Pulmonary function in overweight and obese children aged 6-12 years: a hospital and school-based observational study

Hariharan A.; Chidambaranathan S.; Preethi N.

doi:10.18203/2349-3291.ijcp20263806

Authors

Hariharan A. Department of Paediatrics, Government Medical College and hospital, Cuddalore, Chidambaram, Tamil Nadu, India
Chidambaranathan S. Department of Paediatrics, Government Medical College and hospital, Cuddalore, Chidambaram, Tamil Nadu, India
Preethi N. Department of Paediatrics, Government Medical College and hospital, Cuddalore, Chidambaram, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20263806

Keywords:

Childhood obesity, Overweight, Pulmonary function, Spirometry, FEV₁

Abstract

Background: Childhood overweight and obesity may adversely influence respiratory mechanics and pulmonary function through mechanical restriction of the chest wall, altered diaphragmatic excursion, and changes in lung volumes. This study aimed to assess pulmonary function among overweight and obese children aged 6 to 12 years and compare spirometric parameters between BMI categories.

Methods: A hospital-and school-based observational study was conducted among 45 overweight and obese children aged 6 to 12 years at Government Medical College and Hospital, Cuddalore District, Tamil Nadu, and selected schools in the district from December 2024 to May 2026. Baseline demographic and anthropometric characteristics were recorded. Pulmonary function was assessed using spirometry, including peak expiratory flow rate (PEFR), forced expiratory volume in the first second (FEV₁), forced vital capacity (FVC), and FEV₁/FVC ratio. Observed values were compared with normal predicted values derived using Chhabra equations, and pulmonary function parameters were compared between overweight and obese children. Data were analysed using SPSS version 26.0.

Results: The mean age was 10.31±0.90 years, and the mean BMI was 22.13±3.08 kg/m². Of the 45 participants, 21 (46.7%) were overweight and 24 (53.3%) were obese. The mean PEFR, FEV₁, and FVC were 3.74±0.96 L/s, 1.37±0.36 L, and 1.36±0.37 L, respectively. Their corresponding mean percentage predicted values were 69.82±21.62, 53.71±13.06, and 48.43±12.55. The mean FEV₁/FVC percentage predicted remained preserved at 107.52±2.56. Obese children showed slightly higher absolute spirometric values than overweight children.

Conclusions: Overweight and obese children demonstrated reduced PEFR, FEV₁, and FVC compared with predicted normal values, while the FEV₁/FVC ratio remained preserved. Early pulmonary assessment and appropriate weight-management interventions may help reduce long-term respiratory consequences.

References

NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults. Lancet. 2024;403(10431):1027-50.

Ranjani H, Mehreen TS, Pradeepa R, Anjana RM, Garg R, Anand K, et al. Epidemiology of childhood overweight & obesity in India: a systematic review. Indian J Med Res. 2016;143(2):160-74.

Salome CM, King GG, Berend N. Physiology of obesity and effects on lung function. J Appl Physiol. 2010;108(1):206-11.

Dixon AE, Peters U. The effect of obesity on lung function. Expert Rev Respir Med. 2018;12(9):755-67.

Peters U, Dixon AE, Forno E. Obesity and asthma. J Allergy Clin Immunol. 2018;141(4):1169-79.

Forno E, Han YY, Mullen J, Celedón JC. Overweight, obesity, and lung function in children and adults-a meta-analysis. J Allergy Clin Immunol Pract. 2018;6(2):570-81.e10.

Forno E, Weiner DJ, Mullen J, Sawicki G, Kurland G, Han YY, et al. Obesity and airway dysanapsis in children with and without asthma. Am J Respir Crit Care Med. 2017;195(3):314-23.

Spathopoulos D, Paraskakis E, Trypsianis G, Tsalkidis A, Arvanitidou V, Emporiadou M, et al. The effect of obesity on pulmonary lung function of school-aged children in Greece. Pediatr Pulmonol. 2009;44(3):273-80.

Satapathy AK, Das RR, Mahapatro S, Panigrahi MK, Bandopadhaya D. Effect of body mass index on pulmonary functions in children aged 6-14 years: a cross-sectional study. J Family Med Prim Care. 2022;11(6):3156-60.

Torun E, Cakir E, Ozgüç F, Ozgen IT. The effect of obesity degree on childhood pulmonary function tests. Balkan Med J. 2014;31(3):235-8.

Rao C, Renukappa VB, Ramu SA, Srinivas MN. Effect of central adiposity on lung function tests in adolescents. Indian J Child Health. 2017;4(3):306-9.

Kongkiattikul L, Sritippayawan S, Chomtho S, Deerojanawong J, Prapphal N. Relationship between obesity indices and pulmonary function parameters in obese Thai children and adolescents. Indian J Pediatr. 2015;82(12):1112-6.

Yao TC, Tsai HJ, Chang SW, Chung RH, Hsu JY, Tsai MH, et al. Obesity disproportionately impacts lung volumes, airflow and exhaled nitric oxide in children. PLoS One. 2017;12(3):e0174691.

Graham BL, Steenbruggen I, Miller MR, Barjaktarevic IZ, Cooper BG, Hall GL, et al. Standardization of spirometry 2019 update. An official American Thoracic Society and European Respiratory Society technical statement. Am J Respir Crit Care Med. 2019;200(8):e70-88.

Vijayan VK, Reetha AM, Kuppurao KV, Venkatesan P, Thilakavathy S. Pulmonary functions in normal South Indian children aged 7 to 19 years. Indian J Chest Dis Allied Sci. 2000;42(3):147-56.

Budhiraja S, Singh D, Pooni PA, Dhooria GS. Pulmonary functions in normal school children in the age group of 6-15 years in North India. Iran J Pediatr. 2010;20(1):82-90.

Chhabra SK, Kumar R, Mittal V. Prediction equations for spirometry for children from northern India. Indian Pediatr. 2016;53(9):781-5.

Raji G, Kumar K, Ganga N, Narasimhan M. Analysis of peak expiratory flow rate and spirometry in obese and nonobese schoolchildren. Indian J Respir Care. 2022;11(4):337-41.

Paralikar SJ, Kathrotia RG, Pathak NR, Jani MB. Assessment of pulmonary functions in obese adolescent boys. Lung India. 2012;29(3):236-40.

Shingne R, Berad A, Ghugare B. Effect of obesity on pulmonary function test in adolescent boys. Natl J Physiol Pharm Pharmacol. 2020;10(7):1.

Ferreira MS, Mendes RT, de Lima Marson FA, Zambon MP, Paschoal IA, Toro AA, et al. The relationship between physical functional capacity and lung function in obese children and adolescents. BMC Pulm Med. 2014;14:199.

Das D, Mondal H, Patnaik M. Study of dynamic lung function parameters in normal, overweight, and thin school boys. J Sci Soc. 2017;44(1):36-9.

Charoensittisup P, Udomittipong K, Mahoran K, Palamit A. Longitudinal effects of obesity on pulmonary function in obese children and adolescents. Pediatr Res. 2025;97(5):1644-9.