Weight Management Interventions in Adult and Pediatric Asthma Populations: A Systematic Review
- *Corresponding Author:
- Jun Ma
Senior Scientist, Palo Alto Medical Foundation Research Institute
795 El Camino Real, Ames Building, Palo Alto, CA, USA
Tel: (650) 853-4809
Fax: (650) 329-9114
E-mail: [email protected]
Received date: November 26, 2014; Accepted date: December 23, 2014; Published date: December 26, 2014
Citation: Nan Lv, Xiao L, Ma J (2015) Weight Management Interventions in Adult and Pediatric Asthma Populations: A Systematic Review. J Pulm Respir Med 5:232. doi:10.4172/2161-105X.1000232
Copyright: © 2015 Nan Lv, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Ample evidence suggests a dose-response relationship between increasing weight and level of asthma risk or reduced asthma control. To establish reversibility, several randomized controlled trials (RCTs) have recently been published to investigate the impact of weight management on asthma. This systematic review synthesizes evidence from these RCTs on the effects of weight management (weight loss, weight maintenance, maintenance of lost weight, or weight gain prevention) interventions on asthma outcomes in both adult and pediatric populations.
Methods: We searched Medline, CINAHL, PsychInfo, and Cochrane for studies published between 1950 and November 2014. Two researchers independently rated the included studies using the quality assessment tool for RCTs as outlined in the 2013 Obesity Treatment Guideline. Discrepancies were resolved by consensus after discussion between the raters and, if needed, with the senior author.
Results: Four RCTs in adults and 3 in children and adolescents were included. The adult studies seem to consistently support the benefit of substantial weight loss, but a threshold effect may exist such that only weight loss beyond a minimal amount will likely lead to clinically important improvement in asthma outcomes. Three of them suggest that the threshold may lie between 5-10% of weight loss. RCTs in youth suggest that modest calorie reductions alone or combined with increased physical activity, or even a healthy normocaloric diet, may lead to improved asthma outcomes. However, most RCTs reviewed were limited by small sample size, short intervention durations, and short follow-up periods.
Conclusion: Trial evidence shows the promise of weight loss interventions for asthma control in adults and youth. More adequately-powered, long-term RCTs are needed to elucidate the role of weight loss and other weight management interventions in asthma control and prevention. Definitive data are needed to guide clinical and public health practice to effectively address the dual epidemic of obesity and asthma.