Asthma and Maternal Body Mass Index Are Related to Pediatric Body Mass Index and Obesity: Results from the Third National Health and Nutrition Examination Survey

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Abstract
EPSTEIN, LEONARD H., YOW-WU B. WU, ROCCO A. PALUCH, FRANK J. CERNY, AND JOAN P. DORN. Asthma and maternal body mass index are related to pediatric body mass index and obesity: Results from the Third National Health and Nutrition Examination Survey. Obes Res. 2000;8:575-581. Objective: Clinical research has shown an increased preva- lence of obesity in children with asthma. This study was designed to assess the relationship between asthma and pediatric body mass index (BMI) in a national database and to examine factors that may modify this relationship. Design: The cross-sectional relationship between asthma and pediatric BMI and obesity (BMI $ 85th percentile) was studied. Variables that may influence the relationship be- tween asthma and pediatric BMI, such as race/ethnicity and television watching were included in the model for the total sample. A smaller sample of 3009 white and African Amer- ican youth were studied in regression models including maternal BMI. Study Population: A nationally representative cross- sectional sample of 5154 children and adolescents of 6 to 16 years of age from the Third National Health And Nutrition Examination Survey. Results: In the full sample, asthma and television watching were related to BMI, accounting for 3% of the variance in BMI. When maternal BMI was included in the non- Hispanic sample, television watching, maternal BMI, and the interaction of maternal BMI and asthma were related to youth BMI, accounting for 15% of the variance. The stan- dardized BMI z-score for those youth without asthma and no maternal obesity was 0.06, which increased to 0.33 if the youth had asthma, to 0.70 if the youth did not have asthma but the mother was obese, and to 1.71 if the youth had asthma and the mother was obese. Asthma, television watching, and maternal BMI were independent predictors of youth obesity. Conclusions: BMI and prevalence of obesity is higher in youth with asthma. Pediatric BMI, but not obesity, is also related to the interaction of asthma and maternal BMI in white and African American youth. Comorbidity of asthma and obesity may complicate treatment of either condition, and prevention of obesity should be encour- aged for asthmatic children.