Introduction
Globally, childhood obesity is a major issue that is only becoming worse. For instance, 40 percent of adults and 19 percent of children in the US are obese. This indicates that individuals have excess body fat, which can lead to several health issues. The global population of children who are overweight or obese is increasing, impacting millions of people.
Childhood obesity has been associated with major health concerns, including diabetes, high blood pressure, liver disease, and even fractures. Furthermore, it exacerbates respiratory conditions such as asthma and sleep apnea, which cause breathing difficulties for children during sleep. Later in life, obesity may also contribute to other lung issues, such as chronic bronchitis or low blood oxygen levels.
Why Do Respiratory Problems Occur in Obese Children?
Gaining weight, particularly in the belly area, might impact lung function. Lung volumes tend to decline with increased body mass index (BMI), making it more difficult for children to breathe correctly.
Measurements such as
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Forced Vital Capacity (FVC): The maximum volume of air that one can forcefully exhale after taking a complete breath.
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Forced Expiratory Volume in 1 Second (FEV1): It determines the amount of air that a person may forcefully expel in one second.
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Functional Residual Capacity (FRC): The air in the lungs during a typical, passive exhale.
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Expiratory Reserve Volume (ERV): The additional volume of air that can be exhaled maximally, above and beyond the peak attained during a typical, silent exhalation.
All these measurements show a decline in lung capacity. Not only children with extreme obesity but also children who are mildly overweight can have these alterations in lung function.
The location of fat deposition is also important. Abdominal obesity, or belly fat, is especially detrimental to lung health. It compresses the chest and belly, which hinders the lungs' ability to expand while breathing fully. This leads to low blood oxygen levels, irregular ventilation-perfusion patterns, and increased breathing effort. These alterations may result in breathing difficulties, particularly when engaging in strenuous activity or lying down, as in sleep or during anesthesia. It is critical to comprehend these impacts because they are not exclusive to extremely obese children and can manifest even in the first phases of weight growth.
What Are the Different Respiratory Problems Caused in Obese Children?
The following are the common respiratory problems caused by obese children.
These include
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Asthma: Breathing becomes difficult due to inflammation and narrowing of the airways in asthma. Having too much body fat, or obesity, might aggravate a child's asthma. In children, obesity and asthma frequently coexist, with one illness possibly predisposing to the other. Children with early-onset asthma are more likely to become obese, and obesity itself can worsen asthma by decreasing physical activity and aggravating symptoms, especially in teenagers.There are two primary phenotypes of obesity and asthma in children and adolescents: early-onset and late-onset obese asthma. Children who have the late-onset variety typically have more severe asthma and have difficulty controlling their symptoms. They frequently experience more asthma attacks and require stronger treatments. Children with early-onset asthma, on the other hand, may not have as severe a condition, but they still have breathing difficulties and require more medical attention. In obese children, there is an impact on the flow of air in and out. Breathing issues may result from this, particularly if they are trying to exercise or are active. Furthermore, excess fat around the abdomen can exert pressure on the diaphragm, the breathing muscle, which makes it more difficult to inhale deeply.
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Obstructive Sleep Apnea Syndrome (OSAS): An obstruction of the upper airways during sleep is known as OSAS, and it causes irregular breathing patterns and frequent nighttime awakenings. This occurs due to the neck muscles relaxing excessively, which narrows or closes the airway. Obesity and OSAS frequently coexist, particularly in young people. Children who are obese or overweight may accumulate extra fat in their upper respiratory tract and around their necks. This excess weight may exacerbate OSAS and weaken the throat muscles by increasing the likelihood of airway collapse as one sleeps. This may account for the increasing correlation between obesity and OSAS with age, especially in children older than 12 years. On the other hand, because of things like hormone changes and decreased physical activity, OSAS can exacerbate obesity. Both disorders are associated with oxidative stress and inflammation, which can intensify each other's effects and lead to problems with the heart and metabolism. Furthermore, evidence indicates that the gut microbiota may contribute to obesity and OSAS, further confounding their interaction. The gut microbiota is regulated by factors such as nutrition and sleep disorders.
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COVID-19: According to new research, fat children may be more susceptible than children of normal weight to experience a serious respiratory infection in the future when they come into contact with the COVID-19 virus. Obesity appears to increase the likelihood of severe disease, even though COVID-19 infection in children is usually less severe than in adults and commonly presents with symptoms like cough, fever, sore throat, and nasal congestion. Obesity was discovered to be the most prevalent underlying medical condition among children hospitalized in the intensive care unit (ICU) for COVID-19 in locations such as Canada and New York. Several variables, such as chronic inflammation, insulin resistance, and mechanical problems in the respiratory system, can make obesity worse. Furthermore, the virus needs ACE2 receptors to enter respiratory cells, thus, fat people may have higher numbers of these receptors than normal, which could increase their susceptibility to infection.
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Hypoventilation Syndrome: Obesity-related hypoventilation syndrome in children is a disorder in which being overweight results in insufficient breathing while they sleep and occasionally when they are awake. Low oxygen and high carbon dioxide levels in the blood are caused by inadequate ventilation of the lungs in this illness. In addition to the hormonal and metabolic changes linked to obesity, mechanical variables such as decreased lung capacities and respiratory muscle strength can also contribute to obesity-related hypoventilation syndrome. There could be weariness, headaches in the morning, difficulties concentrating, and daytime sleepiness. Hypoventilation syndrome can have major side effects like heart failure and pulmonary hypertension if it is not managed.
How to Manage Respiratory Problems in Obese Children?
The following strategies are useful for managing respiratory problems in children.
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Encourage a Healthy Lifestyle: To prevent obesity and its related respiratory issues, promote a balanced diet and frequent exercise.
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Early Identification: It is critical to do routine health screenings to discover respiratory problems in fat children quickly.
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Strategies for Treatment: Implement respiratory treatments, weight-management plans, and condition-specific interventions, such as those for asthma and obstructive sleep apnea.
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Increase Knowledge: To promote efficient prevention and management techniques, inform parents, medical professionals, and educators about the link between obesity and respiratory health.
Conclusion
Children who are obese face serious obstacles to their respiratory health, including reduced lung function, obstructive sleep apnea, and impaired asthma management, among other issues. Reducing the negative effects of childhood obesity on respiratory health requires a thorough understanding of the mechanisms underlying these respiratory issues and implementing prevention and management methods.
