title: Immediate and long term effects of weight reduction in obese people with asthma: randomised controlled study.
abstract: OBJECTIVE
  To investigate the influence of weight reduction on obese patients with asthma.
  
  
  METHODS
  Open study, two randomised parallel groups.
  
  
  METHODS
  Private outpatients centre, Helsinki, Finland.
  
  
  METHODS
  Two groups of 19 obese patients with asthma (body mass index (kg/m(2)) 30 to 42) recruited through newspaper advertisements.
  
  
  METHODS
  Supervised weight reduction programme including 8 week very low energy diet.
  
  
  METHODS
  Body weight, morning peak expiratory flow (PEF), forced vital capacity (FVC), forced expiratory volume in one second (FEV(1)); and also asthma symptoms, number of acute episodes, courses of oral steroids, health status (quality of life).
  
  
  RESULTS
  At the end of the weight reducing programme, the participants in the treatment group had lost a mean of 14.5% of their pretreatment weight, the controls 0.3%. The corresponding figures after one year were 11.3% and a weight gain of 2.2%. After the 8 week dieting period the difference in changes in percentage of predicted FEV(1) from baseline in the treatment and control groups was 7.2% (95% confidence interval 1.9% to 12.5%, P=0. 009). The corresponding difference in the changes in FVC was 8.6% (4. 8% to 12.5%, P<0.0001). After one year the differences in the changes in the two groups were still significant: 7.6% for FEV(1) (1. 5% to 13.8%, P=0.02) and 7.6% for FVC (3.5% to 11.8%, P=0.001). By the end of the weight reduction programme, reduction in dyspnoea was 13 mm (on a visual analogue scale 0 mm to 100 mm) in the treatment group and 1 mm in the control group (P=0.02). The reduction of rescue medication was 1.2 and 0.1 doses respectively (P=0.03). After one year the differences in the changes between the two groups were -12 for symptom scores (range -1 to -22, P=0.04) and -10 for total scores (-18 to -1, P=0.02). The median number of exacerbations in the treatment group was 1 (0-4) and in the controls 4 (0-7), P=0.001.
  
  
  CONCLUSIONS
  Weight reduction in obese patients with asthma improves lung function, symptoms, morbidity, and health status.
authors.affiliation: Division of Pulmonary Medicine and Allergology, Helsinki University Central Hospital, FIN-00029 HYKS, Helsinki, Finland. bstenius@cc.helsinki.fi
authors.forename: B
authors.initials: B
authors.lastname: Stenius-Aarniala
authors.forename: T
authors.initials: T
authors.lastname: Poussa
authors.forename: J
authors.initials: J
authors.lastname: Kvarnström
authors.forename: E L
authors.initials: EL
authors.lastname: Grönlund
authors.forename: M
authors.initials: M
authors.lastname: Ylikahri
authors.forename: P
authors.initials: P
authors.lastname: Mustajoki
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001249:Asthma / Q000150:complications / Q000178:diet therapy / Q000503:physiopathology*; D016001:Confidence Intervals; D004038:Diet, Reducing; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000178:diet therapy / Q000503:physiopathology*; D010366:Peak Expiratory Flow Rate; D018709:Statistics, Nonparametric; D013997:Time Factors; D015431:Weight Loss