, Volume 83, Issue 3, pp 421-433
Date: 19 May 2006

Childhood Asthma and Extreme Values of Body Mass Index: The Harlem Children’s Zone Asthma Initiative

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Abstract

To examine the association between body mass index (BMI) percentile and asthma in children 2–11 years of age, we performed a cross-sectional analysis of 853 Black and Hispanic children from a community-based sample of 2- to 11-year olds with measured heights and weights screened for asthma by the Harlem Children’s Zone Asthma Initiative. Current asthma was defined as parent/guardian-reported diagnosis of asthma and asthma-related symptoms or emergency care in the previous 12 months. Among girls, asthma prevalence increased approximately linearly with increasing body mass index (BMI) percentile, from a low of 12.0% among underweight girls (BMI ≤5th percentile) to a high of 33.3% among girls at risk for overweight (BMI 85th–94th percentile). Among boys, asthma prevalence was associated in a U-shaped curve with the extremes of BMI percentile, that is, 36.4% among underweight boys, 19.1% among normal weight boys (BMI 6th–84th percentile), and 34.8% among overweight boys (>95th percentile). After adjusting for age, race/ethnicity, and household smoking, among girls, having asthma was associated with being at risk for overweight (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.4–5.0) and being overweight (OR, 2.1; 95% CI, 1.2–3.8) compared to normal weight; among boys, having asthma was associated both with overweight (OR, 2.4; 95% CI, 1.4–4.3) and with underweight (OR, 2.9; 95% CI, 1.1–7.7). Large, prospective studies that include very young children are needed to further explore the observed association between underweight and asthma among boys. Early interventions that concomitantly address asthma and weight gain are needed among pre-school and school-aged children.

Kwon and Ortiz share co-first aithorship. Ortiz and Nicholas are with the Department of Pediatrics, Harlem Hospital Center/Columbia University, New York, NY, USA; Kwon and Borrell are with the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA; Swaner, Shoemaker, and Jean-Louis are with the Harlem Children’s Zone, Inc., New York, NY; Northridge and Vaughan are with the Harlem Health Promotion Center, Mailman School of Public Health, Columbia University, New York, NY, USA; Northridge is with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA; Vaughan is with the Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA; Marx is with the Department of Education, New York City, NY, USA; Goodman is with the East and Central Harlem District Public Health Office, New York City Department of Health and Mental Hygiene, New York, NY, USA.