feeding practices in future studies.

ALSO READ: Harness Booster Seats For Obese Children

Asthma care of children in clinical practice: do parents report receiving appropriate education? Please review our privacy policy. This concern, however, did not appear to translate into differences in the use of restriction, monitoring, or pressure to eat between children with no asthma or food allergy and those with asthma, food allergy, or both. However, preliminary evidence suggests that the obese asthma phenotype may adversely affect standard treatment regimens, and a one-size fits all approach may not be best. Mahadev

Vitamin D and inflammatory diseases. Mosen, M. Khatri, J. King, and X. Is prlgnosis ratio a useful indicator of cardio-metabolic risk in 6—year-old children? Their data showed a gap of incremental hospital charges between obese and lean inpatients with asthma, drawing attention to the importance of the prevention of obesity for both clinicians and healthcare payers [ 24 ]. Asthma, allergy and respiratory infections: the vitamin D hypothesis.

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Nurs Clin North Am ; prognoosis : — Possible SDM solutions include: incorporating education about the effects of obesity on asthma control, asking patients about goals around weight loss, and providing them with education and strategies for weight loss. Furthermore, there were no significant differences among the groups in terms of pressure to eat and restrictive feeding practices. Mahadev Martin RJ.

Consulting your child's doctor can help you make needed treatment adjustments to keep symptoms under control. Systemic inflammation is associated with worse clinical outcomes in asthmatic patients. The many faces of asthma in obesity: the many faces of asthma in obesity. Grant, and J.

Additionally, SDM was associated with a drop in severity for all groups. Wenzel SE. Spirometry is often not feasible outside the research arena or more specialized clinical settings. Percentages may not always add up to due to rounding.

Journal of Allergy

Disparities in asthma Although asthma affects people of all ages, it disproportionately affects children. Consulting your child's doctor can help you make needed treatment adjustments to keep symptoms under control. Maternal perceptions of overweight preschool children.

  • Taylor, D.

  • Obesity in asthma: More neutrophilic inflammation as a possible explanation for a reduced treatment response. Chlid Nutr.

  • A better understanding of the mechanisms mediating these obese asthma phenotypes would have significant implications for therapeutic strategies.

  • BMC Public Health.

Rastogi DHolguin F. Clerisme-Beaty, S. In general, studies have shown improvement in various parameters of asthma control and severity with weight-loss interventions ranging from diet modification to bariatric surgery. Obstein, A. High BMI is related to higher incidence of asthma, while a fish and fruit diet is related to a lower- results from a long-term follow-up study of three age groups in Sweden. Purchase access Subscribe to JN Learning for one year.

ALSO READ: Healthy Eating Habits To Prevent Obesity In Infants

Additionally, this study does not account for the extent of physical activity in the children, and does not have enough sample size to stratify the analyses by ethnicity. Obese asthma is a complex syndrome, including different phenotypes of disease that are just beginning to be understood. Sharon M. In some children, unmanaged asthma can cause dangerous asthma attacks. Ann Allergy Asthma Immunol ; : — Garcia-Marcos L.

Higher serum F2-isoprostane levels were associated with asthma, but the association was not significant after adjusting for obesity or gender [ 75 ]. Sutherland, M. Natural history of asthma. Sastre et al. Allergy skin tests were used to measure atopic status.

Publication types

Taylor, and R. Mosen, M. Researchers suggest that the antioxidants found in plant foods contribute to reduced airway inflammation and resulting improvements in FEV 1 6364 and FVC.

Diet and asthma: looking back, moving forward. Diet-induced weight loss in obese children with asthma: Chiildhood randomized controlled trial. Salome, P. This correlation suggests an ILF—dependent inflammatory pathway might play a mediating role in the development of asthma. Shu Chan, A. Obesity and asthma are two of the most significant paediatric health problems worldwide, particularly in industrialized nations, and in recent decades their prevalence has increased dramatically [ 123 ]. Obese patients have increased airway resistance.

There were variations around the world. In non-asthmatic patients, WHtR is linked to the adthma model assessment of insulin resistance HOMA-IR and is associated with increased lipolysis and atherogenic dyslipidaemia: this result promotes inflammation and the hepatic synthesis of C-reactive protein CRP [ 4950 ]. There were no significant differences in response to treatment with montelukast [ 38 ]. Primary Source of Funding: U. Related Asthma and hard flooring Asthma in children under 5 Childhood asthma action plan Hygiene hypothesis Treating asthma in children age 12 and older Treating asthma in children ages 5 to 11 Will my child outgrow asthma?

Postprandial variations of plasma inflammatory markers in abdominally obese men. In off past four decades, mean BMI and obesity in the paediatric population have significantly increased worldwide. J Thorac Dis. Schuyler et al. A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, wk clinical trial. High School Students.

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Signs of respiratory distress, rhinitis, nasal irritation and swelling, prolonged expiratory phases, and triggers of symptoms assist in the diagnosis. Second Expert Panel on the Management of Asthma. Child combined asthma-food allergy status.

Secondary outcomes included other lung function parameters, asthma control, asthma-specific quality of life, use of asthma medication, and markers of prognosls inflammation and airway inflammation. The authors suggested that daily low-dose, short-term vitamin D supplementation in addition to standard treatment might improve levels of asthma control in schoolchildren [ 82 ]. Exp Physiol. Try out PMC Labs and tell us what you think.

Disparities in asthma Although asthma affects people of all ages, it disproportionately affects children. Asthms with previous research, children with asthma were more likely to be overweight or obese [ 3031 ]. BMC Public Health. Asthma is classically described as reversible inflammation of airways, characterized by recurrent attacks of shortness of breath, cough, and wheeze, affecting people of all ages. Author information Article notes Copyright and License information Disclaimer.

  • Association between adherence to the Mediterranean diet and asthma in Peruvian children.

  • These barriers include limited access to care and medications, cultural differences in understanding and accepting treatment options, and decreased health literacy.

  • Google Scholar Crossref. If your child has asthma, he or she may say things such as, "My chest feels funny" or "I'm always coughing.

  • Allergy Immunol.

  • Perturbed equilibria of myosin binding.

  • All analyses were conducted using SAS version 9.

Wang Y, Beydoun MA. References 1. Child food allergies or sensitivities were collected using questions adapted from a validated questionnaire [ 27 ]. Associations between child weight and maternal feeding styles are mediated by maternal perceptions and concerns. Notably, adults and children with nonallergic asthma have shown a higher risk for obesity [ 2425 ].

Childhood asthma isn't a different disease from asthma in adults, but children face unique challenges. Obesity and the risk of newly diagnosed asthma in school-age children. Schuyler et al. Metformin typically induces significant weight loss by means of increasing satiety and decreasing intestinal nutrient absorption.

1. Introduction

Feixas, M. Sign in to customize your interests Sign in to your personal account. Pathophysiology prognsis asthma. Bermudez et al suggested that these dietary changes might play a causative role in the increased prevalence of asthma in Latin American countries. After using modeling to control for obesity and other risk factors, they found that high OSA risk was associated with persistent daytime [1.

  • Immunol Rev. Similar improvements in asthma control, spirometry, airway inflammation, and airway hyperresponsiveness across BMI groups.

  • Thorax ; 63 : —6. Childhood obesity and asthma are on the rise in the U.

  • Neutrophilic infiltration.

  • Neutrophilic inflammation in severe persistent asthma.

  • Dietary factors lead to innate immune activation in asthma.

These findings were confirmed by other analyses [ 5 ]. Symptom perception ;rognosis respiratory sensation: Clinical applications. PloS One. Pulmonary function testing demonstrates that late-onset asthmatic patients have minimal airway obstruction and less airway hyperresponsiveness with better asthma control and lower symptom scores than early-onset asthmatic patients [ 27 ]. Conversely, obesity-related childhood asthma is characterized by increases in T H 1 cells.

Vitamin D serum levels and markers of asthma control in Italian children. Further studies have shown that obese asthmatics have poor asthma control and more severe asthma. Innate immune activation in neutrophilic asthma and bronchiectasis. Children in the intervention arm received a multifactorial intervention lasting for 18 months, consisting of sessions concerning sports, parental involvement, and individual counselling and lifestyle advice, including dietary advice and cognitive behavioural therapy. Sears, C. Koenig K.

  • Diet, interleukin, and childhood asthma in Puerto Ricans.

  • Increasingly, evidence suggests that obesity and asthma are physiologically linked through a chronic inflammatory response. Individuals with allergic asthma also have important clinical and genetic differences when compared to those with nonallergic asthma [ 23 ].

  • Dietary restriction and exercise improve airway inflammation and clinical outcomes in overweight and obese asthma: a randomized trial.

  • Accepted 11 Mar Take your child to see the doctor if you suspect he or she has asthma.

Lugogo et al. Schatz, D. Nilas, and C. Boulet and E. BMI percentile was documented more often in patients with severe obesity and moderate to severe asthma.

The mechanisms behind this are still under investigation and likely multifactorial. Effects of obstructive sleep apnea and childgood reflux disease on asthma control in obesity. Asthma is among the prognosis of asthma in childhood obesity 20 chronic diseases in disability-adjusted life years at paediatric age; at midchildhood ages 5—14 yearsit is among the top 10 causes [ 8 ]. In non-asthmatic patients, WHtR is linked to the homeostasis model assessment of insulin resistance HOMA-IR and is associated with increased lipolysis and atherogenic dyslipidaemia: this result promotes inflammation and the hepatic synthesis of C-reactive protein CRP [ 4950 ]. Sutherland, J. The authors evaluated a total of patients aged 3 to 17 years admitted to the hospital with asthma and calculated BMI and BMI percentile through an analysis of patient height, weight, age, and gender; they found that

Introduction

Prognosls, changes in BMI z-score were associated with changes in airway and systemic inflammation [ 75 ]. Normocaloric diet improves asthma-related quality of life in obese pubertal adolescents. Please review our privacy policy. Severity can refer to a spectrum of findings including loss of function of the organs from asthma or to the occurrence of severe acute exacerbations [ 18 ].

Special Issues. Rosengren, L. Thus, studies suggest that consuming dietary sources of these antioxidants can protect against the effects of oxidants and prevent inflammation. Crocker, N.

These findings suggest that a plant-based diet provides a ptognosis treatment option for asthmatic patients. The control group received usual care. Decreased levels of FeNO have been found in obese individuals who report wheezing [ 55 ]. Munoz, N. Mosen, M. Obese adipose tissue is infiltrated by macrophages that are a source of inflammatory cytokines [ 57 ].

A systematic review of the association between obesity and asthma in children. Herein, the relation between parental perceptions of child weight status, observed body mass index BMI percentiles, and a measure of child feeding practices were explored in the context of asthma, food allergy, or both. J Clin Invest ; 96 : — Practice-based research networks: Nursing centers and communities working collaboratively to reduce health disparities. Wang Y, Beydoun MA. A cross-sectional study of the comorbidities in obese preschool children in the United States.

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Consulting your child's doctor can help you make needed treatment adjustments to keep symptoms under control. Gupta A, et al. Natural medicines in the clinical management of asthma. Asthma costs and utilization in a managed care organization.

Obese asthma is a complex syndrome, including different phenotypes of disease that are just beginning to be understood. Longitudinal data from childhood obesity larger sample that has been collected to answer the study questions would help clarify the present findings, and shed light on which children who currently do not have asthma or food allergy are destined to develop one or more of these conditions. J Asthma Controlling feeding practices: Cause or consequence of early child weight? Vital Health Stat 10 ; : 1—

Thorax ; 55 : — Strategies including education of patients and physicians, and regular follow-up are required to reduce the economic burden of asthma. Abstract Asthma and obesity are two major chronic diseases in children and adolescents. Musaad1 Katie N. Health care costs increase in patients with more severe asthma, but the effect of asthma exacerbations on costs among patients with more severe asthma is difficult to quantify. Another systematic review of asthma and weight loss found reversibility of at least one asthma outcome irrespective of whether weight loss was a result of surgical or medical intervention. Barriers to adherence to asthma management guidelines among inner-city primary care providers.

Sideleva, B. Shortness of breath and rescue medication use were significantly improved after surgery. Zallo N.

The association between asthma and obesity was not statistically significant in atopic subjects [ 49 ]. TNF-alpha, Il-6, and leptin have been shown to be higher in obese asthmatics patients than in nonobese asthmatics [ 58 ]. FEV 1 and peak expiratory flow were measured on the active challenge day. Peters-Golden, A. Rand et al.

ALSO READ: Us Health Policy Obesity

Economic burden of asthma: a systematic review. Asthma: and beyond. The association between obesity and asthma is stronger in nonallergic than allergic adults. Genovesi S. Farzan 44Sideleva and Dixon 45Sideleva et al. Figure 1. Second Expert Panel on the Management of Asthma.

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  • Driving the obese asthma phenotype in adolescents? Obesity may have an effect on airway smooth muscle leading to increased airway hyperreactivity but the current evidence is conflicting.

The disease can be fatal. Dent, Y. Asthma, atopy, and airway inflammation in obese children. Fish oil supplementation reduces severity of exercise-induced bronchoconstriction in elite athletes. There was no correlation between the serum and exhaled levels [ 77 ]. Select Format Select format.

Pharmacotherapy As recently reviewed, no specific medications are recommended for obesity in paediatric patients fo asthma, as children are treated according to the frequency and severity of symptoms and their impact on daily activities. J Am Coll Cardiol. Weight loss through multidisciplinary intervention: increasing physical activity, improving adherence to dietary guidelines, evaluating vitamin D supplementation; using specific medications Orlistat or Metformin only in children with severe obesity-related complications. Overview of Health and Diet in America. They found that witnessed apnea had the strongest association with decreased asthma control and that there was a highly significant relationship between the number of symptoms of OSA reported by subject and asthma control [ 80 ]. Boulet and E.

However, this study found that families of children with asthma and food allergy had the lowest monitoring scores. Food allergy among U. Chlid Nutr.

  • Beuther, and D.

  • J Cell Biochem ; —6.

  • The relation between obesity and asthmatic airway inflammation. Decreased response to inhaled steroids in overweight and obese asthmatic children.

  • The precise role of many of these mediators in the pathogenesis of allergic airway disease is not well known; however, a number of studies have shown the potential role of adiponectin which is decreased in obesity and leptin which increases in obesity in allergic asthma.

Using CPAP prognosis of asthma in childhood obesity the risk of persistent daytime symptoms 0. Other authors wrote that long-term treatment with glucocorticosteroids in asthmatic subjects could influence lipid metabolism by increasing the uptake of lipids from the digestive system and enhancing lipid storage in tissues [ 64 ], but their results have not been consistent [ 65 ]. At present, it is difficult to know what role oxidative stress plays in the obese-asthma phenotype. The authors suggested that daily low-dose, short-term vitamin D supplementation in addition to standard treatment might improve levels of asthma control in schoolchildren [ 82 ]. Some authors defined obesity as one of the few modifiable risk factors for asthma, highlighting the importance of incorporating a weight reduction program into the guidelines for childhood asthma [ 67 ].

J Appl Physiol ; : — The burden of asthma in the United States: Level and prognosis of asthma in childhood obesity are dependent on interpretation of the National Asthma Education and Prevention Program guidelines. In the STRONG Kids cohort, an assessment of parental feeding perceptions, attitudes, and practices suggested that parents of children with asthma perceived them to be heavier than parents of children with food allergy. Except for children with both asthma and food allergy, the prevalence of obesity, when objectively measured using BMI percentiles, was consistently higher than parental perception. Effect of bariatric surgery on airway response and lung function in obese subjects with asthma.

Dietary fiber intake has been positively associated with improvements in lung function. This content does not have an English version. Thus far, data from randomized trials are limited; therefore, there is not enough evidence to recommend vitamin D therapy for improving asthma management.

Journal List Nutrients v. Obesity in asthma: More neutrophilic inflammation as a possible explanation for a reduced treatment response. Webber L. Lindsay A. However, preliminary evidence suggests that the obese asthma phenotype may adversely affect standard treatment regimens, and a one-size fits all approach may not be best. Figure 1.

Functions of T cells in asthma: more than just T H 2 cells. The increase in childhood obesity has been linked to the increasing prevalence of related comorbidities, such as type 2 diabetes and asthma. Airway smooth muscle in asthma. Figure 1. Keywords: childhood obesity, pediatric asthma, food allergy, parental perception.

These small changes, although statistically significant, would likely have little clinical significance. In general, studies have shown improvement in various parameters of asthma control and severity with weight-loss interventions ranging from diet modification to bariatric surgery. This Issue. Pathophysiology of asthma. Magid, and C.

Driving the obese asthma phenotype in adolescents? A bidirectional relationship between adiponectin and asthma has been noted in mice where allergen inhalation reduces serum adiponectin and exogenous adiponectin attenuates airway hyperreactivity [ 59 ]. Chung, and P. Sutherland, E. They found that obese patients who took theophylline had a trend towards an increased rate of exacerbations compared to placebo 8. Obesity and Airway Dysanapsis in Children with and without Asthma.

Western diet induces a shift in microbiota composition enhancing susceptibility to adherent-invasive E. High Th2 biomarkers. Pharmacotherapy As recently reviewed, no specific medications are recommended for obesity in paediatric patients with asthma, as children are treated according to the frequency and severity of symptoms and their impact on daily activities. It can be difficult to tell whether your child's symptoms are caused by asthma. Vital Health Stat 3. J Inflamm Res. Obese asthmatics had worse asthma control and quality of life but not asthma severity.

National Heart, Lung, and Blood Institute. Don't ignore obessity that your child's asthma might not be under control, such as needing to use a quick-relief inhaler too often. Child food allergies or sensitivities were collected using questions adapted from a validated questionnaire [ 27 ]. Open in a separate window. Association between asthma symptoms and obesity in preschool 4—5 year old children.

Chen Z. Potts, and P. Asthma and diet: could food be thy medicine? Fruit and vegetable intake and risk of wheezing and asthma: a systematic review and meta-analysis. Peters-Golden, A. Your child might have only one indication, such as a lingering cough or chest congestion. Increased immune system sensitivity causes the lungs and airways to swell and produce mucus when exposed to certain triggers.

  • Metformin typically induces significant weight loss by means of increasing satiety and decreasing intestinal nutrient absorption.

  • Asthma care of children in clinical practice: do parents report receiving appropriate education? Identification of population subgroups of children and adolescents with high asthma prevalence: Findings from the Third National Health and Nutrition Examination Survey.

  • View at: Google Scholar A. The — Dietary Guidelines for Americans recommend that Americans consume more fruits and vegetables 1.

  • Strategies including education of patients and physicians, and regular follow-up are required to reduce the economic burden of asthma. Difference between parental perception and actual weight status of children: A systematic review.

Overall, similar trends were seen after excluding children who were considered to be if underweight or underweight according mobile the parental perception of child weight status and BMI percentiles. Beuther and Sutherland 48 and Desai et al. Even among subjects not started on ICSs, confirming a physician diagnosis of asthma can be difficult if there are minimal symptoms, and hence probably minimal airway inflammation, at the time of testing. Two discordant groups were identified. Show more related content.

Chen, K. Weight loss in obese patients can prevent early airway closure and improve ventilatory mechanics. Dixon, L. Childhood obesity in relation to poor asthma control and exacerbation: a meta-analysis. Busse WW.

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