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    The association between BMI, vigorous physical activity and television viewing and the risk of symptoms of asthma, rhinoconjunctivitis and eczema in children and adolescents: ISAAC Phase Three
    (Wiley, 2013-01)
    Mitchell, E A
    ;
    Beasley, R
    ;
    Björkstén, B
    ;
    Crane, J
    ;
    García-Marcos, L
    Background: Several studies have observed an association between obesity and asthma, but whether or not there is an association with rhinoconjunctivitis or eczema is unclear. Aims To examine the relationship between body mass index categories (underweight, overweight and obesity), vigorous physical activity and television viewing and the risk of symptoms of asthma, rhinoconjunctivitis and eczema. Methods: As part of International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three, parents or guardians of children aged 6–7 years completed written questionnaires about symptoms of asthma, rhinoconjunctivitis and eczema, and several potential risk factors, such as vigorous physical activity and television viewing, and other information such as the child’s height and weight. Adolescents aged 13–14 years self-completed the questionnaires on these symptoms and potential risk factors and reported their own height and weight. For 28% of children and 24% of adolescents, the height and weight was objectively measured. Results: A total of 76 164 children aged 6–7 years (from 29 centres and 17 countries) and 201 370 adolescents aged 13–14 years (from 73 centres and 35 countries) provided data meeting the inclusion criteria. There were associations between overweight and obesity, but not underweight, and symptoms of asthma and eczema but not rhinoconjunctivitis. Vigorous physical activity was positively associated with symptoms of asthma, rhinoconjunctivitis and eczema in adolescents, but not children. Viewing television for five or more hours/day was associated with an increased risk of symptoms of asthma, rhinoconjunctivitis and eczema in adolescents and symptoms of asthma in children. Conclusions and Clinical Relevance: This study has confirmed the association between overweight and obesity and symptoms of asthma. It has extended these observations to include significant associations with symptoms of eczema, but not rhinoconjunctivitis. There are complex relationships between obesity, vigorous physical activity and sedentary behaviour and the symptoms of asthma, rhinoconjunctivitis and eczema in children.
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    Exposure to Cats and Dogs, and Symptoms of Asthma, Rhinoconjunctivitis, and Eczema
    (Ovid Technologies (Wolters Kluwer Health), 2012-09)
    Brunekreef, Bert
    ;
    Von Mutius, Erika
    ;
    Wong, Gary
    ;
    Odhiambo, Joseph
    ;
    García-Marcos, Luis
    Background: Associations between exposure to cats and dogs and respiratory and allergic outcomes in children have been reported in affluent countries, but little is known about such associations in less-affluent countries. Methods: The International Study of Asthma and Allergies in Childhood, phase 3 was carried out in children aged 6–7 years and adolescents aged 13–14 years across the world. Questions about cats and dogs in the home were included in an additional questionnaire. Using logistic regression, we investigated the association between such exposures and symptoms of asthma, rhinoconjunctivitis, and eczema. Adjustments were made for sex, region of the world, language, gross national income per capita, and 10 other covariates. Results: Among children (6–7 years of age), cat exposure in the first year of life was associated with current symptoms of asthma, wheeze, rhinoconjunctivitis, and eczema, especially in less-affluent countries. Among adolescents (13–14 years of age), we found a positive association between exposure to cats or dogs and symptom prevalence in more-affluent and less-affluent countries. The global multivariate odds ratios for children with complete covariate data were 1.17 (95% confidence interval = 1.08 –1.29) for current symptoms of asthma, 1.13 (1.05–1.23) for rhinoconjunctivitis, and 1.38 (1.26 –1.52) for eczema. Smaller odds ratios were found for exposure to only dogs. Exposure to only cats was associated with eczema. Conclusion: Early-life exposure to cats is a risk factor for symptoms of asthma, rhinoconjunctivitis, and eczema in 6- to 7-year-old children, especially in less-affluent countries. Current exposure to cats and dogs combined, and only to dogs, is a risk factor for symptom reporting by 13- to 14-year-old adolescents worldwide.