Effects of body mass index, tobacco smoking, alcohol drinking and solid fuel use on the risk of asthma: meta-analysis from BMJ Open Resp Res 2016 (free full text)

Background We assessed the relationship of body mass index (BMI), smoking, drinking and solid fuel use (r; SFU), and the individual and combined effects of these factors on wheezing symptoms (WS) and on diagnosed asthma (DA).

Methods We analysed 175 000 individuals from 51 nationally representative surveys, using self-reports of WS and DA as the measures of asthma. The fixed-effects and random-effects estimates of the pooled ORs between asthma and underweight (BMI <18.5 kg/m²), obesity (BMI ≥30 kg/m²), smoking, drinking and SFU were reported.

Results The pooled risks of all individual risk factors were significantly associated with WS and DA (with the exception of current smoking with DA in women and SFU with DA in both genders). Stronger dose–response relationships were seen in women for smoking amounts and duration; BMI showed stronger quadratic relationships. The combined risks were generally larger in women than in men, with significant risks for underweight (OR=2.73) as well as obese (OR=2.00) smokers for WS (OR=2.13 and OR=1.58 for DA, respectively). The magnitude of the combined effects from low/high BMI, smoking and drinking were also consistently higher among women than among men in WS and DA. SFU among underweight smokers also had positive association with WS (men and women) and DA (women).

Conclusions BMI, smoking, drinking and SFU—in combination—are associated with double or triple the risk of development of asthma. These risk factors might help explain the wide variation in asthma burden across countries. 

Free full text:

http://bmjopenrespres.bmj.com/content/3/1/e000121.full

Press Conference at ERS Annual Congress 2012: Connection between Parental Problems and Children's Non-Adherence to Asthma Medication

Professor Paul Brand, Princess Amalia children's Clinic, The Netherlands presented a study on parental problems which prevent children taking much-needed asthma medication.

The motive of realising this investigation is the indeterminacy of major barriers which many little patients face while asthma treatment. The research was based not only on clinical cases, but mostly on discussion of hows and whys of (non)adherence. A part of qualitative study consisted in recording and analysing of factors associated with family lifestyles which could be causing low adherence to asthma medication.  

It was established that there are several types of users:

1) Followers manifest stable adherence to doctor's prescriptions.  These are highly disciplined parents who are always aware of giving the medicine to their children. 

2) Self-managers usually look closely at how child is doing. They have a high observation spirit and link the treatment to their schedule. 

3) A highly variable adherence is typical for Strugglers who follow the medication in a disordered way.

4) Chaotic users belong to the families with lower education. They never force the child and are even shocked when the kids do not take the medication. They think of a child as of an adult who is responsible and can do everything by himself.

In-depth interviews have shown that the lifestyle factors often hide behind children's non-adherence to the prescribed medication. It was concluded that parenting problems can be the reasons of ineffective following of the treatment.

Therefore it would be reasonable if doctors would give a genuine interest in what happens with the patient and would encourage the parents to keep a close eye on their child's adherence. Otherwise it will be impossible to reveal and to remove the barriers preventing the appropriate asthma treatment in children.

Liudmila CORLATEANU,
Respiratory Decade Official Media-Representative at ERS 2012 Vienna Congress

World Asthma Day 2012

World Asthma Day 2012, organized and sponsored by the Global Initiative for Asthma (GINA), will be held on May 1, 2012 as a partnership between health care groups and asthma educators to raise awareness about asthma and improve asthma care throughout the world.

The theme of World Asthma Day 2012 will be “You Can Control Your Asthma.” This year’s event continues the focus on this positive theme established over the past several years, and is consistent with the emphasis on asthma control set out in the latest versions of the GINA documents.

The event will also bring continued efforts around the Asthma Control Challenge, a global campaign GINA launched on World Asthma Day 2010 to encourage governments, health departments, and health care professionals to improve asthma control and reduce asthma hospitalization 50% in 5 years. Researchers and public health workers around the world are encouraged to enter their information in the online data collection system to help track their
progress towards this goal: http://www.core.ubc.ca/Asthma/GINA.


Asthma control is the goal of treatment and can be achieved in the vast majority of asthma patients with proper management. A person’s asthma is under control when he or she has:
• No (or minimal) asthma symptoms.
• No waking at night due to asthma.
• No (or minimal) need to use “reliever” medication.
• The ability to do normal physical activity and exercise.
• Normal (or near-normal) lung function test results (PEF and FEV1).
• No (or very infrequent) asthma attacks.


A strategy for achieving and maintaining asthma control is set out in the GINA Global Strategy for Asthma Management and Prevention. The strategy requires four interrelated components of
therapy:

• Develop patient/doctor partnership.
• Identify and reduce exposure to risk factors.
• Assess, treat, and monitor asthma.
• Manage asthma exacerbations.


Under this strategy, asthma is treated in a stepwise manner to achieve and maintain control of the disease. Medication is increased—“stepped up”—when asthma is not controlled, and gradually stepped down once good control is achieved and maintained for a period of time. 

Respiratory Decade joins World Allergy Week 2012!

Dear Respiratory friends we have great news: next week is World Allergy Week 2012! This is Global event which is organized by World Allergy Organization! Join this important event! Be a part of this Respiratory event in your country at the local level and you will become visible globally!

The prevalence of allergic diseases worldwide is rising  dramatically in both developed and developing countries.

These diseases include:  

  asthma; 

  rhinitis; 

  anaphylaxis; 
  drug, food, and insect allergy; 
  eczema; 
  urticaria (hives) 
  angioedema.
This increase is especially problematic in children, who are bearing the greatest burden of the rising trend which has occurred over the last two decades. In spite of this increase, even in the developed world, services for patients with allergic diseases are fragmented and far from ideal. Very few countries have comprehensive services in this field of medicine.

2012 International Guidelines on Rhinitis, Asthma and COPD: Italian Update of Global Initiatives ARIA, GINA and GOLD

These days in Modena, Italy (28 February-2 March 2012) is taking place Congress 2012 International Guidelines on Rhinitis, Asthma and COPD Global Initiatives ARIA, GINA and GOLD.

I invite you to see free online and directly all presentations from this important Respiratory event. Speakers are world known leaders of opinion in Respiratory Medicine from Italy and from all over the world.

Today is day dedicated to Asthma and will be many interesting presentations: 

IgE, anti-IgE and remodelling in allergic asthma by Professor Klaus F. Rabe, President of European Respiratory Society;

Novel therapies for asthma and COPD by Professor Leonardo M. Fabbri

Viral infections and asthma by Professor Alberto Papi.

Please watch live translation HERE

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Moderate Alcohol Consumption: A Protective Effect Against Asthma Development

by Liudmila Corlateanu

During the European Respiratory Society Annual Congress Sophie Lieberoth from Copenhagen University presented a curious study about the connection between asthma treatment and alcohol intake.

There is a vast range of studies concerning the hazards and benefits of alcohol. Some studies proved that frequent alcohol consumption (1-2 times/day) increases the chances of good health in old age by 30%. The authors of another work have found that consumption of one glass of wine a day helps you lose weight. 

Danish researches established that drinking alcohol in moderate quantities can reduce the risk of developing asthma. In this way, drinking 1-6 units of alcohol a week could reduce the risk of developing the condition. But what is considered to be a unit of alcohol? A half pint (284 ml) of beer that has a strength of 3.5% abv contains almost exactly one unit or a medium glass (175 ml) of 12% abv wine contains around two units of alcohol.

The research examined 19,349 twins between the ages of 12 and 41 years of age. All participants have completed a questionnaire at the start and end of the study to compare alcohol intake with the risk of developing asthma over 8 years. The results showed that the lowest risk of asthma was seen in the group which had a moderate intake of alcohol, as less than 4% of those who drank 1-6 units per week developed asthma.

Another important point of the study was that a preference for beer drinking was associated with an increased risk of asthma when compared with no preference.

It was concluded that higher incidence of asthma development occurs in the never drinking and rarely drinking group.

The relationship between alcohol intake and the risk of developing adult-onset asthma could be U-shaped, but still there is a need of further investigation. What needs no basis or explanation is the old French Proverb which states: “Eat with pleasure; drink with measure.”

ASTHMA ART CONTEST 2011

On World Asthma Day 2011 (3 May), people with asthma and severe asthma are being encouraged to get creative for a unique art contest which will explore what it is like to live with the condition. 

The contest is open to people of all ages and will help bridge the gap between doctors’ understanding of the condition and a person’s experience of it.

Asthma is a major health problem around the world and is a one of the world’s major non-communicable diseases. Not all types of asthma are the same and current treatments adopt a uniform approach, meaning they don’t work well for everybody. The art contest is part of a European-wide project called U-BIOPRED - Unbiased BIOmarkers in PREDiction of respiratory disease outcomes. U-BIOPRED is a research project funded by the Innovative Medicines Initiative (IMI), to understand more about severe asthma that involves scientists from universities, research institutes, the pharmaceutical industry and small companies.

U-BIOPRED will help scientists understand more about severe asthma. The researchers will look at how severe asthma differs from one person to another in the hope of uncovering more effective treatments in the future. 

                                            U-BIOPRED video

The competition is open to any person with asthma and all types of art work from dance, music and poetry, to paintings and photography are encouraged. The top three winning entries will be displayed on the U-BIOPRED website. 

The winner will be invited to the European Respiratory Society Congress in Amsterdam (24-25 September) to receive their award and see their winning entry presented at the opening ceremony. Professor Peter Sterk, project lead, said:  “The U-BIOPRED project aims to understand more about asthma and severe asthma. One important way we can do this is to hear from patients directly. This contest enables patients to express, through art, what the condition is like and how it impacts upon their life.”

Professor Peter STERK

University of Amsterdam

“The winning entry will be the piece which best conveys what it is like to have asthma and we want to hear from anyone with the condition, whether you are a budding or artist, or a complete beginner.”

The closing date for all entries is 1 June 2011. You can enter the art contest by uploading a digital copy of your artwork to the website. For full terms and conditions, visit: www.ubiopred.european-lung-foundation.org/artcontest.