Association of Obesity with Asthma Control and Physical Activity in Children with Asthma: A Cross-Sectional Pilot Study

Özden Gökçek; Miray Başer; Ferve Türkeli; Çiğdem El

doi:10.31067/acusaglik.1928918

Association of Obesity with Asthma Control and Physical Activity in Children with Asthma: A Cross-Sectional Pilot Study

Abstract

Background/Purpose: Obesity and asthma are two prevalent chronic conditions in childhood that frequently coexist and may be associated with adverse disease outcomes. This study aimed to evaluate the association between body mass index (BMI), asthma control, physical activity levels, and selected demographic and early-life factors in children with asthma. Methods: This cross-sectional pilot study included 24 children aged 9–17 years with physician-diagnosed asthma. Participants were categorized into two groups: obese (n = 12) and normal-weight (n = 12) according to age- and sex-specific BMI percentiles defined by the Centers for Disease Control and Prevention (CDC). Asthma control was assessed using the Asthma Control Test (ACT). Physical activity levels were evaluated using the Physical Activity Questionnaire for Older Children (PAQ-C) and the Children’s Leisure Activities Study Survey (CLASS). Results: Poor asthma control was significantly more frequent in the obese group compared with the normal-weight group (75% vs 16.7%, p = 0.028). PAQ-C mean scores were slightly higher in the obese group (2.03 ± 0.75) compared with the normal-weight group (1.78 ± 0.65); however, this difference was not statistically significant (p = 0.436). No significant differences were observed in CLASS-derived physical activity indicators between groups (all p > 0.05). Conclusion: Obesity was associated with poorer asthma control in children with asthma. Although obese children showed slightly higher PAQ-C scores compared with normal-weight children, this difference was not statistically significant. These findings suggest that BMI may be an important factor in asthma control, while its relationship with physical activity levels warrants further investigation in pediatric asthma populations.

Keywords

Ethical Statement

This study was conducted in accordance with the principles set forth in the Declaration of Helsinki. It was approved by the Hatay Mustafa Kemal University Ethics Committee on 23 December 2021, with decision number 14 (approval number: 2021/14).

References

1. Zar HJ, Ferkol TW. The global burden of respiratory disease—impact on child health. Pediatric pulmonology. Wiley Online Library; 2014. p. 430–4.
2. Kim TH, Kim H, Oh J, Kim S, Miligkos M, Yon DK, et al. Global burden of asthma among children and adolescents with projections to 2050: a comprehensive review and forecasted modeling study. Clin Exp Pediatr. 2025;68(5):329.
3. Martin J, Townshend J, Brodlie M. Diagnosis and management of asthma in children. BMJ Paediatr Open. 2022;6(1):e001277.
4. Holst GJ, Pedersen CB, Thygesen M, Brandt J, Geels C, Bønløkke JH, et al. Air pollution and family related determinants of asthma onset and persistent wheezing in children: nationwide case-control study. bmj. 2020;370.
5. Reyes-Angel J, Kaviany P, Rastogi D, Forno E. Obesity-related asthma in children and adolescents. Lancet Child Adolesc Health. 2022;6(10):713–24.
6. Wangberg H, Mortazavi D, Kitsen J, Sanni A, Leibel S, Geng B. Dose dependent association between inhaled corticosteroid use and risk of obesity and metabolic syndrome in asthma. In: Allergy & Asthma Proceedings. 2022.
7. Sansone F, Attanasi M, Di Pillo S, Chiarelli F. Asthma and obesity in children. Biomedicines. 2020;8(7):231.
8. Zhang Y, Chen Z, Berhane K, Urman R, Chatzi VL, Breton C, et al. The dynamic relationship between asthma and obesity in schoolchildren. Am J Epidemiol. 2020;189(6):583–91.

9. Al-Alwan A, Bates JHT, Chapman DG, Kaminsky DA, DeSarno MJ, Irvin CG, et al. The nonallergic asthma of obesity. A matter of distal lung compliance. Am J Respir Crit Care Med. 2014;189(12):1494–502.
10. Souza de Almeida AH, Rodrigues Filho E de A, Lubambo Costa E, de Albuquerque CG, Sarinho ESC, Medeiros Peixoto D, et al. Obesity is a risk factor for exercise‐induced bronchospasm in asthmatic adolescents. Pediatr Pulmonol. 2020;55(8):1916–23.
11. Lugogo NL, Kraft M, Dixon AE. Does obesity produce a distinct asthma phenotype? J Appl Physiol. 2010;108(3):729–34.
12. Ramirez LG, Lee-Sarwar K, Kelly RS, Weiss ST, Litonjua AA. Association of Prenatal Maternal and Infant Vitamin D Supplementation with Offspring Asthma. Ann Am Thorac Soc. 2024;21(2):279–86.
13. Karampela I, Sakelliou A, Vallianou N, Christodoulatos GS, Magkos F, Dalamaga M. Vitamin D and obesity: current evidence and controversies. Curr Obes Rep. 2021;10(2):162–80.
14. Nathan RA, Sorkness CA, Kosinski M, Schatz M, Li JT, Marcus P, et al. Development of the asthma control test: a survey for assessing asthma control. Journal of allergy and clinical immunology. 2004;113(1):59–65.
15. İşler O, Demirci N, Karaca A. Adaptation of Children’s Leisure Activities Study Survey: validity and reliability study. Hacettepe Journal of Sport Sciences. 2020;31(1):9–19.
16. Erdim L, Ergün A, Kuğuoğlu S. Reliability and validity of the Turkish version of the Physical Activity Questionnaire for Older Children (PAQ-C). Turk J Med Sci. 2019;49(1):162–9.
17. Dixon AE, Que LG. Obesity and asthma. In: Seminars in respiratory and critical care medicine. Thieme Medical Publishers, Inc.; 2022. p. 662–74.
18. Sio YY, Chew FT. Risk factors of asthma in the Asian population: a systematic review and meta-analysis. J Physiol Anthropol. 2021;40(1):22.
19. Hammad H, Lambrecht BN. The basic immunology of asthma. Cell. 2021;184(6):1469–85.
20. Schneeberger C, Kazemier BM, Geerlings SE. Asymptomatic bacteriuria and urinary tract infections in special patient groups: women with diabetes mellitus and pregnant women. Curr Opin Infect Dis. 2014;27(1):108–14.
21. Werter DE, Kazemier BM, Schneeberger C, Mol BWJ, de Groot CJM, Geerlings SE, et al. Risk indicators for urinary tract infections in low risk pregnancy and the subsequent risk of preterm birth. Antibiotics. 2021;10(9):1055.
22. Gestels T, Vandenplas Y. Prenatal and perinatal antibiotic exposure and long-term outcome. Pediatr Gastroenterol Hepatol Nutr. 2023;26(3):135.
23. Wasilewska E, Małgorzewicz S, Szczepankiewicz A, Myśliwczyk D, Hennig M, Jassem E, et al. Are obesity and asthma in school-age children still strongly related to breastfeeding in infancy?-A real-life study. Eur Rev Med Pharmacol Sci. 2022;26(5).
24. Esch BCAM van, Porbahaie M, Abbring S, Garssen J, Potaczek DP, Savelkoul HFJ, et al. The impact of milk and its components on epigenetic programming of immune function in early life and beyond: implications for allergy and asthma. Front Immunol. 2020;11:2141.
25. Mackintosh KA, McNarry MA, Berntsen S, Steele J, Sejersted E, Westergren T. Physical activity and sedentary time in children and adolescents with asthma: A systematic review and meta‐analysis. Scand J Med Sci Sports. 2021;31(6):1183–95.
26. Sousa AW, Cabral ALB, Martins MA, Carvalho CRF. Daily physical activity in asthmatic children with distinct severities. Journal of Asthma. 2014;51(5):493–7.

Details

Primary Language

English

Subjects

Physical Medicine and Rehabilitation

Journal Section

Research Article

Authors

Özden Gökçek
0000-0003-3396-4108
Türkiye

Miray Başer ^*
0000-0003-4616-4468
Türkiye

Ferve Türkeli
0000-0002-6447-7401
Türkiye

Çiğdem El
0000-0002-7110-3504
Türkiye

Publication Date

May 14, 2026

Submission Date

April 13, 2026

Acceptance Date

May 1, 2026

Published in Issue

Year 2026 Volume: 17 Number: April, May, June 2026

DOI

https://doi.org/10.31067/acusaglik.1928918

IZ

https://izlik.org/JA73NA72FK

Cite

RIS / Bibtex

APA

Gökçek, Ö., Başer, M., Türkeli, F., & El, Ç. (2026). Association of Obesity with Asthma Control and Physical Activity in Children with Asthma: A Cross-Sectional Pilot Study. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 17(April, May, June 2026). https://doi.org/10.31067/acusaglik.1928918

AMA

1.Gökçek Ö, Başer M, Türkeli F, El Ç. Association of Obesity with Asthma Control and Physical Activity in Children with Asthma: A Cross-Sectional Pilot Study. Acibadem Univ Saglik Bilim Derg. 2026;17(April, May, June 2026). doi:10.31067/acusaglik.1928918

Chicago

Gökçek, Özden, Miray Başer, Ferve Türkeli, and Çiğdem El. 2026. “Association of Obesity With Asthma Control and Physical Activity in Children With Asthma: A Cross-Sectional Pilot Study”. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 17 (April, May, June 2026). https://doi.org/10.31067/acusaglik.1928918.

EndNote

Gökçek Ö, Başer M, Türkeli F, El Ç (May 1, 2026) Association of Obesity with Asthma Control and Physical Activity in Children with Asthma: A Cross-Sectional Pilot Study. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 17 April, May, June 2026

IEEE

[1]Ö. Gökçek, M. Başer, F. Türkeli, and Ç. El, “Association of Obesity with Asthma Control and Physical Activity in Children with Asthma: A Cross-Sectional Pilot Study”, Acibadem Univ Saglik Bilim Derg, vol. 17, no. April, May, June 2026, May 2026, doi: 10.31067/acusaglik.1928918.

ISNAD

Gökçek, Özden - Başer, Miray - Türkeli, Ferve - El, Çiğdem. “Association of Obesity With Asthma Control and Physical Activity in Children With Asthma: A Cross-Sectional Pilot Study”. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 17/April, May, June 2026 (May 1, 2026). https://doi.org/10.31067/acusaglik.1928918.

JAMA

1.Gökçek Ö, Başer M, Türkeli F, El Ç. Association of Obesity with Asthma Control and Physical Activity in Children with Asthma: A Cross-Sectional Pilot Study. Acibadem Univ Saglik Bilim Derg. 2026;17. doi:10.31067/acusaglik.1928918.

MLA

Gökçek, Özden, et al. “Association of Obesity With Asthma Control and Physical Activity in Children With Asthma: A Cross-Sectional Pilot Study”. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, vol. 17, no. April, May, June 2026, May 2026, doi:10.31067/acusaglik.1928918.

Vancouver

1.Özden Gökçek, Miray Başer, Ferve Türkeli, Çiğdem El. Association of Obesity with Asthma Control and Physical Activity in Children with Asthma: A Cross-Sectional Pilot Study. Acibadem Univ Saglik Bilim Derg. 2026 May 1;17(April, May, June 2026). doi:10.31067/acusaglik.1928918