Asthma May Stand in the Way of Overcoming Obesity for Some Children

There's one barrier to overcoming childhood obesity that might be a surprise. Asthma. For more than 4 million children with uncontrolled asthma, the simple mantra of "eat less, move more" might be easier said than done.
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National Childhood Obesity Awareness Month is a time to focus on the serious roadblocks that stand between overweight children and good health. From poverty and lack of education to where you live and family history... the list goes on and on. But there's one barrier to overcoming childhood obesity that might be a surprise. Asthma. For more than 4 million children with uncontrolled asthma, the simple mantra of "eat less, move more" might be easier said than done.

Childhood asthma and obesity have more in common than some realize. To start, the rates of both of these conditions have soared in the United States over the past few decades. Children and adolescents who are overweight or obese are more likely to have asthma than their healthy-weight counterparts. Among youth with asthma, being overweight or obese is associated with more frequent visits to the doctor or emergency room.

Looking at those affected even more closely, we see another confounding connection between childhood obesity and asthma: they both hit high-risk, low-income and minority children and families the hardest. These families often don't have the resources they need for effective asthma management, including a healthy living environment, educational services, sustained access to quality primary care and community support systems. The sad irony? These barriers are often the same that preclude families from effectively tackling obesity.

Children with well-controlled asthma can play, exercise and do virtually all the things that other kids do. However, when a family lacks the resources and knowledge to control asthma symptoms, activity is limited and overweight and obesity could rear its ugly head. In addition, children with relatively severe or poorly-controlled asthma symptoms that require frequent doses of oral corticosteroids have greater difficulty in controlling appetite and may gain excessive weight.

At this point, there is no definitive research that confirms whether one issue causes the other. So we don't know today whether bigger waistlines are to blame for extra asthma flare ups or the other way around. But we do know that there continues to be a gap between the care that's recommended for children and the care most children receive -- whether they have asthma or obesity. We also know enough not to continue treating these conditions as mutually exclusive. Research does show that obese kids have a harder time controlling their asthma flare ups than normal-weight kids. Better access to quality, affordable care plus healthier communities can improve health for children with asthma and obesity.

Like asthma, obesity is a complex issue and overcoming it requires a coordinated, multifaceted and collaborative approach involving communities, health care providers, policymakers and families. We all have a role to play.

As National Childhood Obesity Awareness Month nears an end, I urge you not to let your focus on the needs of these children fade. Continue exploring year-round ways to remove the barriers standing in the way of children's good health. While the road to addressing obesity, or asthma for that matter, is not without speed bumps, we owe it to our children to make the important connections and work toward giving them a healthier future.

The Merck Childhood Asthma Network is working to break down barriers for children with asthma by bringing together the right people, programs and policies. We have invested in science-based approaches to improving asthma care in several at-risk cities that have high rates of childhood asthma and childhood obesity. We also are working with the National Education Association to train teachers and other education professionals who spend the majority of the day with our children to recognize and understand asthma.

For more by Floyd J. Malveaux, M.D., Ph.D., click here.

For more on childhood obesity, click here.

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