title: Childhood asthma and extreme values of body mass index: the Harlem Children's Zone Asthma Initiative.
abstract: To examine the association between body mass index (BMI) percentile and asthma in children 2-11 years of age, we performed a cross-sectional analysis of 853 Black and Hispanic children from a community-based sample of 2- to 11-year olds with measured heights and weights screened for asthma by the Harlem Children's Zone Asthma Initiative. Current asthma was defined as parent/guardian-reported diagnosis of asthma and asthma-related symptoms or emergency care in the previous 12 months. Among girls, asthma prevalence increased approximately linearly with increasing body mass index (BMI) percentile, from a low of 12.0% among underweight girls (BMI </=5th percentile) to a high of 33.3% among girls at risk for overweight (BMI 85th-94th percentile). Among boys, asthma prevalence was associated in a U-shaped curve with the extremes of BMI percentile, that is, 36.4% among underweight boys, 19.1% among normal weight boys (BMI 6th-84th percentile), and 34.8% among overweight boys (>95th percentile). After adjusting for age, race/ethnicity, and household smoking, among girls, having asthma was associated with being at risk for overweight (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.4-5.0) and being overweight (OR, 2.1; 95% CI, 1.2-3.8) compared to normal weight; among boys, having asthma was associated both with overweight (OR, 2.4; 95% CI, 1.4-4.3) and with underweight (OR, 2.9; 95% CI, 1.1-7.7). Large, prospective studies that include very young children are needed to further explore the observed association between underweight and asthma among boys. Early interventions that concomitantly address asthma and weight gain are needed among pre-school and school-aged children.
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W. 168th Street, 7th Floor, New York, NY, 10032, USA. helen.kwon@aya.yale.edu
authors.forename: Helen L
authors.initials: HL
authors.lastname: Kwon
authors.forename: Benjamin
authors.initials: B
authors.lastname: Ortiz
authors.forename: Rachel
authors.initials: R
authors.lastname: Swaner
authors.forename: Katherine
authors.initials: K
authors.lastname: Shoemaker
authors.forename: Betina
authors.initials: B
authors.lastname: Jean-Louis
authors.forename: Mary E
authors.initials: ME
authors.lastname: Northridge
authors.forename: Roger D
authors.initials: RD
authors.lastname: Vaughan
authors.forename: Terry
authors.initials: T
authors.lastname: Marx
authors.forename: Andrew
authors.initials: A
authors.lastname: Goodman
authors.forename: Luisa N
authors.initials: LN
authors.lastname: Borrell
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Nicholas
mesh_terms: D001249:Asthma / Q000208:ethnology / Q000209:etiology*; D044383:Black People / Q000706:statistics & numerical data; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009519:New York City / Q000453:epidemiology; D050177:Overweight; D015995:Prevalence; D012737:Sex Factors; D013851:Thinness / Q000150:complications*; D001741:Black or African American