@article{3056931,
    title = "Overweight/obesity and respiratory and allergic disease in children: International study of asthma and allergies in childhood (ISAAC) phase two",
    author = "Weinmayr, G. and Forastiere, F. and Büchele, G. and Jaensch, A. and Strachan, D.P. and Nagel, G. and Weiland, S.K. and Dentler, C. and Rzehak, P. and Priftanji, A. and Shkurti, A. and Simenati, J. and Grabocka, E. and Shyti, K. and Agolli, S. and Gurakuqi, A. and Stein, R.T. and De Pereira, M.U. and Jones, M.H. and Pitrez, P.M. and Cooper, P.J. and Chico, M. and Chen, Y.Z. and Zhong, N.S. and Lai, C.K.W. and Wong, G.W.K. and Riikjärv, M.-A. and Annus, T. and Annesi-Maesano, I. and Gotua, M. and Rukhadze, M. and Abramidze, T. and Kvachadze, I. and Karsanidze, L. and Kiladze, M. and Dolidze, N. and Leupold, W. and Keil, U. and Von Mutius, E. and Arthur, P. and Addo-Yobo, E. and Gratziou, C. and Priftis, K. and Papadopoulou, A. and Katsardis, C. and Tsanakas, J. and Hatziagorou, E. and Kirvassilis, F. and Clausen, M. and Shah, J.R. and Mathur, R.S. and Khubchandani, R.P. and Mantri, S. and Di Domenicantonio, R. and De Sario, M. and Sammarro, S. and Pistelli, R. and Serra, M.G. and Corbo, G. and Perucci, C.A. and Svabe, V. and Sebre, D. and Casno, G. and Novikova, I. and Bagrade, L. and Brunekreef, B. and Schram, D. and Doekes, G. and Jansen-Van Vliet, P.H.N. and Janssen, N.A.H. and Aarts, F.J.H. and De Meer, G. and Crane, J. and Wickens, K. and Barry, D. and Nystad, W. and Bolle, R. and Lund, E. and Garrido, J.B. and Ruiz, T.R. and Perales, A.B. and Jiménez, Y.G. and Rodriguez, J.A. and De Cabo, J.M. and Maldonado, A.L. and Torres, M.D. and García-Marcos, L. and Torres, A.M. and Pérez, J.J.G. and López, A.P. and Robles, S.C. and Hernandez, G.G. and Gimeno, A.M. and Rodríguez, A.L.M. and Paredes, C.L. and Gil, I.G. and Suarez-Varela, M.M.M. and González, A.L. and Montaner, A.E. and Guerola, M.T. and Bråbäck, L. and Sandin, A. and Kjellman, M. and Nilsson, L. and Mai, X.-M. and Saraçlar, Y. and Tuncer, A. and Saçkesen, C. and Sumbulglu, V. and Geyik, P. and Kocabas, C. and Kuyucu, S. and Kaur, B. and El-Sharif, N. and Barghuthy, F. and Abu Huij, S. and Qlebo, M. and Nemery, B. and Aït-Khaled, N. and Anderson, H.R. and Pearce, N. and Strachan, D.P. and Flohr, C. and Williams, H. and Asher, M.I. and Ellwood, P. and Stewart, A. and Mitchell, E. and Beasley, R. and Björkstén, B. and Foliaki, S. and Mallol, J. and Montefort, S. and Odhiambo, J. and Robertson, C. and ISAAC Phase Two Steering Group",
    journal = "PLOS ONE",
    year = "2014",
    volume = "9",
    number = "12",
    publisher = "Public Library of Science",
    doi = "10.1371/journal.pone.0113996",
    keywords = "immunoglobulin E, airway obstruction;  allergic disease;  Article;  body height;  body mass;  body weight;  child;  childhood obesity;  clinical research;  controlled study;  coughing;  cross-sectional study;  disease association;  eczema;  female;  forced expiratory volume;  forced vital capacity;  human;  major clinical study;  male;  prevalence;  questionnaire;  respiratory tract disease;  rhinitis;  school child;  sex difference;  wheezing;  asthma;  complication;  international cooperation;  obesity, Asthma;  Body Mass Index;  Child;  Cross-Sectional Studies;  Female;  Humans;  Internationality;  Male;  Obesity;  Prevalence",
    abstract = "Background: Childhood obesity and asthma are increasing worldwide. A possible link between the two conditions has been postulated. Methods: Cross-sectional studies of stratified random samples of 8-12-year-old children (n=10 652) (16 centres in affluent and 8 centres in non-affluent countries) used the standardized methodology of ISAAC Phase Two. Respiratory and allergic symptoms were ascertained by parental questionnaires. Tests for allergic disease were performed. Height and weight were measured, and overweight and obesity were defined according to international definitions. Prevalence rates and prevalence odds ratios were calculated. Results: Overweight (odds ratio=1.14, 95%-confidence interval: 0.98; 1.33) and obesity (odds ratio=1.67, 95%-confidence interval: 1.25; 2.21) were related to wheeze. The relationship was stronger in affluent than in non-affluent centres. Similar results were found for cough and phlegm, rhinitis and eczema but the associations were mostly driven by children with wheeze. There was a clear association of overweight and obesity with airways obstruction (change in FEV1/FVC, 20.90, 95%-confidence interval: 21.33%; 20.47%, for overweight and 22.46%, 95%-confidence interval: 23.84%; 21.07%, for obesity) whereas the results for the other objective markers, including atopy, were null. Conclusions: Our data from a large international child population confirm that there is a strong relation of body mass index with wheeze especially in affluent countries. Moreover, body mass index is associated with an objective marker of airways obstruction (FEV1/FVC) but no other objective markers of respiratory and allergic disorders. © 2014 Weinmayr et al."
}