High body mass index and allergies in schoolchildren: the French six cities study

BMJ Open Resp Res 2014;1:e000054 doi:10.1136/bmjresp-2014-000054

• Respiratory epidemiology

1. Danielle Saadeh1,7, 
2. Pascale Salameh1, 
3. Denis Caillaud2, 
4. Denis Charpin3, 
5. Frédéric de Blay4,
6. Christine Kopferschmitt4, 
7. François Lavaud5, 
8. Isabella Annesi-Maesano6, 
9. Isabelle Baldi7 and
10. Chantal Raherison7,8

+Author Affiliations

1. ¹Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Hadath, Lebanon
2. ²Hôpital Gabriel Montpied, Clermont-Ferrand, France
3. ³Hôpital Nord, Marseille, France
4. ⁴Hôpital Civil, Strasbourg, France
5. ⁵Hôpital Maison Blanche, Reims, France
6. ⁶EPAR, UMR-S 1136, Institute Pierre Louis of Epidemiology and Public Health, INSERM and UPMC Sorbonne Universites, Paris, France
7. ⁷INSERM U897, Institut de Santé Publique d'Epidémiologie et de Développement, Université de Bordeaux, Bordeaux, France
8. ⁸Service des maladies respiratoires, Hôpital du Haut-Lévèque, Avenue de Magellan, Pessac, France

1. Correspondence toDanielle Saadeh; daniellesaadeh@hotmail.com

• Received 23 July 2014
• Accepted 3 October 2014
• Published 24 December 2014

Abstract

Background The prevalence of allergic diseases such as asthma, allergic rhinitis and atopic dermatitis is increasing rapidly worldwide, especially among children and in western countries. This coincides with an increase in body mass index (BMI), which might be a major risk factor for atopic diseases.

Objectives To study the relationship between high BMI and allergic diseases, as well as skin-prick test (SPT) positivity and exercise-induced asthma (EIA) in 6733 randomly selected schoolchildren aged 9–11 years in the French Six Cities Study.

Methods A cross-sectional study was carried out in Bordeaux, Clermont-Ferrand, Créteil, Marseille, Reims and Strasbourg. Parental questionnaires based on the International Study on Asthma and Allergies in Childhood (ISAAC) were used to collect information on allergic diseases and potential risk factors. Skin-prick testing to common allergens was performed to identify the existence of an allergic hypersensitivity and an exercise test was also performed to assess EIA. Height and weight were collected by trained investigators. After computing the BMI (weight/height squared), the International Obesity Task Force (IOTF) cut-offs were used to define overweight and obesity. The children were also classified as wheezing or non-wheezing.

Results After adjustment for confounding factors, lifetime asthma was associated with high BMI among non-wheezing children (adjusted OR, aOR=1.98, 95% CI (1.06 to 3.70)). In addition, lifetime and past-year allergic rhinitis was associated with high BMI in wheezing children (aOR=1.63, (1.09 to 2.45) and aOR=2.20, (1.13 to 4.27)). However, high BMI was not significantly associated with eczema, SPT positivity or EIA.

Conclusions This study shows a positive association between high BMI and lifetime asthma in non-wheezing children. High BMI was also associated with lifetime and past-year allergic rhinitis. Further studies are needed to provide causal evidence.

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