Poor growth, nutrition in children may predict respiratory issues in adulthood

Poor growth and nutritional deficits in infants and children may predict respiratory issues later in life, researchers reported in The Lancet Respiratory Medicine.

“Participants who were underweight in childhood had a risk of developing lung restriction that was three times higher than children with normal weight,” Stefano Guerra, MD, PhD, MPH, director of population sciences at the University of Arizona Health Sciences Asthma and Airway Disease Research Center and the Henry E. Dahlberg chair in asthma research at the University of Arizona College of Medicine Tucson, said in a related press release. “Similar increased risks for spirometric restriction were found for infants who were born small for gestational age. This may be an indicator that during early development, perhaps even in utero, something went wrong, and that’s affecting your lungs as well as your cardiovascular system and other organs.”

The longitudinal, population-based study evaluated data from 652 healthy infants at birth from April 1980 to October 1984 from the Tucson Children’s Respiratory Study. Primary caregivers responded to questionnaires immediately after the child’s birth and completed multiple questionnaires throughout their childhood and adulthood. Researchers collected data on demographics, parental health factors, pregnancy and perinatal data, birth measurements, weight, height and BMI from age 6 to 16 years.

Researchers measured lung function at age 22, 26, 32 and 36 years, which was categorized as normal (FEV₁/FVC and FVC 10th percentile), restrictive (FEV₁/FVC 10th percentile and FVC < 10th percentile) or obstructive (FEV₁/FVC < 10th percentile independent of FVC).

Maternal nutritional problems during pregnancy (relative risk ratios [RRR] = 2.48; 95% CI, 1.3-4.76; P = .0062), being born small for gestational age (birth weight < 10th percentile = 3.26; 95% CI, 1.34-7.93; P = .0093) and being underweight in childhood (BMI for age < 5th percentile = 3.54; 95% CI, 1.35-9.26; P = .010) were independent predictors of spirometric restriction in adulthood in multivariate models.

Researchers also observed associations between being small for gestational age (P = .0028) and being underweight in childhood (P < .0001) and spirometric restriction in adulthood. In addition, having a low lean BMI in less than the 10th percentile at 11 years of age was predictive of spirometric restriction in adulthood (RRR = 3.66; 95% CI, 1.48-9.02; P = .0048).

These associations were verified among participants with spirometric restriction and diminished total lung capacity, which indicated that small for gestational age, being underweight in childhood and low lean BMI in childhood were factors that increased lung restriction risk, according to the researchers.

“Our findings really highlight that growth and nutrition problems very early in life have a long-term effect or consequence on adult lung health,” Nipasiri Trudeau, statistician at the University of Arizona Health Sciences Asthma and Airway Disease Research Center in Tucson, said in the release.

Reference:

• Undernourished infants at risk for lung restriction, weaker health as adults, UArizona Health Sciences study finds. Published Feb. 9, 2022. Accessed Feb. 14, 2022.