Obesity and Lung Function in Pediatric Populations

Childhood obesity has risen sharply worldwide and is now recognised as a significant determinant of respiratory health in children. Excess adiposity not only promotes systemic inflammation but also alters thoracic mechanics, leading to complex changes in lung growth and function. In obese children, lung volumes such as forced vital capacity often increase disproportionally to airway calibre, resulting in a reduced FEV1/FVC ratio indicative of airflow limitation. This dysanaptic pattern of growth may predispose to wheeze, exercise intolerance and heightened asthma risk. Beyond mechanical factors, adipose tissue secretes pro-inflammatory mediators that can exacerbate airway inflammation and impair bronchodilator responses. The interplay between central fat distribution and pulmonary development further complicates respiratory outcomes, with abdominal obesity exerting a more deleterious effect on bronchial patency than peripheral adiposity. Evidence also suggests that obesity may modulate fractional exhaled nitric oxide, reflecting shifts in airway inflammation phenotypes. Given the global surge in paediatric obesity, understanding these mechanisms is essential for early identification of at-risk individuals and for designing targeted interventions that address both weight reduction and respiratory health.

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Obesity and Lung Function in Pediatric Populations publication trend

The graph below shows the total number of articles in obesity and lung function in pediatric populations across all publications each year (not limited to Nature Index journals).

Technical terms

Body mass index (BMI): A calculation of body fat based on weight and height, expressed as kg/m2.

Forced expiratory volume in one second (FEV1): The volume of air exhaled in the first second of a forced breath, indicating airway patency.

Forced vital capacity (FVC): The total volume of air forcefully exhaled after maximum inhalation, reflecting lung volume.

FEV1/FVC ratio: The proportion of lung capacity exhaled in one second; a key index of airflow limitation.

Fractional exhaled nitric oxide (FeNO): A non-invasive marker of airway inflammation measured in parts per billion.

Dysanapsis: A mismatch between airway growth and lung parenchyma expansion during development.

References

1. Obesity disproportionately impacts lung volumes, airflow and exhaled nitric oxide in children. PLOS ONE (2017).
2. Association between abdominal obesity and asthma: a meta-analysis. Allergy, Asthma & Clinical Immunology (2019).
3. Obesity in young children and its relationship with diagnosis of asthma, vitamin D deficiency, iron deficiency, specific allergies and flat‐footedness: A systematic review and meta‐analysis. Obesity Reviews (2020).
4. Childhood Obesity and Respiratory Diseases: Which Link?. Children (2021).
5. Differing associations of BMI and body fat with asthma and lung function in children. Pediatric Pulmonology (2013).