title: An obesity-preventive lifestyle score is negatively associated with pediatric asthma.
abstract: OBJECTIVE
  Lifestyle (diet and physical activity) may increase asthma risk, but evidence in this area is lacking. The aims of the present study were to calculate an obesity-preventive lifestyle score comprising of eating and physical activity behaviors and investigate the overall effect of lifestyle on asthma in children.
  
  
  METHODS
  A cross-sectional case-control study was carried out in 514 children (217 asthma cases and 297 healthy controls). Data were collected on medical history, anthropometry, dietary intake, and physical activity. We constructed an overweight/obesity-preventive score (OPLS) using study-specific quartile rankings for nine target lifestyle behaviors that were either favorable or unfavorable in preventing obesity (i.e., screen time was an unfavorable lifestyle behavior). The score was developed using the recommendations of the Expert Committee of American Academy of Pediatrics. Score values ranged from 0-18 points; the higher the score, the more protective against high body weight.
  
  
  RESULTS
  The OPLS was negatively associated with obesity indices (BMI, waist circumference, and hip circumference), (p < 0.05). Control children had a higher score when compared to asthma cases (9.3 ± 2.7 vs. 8.6 ± 2.9, p = 0.007). A high OPLS was protective against physician-diagnosed asthma (OR 0.92; 95% CI 0.86-0.98, p = 0.014), adjusted for several confounders. The OPLS was no longer protective after adjustment for BMI.
  
  
  CONCLUSIONS
  Higher adherence to an obesity-preventive lifestyle score-consistent with several behaviors for the prevention of childhood overweight/obesity-is negatively associated with obesity indices and lowers the odds for asthma in children. Lifestyle behaviors that contribute to a higher body weight may contribute to the obesity-asthma link. These findings are hypothesis-generating and warrant further investigation in prospective intervention studies.
authors.affiliation: Academy of Nutrition and Dietetics, 120 South Riverside Plaza, Suite 2000, Chicago, IL, 60606-6995, USA. cpapoutsakis@eatright.org.|Department of Nursing, National and Kapodistrian University of Athens, Athens, Greece. cpapoutsakis@eatright.org.
authors.forename: Constantina
authors.identifier: http://orcid.org/0000-0001-7173-275X
authors.initials: C
authors.lastname: Papoutsakis
authors.affiliation: Department of Nursing, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Papadakou
authors.affiliation: Department of Internal Medicine-Nutritional Science, Washington University School of Medicine, St. Louis, MO, USA.|Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Chondronikola
authors.affiliation: Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Antonogeorgos
authors.affiliation: Department of Nursing, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Matziou
authors.affiliation: Department of Nursing, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Drakouli
authors.affiliation: Department of Nursing, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Evanthia
authors.initials: E
authors.lastname: Konstantaki
authors.affiliation: Pediatric Allergy and Pulmonology Units, Third Department of Pediatrics, School of Medicine, University General Hospital 'Attikon', National and Kapodistrian University of Athens, Athens, Greece.|Department of Allergy-Pneumonology, Penteli Children's Hospital, Penteli, Greece.
authors.forename: Kostas N
authors.initials: KN
authors.lastname: Priftis
mesh_terms: D001249:Asthma / Q000453:epidemiology / Q000517:prevention & control*; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004032:Diet; D005260:Female; D006115:Greece; D006801:Humans; D008019:Life Style; D008297:Male; D009765:Obesity; D050177:Overweight; D063766:Pediatric Obesity / Q000453:epidemiology / Q000517:prevention & control*; D011446:Prospective Studies
keywords: Asthma; Children; Lifestyle; Obesity