The association between BMI, vigorous physical activity and television viewing and the risk of symptoms of asthma, rhinoconjunctivitis and eczema in children and adolescents: ISAAC Phase Three

• Published in: Clinical and experimental allergy 2013-01, Vol.43 (1), p.73-84
• Main Authors: Mitchell, E. A., Beasley, R., Björkstén, B., Crane, J., García-Marcos, L., Keil, U.
• Format: Article
• Language: English
• Subjects: Adolescent; Allergic diseases; asthma; Asthma - epidemiology; Asthma - etiology; Biological and medical sciences; Body Mass Index; Child; Chronic obstructive pulmonary disease, asthma; Conjunctivitis - epidemiology; Conjunctivitis - etiology; eczema; Eczema - epidemiology; Eczema - etiology; Exercise; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Immunopathology; Male; Medical sciences; Medicin och hälsovetenskap; Non tumoral diseases; Obesity - complications; Obesity - epidemiology; Otorhinolaryngology. Stomatology; Overweight - complications; Overweight - epidemiology; physical activity; Pneumology; Prevalence; Rhinitis - epidemiology; Rhinitis - etiology; rhinoconjunctivitis; Risk Factors; Skin allergic diseases. Stinging insect allergies; Surveys and Questionnaires; Television; television viewing; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
• ISSN: 0954-7894; 1365-2222; 1365-2222
• DOI: 10.1111/cea.12024

Summary Background Several studies have observed an association between obesity and asthma, but whether or not there is an association with rhinoconjunctivitis or eczema is unclear. Aims To examine the relationship between body mass index categories (underweight, overweight and obesity), vigorous physical activity and television viewing and the risk of symptoms of asthma, rhinoconjunctivitis and eczema. Methods As part of International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three, parents or guardians of children aged 6–7 years completed written questionnaires about symptoms of asthma, rhinoconjunctivitis and eczema, and several potential risk factors, such as vigorous physical activity and television viewing, and other information such as the child's height and weight. Adolescents aged 13–14 years self‐completed the questionnaires on these symptoms and potential risk factors and reported their own height and weight. For 28% of children and 24% of adolescents, the height and weight was objectively measured. Results A total of 76 164 children aged 6–7 years (from 29 centres and 17 countries) and 201 370 adolescents aged 13–14 years (from 73 centres and 35 countries) provided data meeting the inclusion criteria. There were associations between overweight and obesity, but not underweight, and symptoms of asthma and eczema but not rhinoconjunctivitis. Vigorous physical activity was positively associated with symptoms of asthma, rhinoconjunctivitis and eczema in adolescents, but not children. Viewing television for five or more hours/day was associated with an increased risk of symptoms of asthma, rhinoconjunctivitis and eczema in adolescents and symptoms of asthma in children. Conclusions and Clinical Relevance This study has confirmed the association between overweight and obesity and symptoms of asthma. It has extended these observations to include significant associations with symptoms of eczema, but not rhinoconjunctivitis. There are complex relationships between obesity, vigorous physical activity and sedentary behaviour and the symptoms of asthma, rhinoconjunctivitis and eczema in children.