HealthDay News — Overweight and obese children with asthma may mistake symptoms such as exertional dyspnea and esophageal reflux for loss of asthma control, leading to unnecessary use of rescue medications, results of a study published in the Journal of Allergy and Clinical Immunology indicate.

“Past studies of asthma in overweight/obese children have been inconsistent,” wrote Jason E. Lang, MD, MPH, of Nemours Children’s Hospital in Orlando, Fla., and colleagues. “The reason overweight/obese children commonly report worse asthma control remains unclear.”

To examine the qualitative differences in symptoms between overweight/obese and lean children with early-onset, atopic asthma, the investigators conducted a cross-sectional analytic study involving children aged 10 to 17 years with persistent, early-onset asthma.

Lung function was similar for overweight/obese and lean children, reported the scientists. Overweight/obese children reported more frequent rescue treatments (3.7 versus 1.1 treatments per week; P=0.0002) despite lower fraction of exhaled nitric oxide (P=0.037) and reduced methacholine responsiveness (P<0.012).

The primary symptoms reported with loss of asthma control varied with weight status (P=0.003); shortness of breath was more frequently reported by overweight/obese children (odds ratio, 11.8), while cough was less often reported (odds ratio, 0.26).

Compared with lean children, overweight/obese children had higher gastroesophageal reflux scores (9.6 versus 23.2; P=0.003), which seemed to mediate symptoms of overweight/obesity-linked asthma.

“Overweight/obese children with early-onset asthma display poorer asthma control and a distinct pattern of symptoms,” concluded the researchers.

“Overweight children with asthma may falsely attribute exertional dyspnea and esophageal reflux to asthma, leading to excess rescue medication use.”


  1. Lang JE et al. Journal of Allergy and Clinical Immunology. 2014; doi: 10.1016/j.jaci.2014.08.029