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February 19, 2013

Study of Nearly 1,000 Children Found Excess Weight Affects Lung Function

In Minority Children More Than Caucasian Children

NEW YORK (February 19, 2013) Even small amounts of excess weight can adversely affect lung function in Hispanic and African-American children who have a higher prevalence of asthma compared to their Caucasian counterparts, according to a Montefiore Medical Center study published in the February print issue of the Journal of Asthma. The study analyzed data collected over four years from nearly 1,000 children in the Bronx, which has one of the highest rates of asthma in the United States.

“While it has been well documented that Hispanics and African-Americans – particularly those who live in urban settings – have a higher prevalence of asthma and obesity, there is less understanding of the lung function in overweight asthmatic minority children,” said Deepa Rastogi, M.D., M.S., senior author and attending physician, Division of Respiratory and Sleep Medicine, The Children's Hospital at Montefiore, and assistant professor of Pediatrics at Albert Einstein College of Medicine of Yeshiva University.  “What we have learned from this study is that even small increases in weight can negatively impact lung function.”

Asthma among normal-weight children is usually attributed to environmental factors like second-hand smoke and exposure to dust, animal dander, mold and roaches.  Weight appears to have more of an impact on lung function in minority children than their Caucasion counterparts.  In fact, airway obstruction may be experienced in both overweight and obese minority children compared to Caucsion children who are only obese.

“This information may prove to be helpful in the clinic,” Dr. Rastogi said.  “Physicians might want to measure the degree of airway obstruction in Hispanic and African-American children who are both overweight or obese and asthmatic. Early identification of a drop in lung function can assist in better patient management.”

The pulmonary function differences in the study may potentially be explained by ethnic differences in body shape and upper body fat distribution. Prior studies have shown that waist circumference inversely correlates with pulmonary function and directly correlates with asthma severity. Since weight gain in Hispanics and African-Americans may be related to additional truncal fat, these differences could explain the higher asthma prevalence observed in those groups compared to Caucasian populations.

The study followed 980 children, ages 7-20 years, who were patients at Montefiore Medical Center in the Bronx. The retrospective study was conducted based on medical records collected from January 2003 to December 2007.

Dr. Rastogi is certified by American Board of Pediatrics and board certified in Pediatric Pulmonology. She is a member of American Academy of Pediatrics, American Thoracic Society and The New York City Asthma Partnership (NYCAP). Dr. Rastogi received her medical degree from GSVM Medical College in India, and completed her residency and Fellowship at Columbia Presbyterian Medical Center.

Additional researchers included Phuong Vo., M.D., Boston Children’s Hospital; Kartikeya Makker, M.D., Department of Pediatrics, Medical College of Wisconsin; Esther Matta-Arroyo, R.T., The Children’s Hospital at Montefiore; Charles Hall, P.h.D., Albert Einstein College of Medicine; and Raanan Arens, M.D., The Children’s Hospital at Montefiore and Albert Einstein College of Medicine.