asthma

Housing Conditions and Outdoor Air Pollution Together Affect Children’s Asthma Risk, New ECHO Study Shows

Posted on by Jodi Snare

Children growing up in homes with water damage or dampness and exposed to higher levels of outdoor air pollution during early childhood face a greater risk of developing asthma, according to new research supported by the NIH’s Environmental influences on Child Health Outcomes (ECHO) Program. The large multisite study found that early-life exposure to fine particulate matter (PM2.5) and indoor housing problems each independently raised asthma risk, while having a dog during infancy was linked to reduced risk.

Asthma affects millions of U.S. children, yet the environmental origins of the disease are complex. While previous research has tended to study exposures such as pollution or indoor allergens separately, this study shows that evaluating them together offers a more accurate picture of children’s risk. The ECHO Program, which brings together data from diverse U.S. populations, made this integrated analysis possible.

Drawing on data from 6,413 children across nine U.S. ECHO Study Sites, the research provides one of the clearest looks yet at how multiple early-life environmental factors interact to influence childhood asthma. The findings underscore the importance of assessing both indoor and outdoor environments together, rather than in isolation — an approach that prior studies often could not address due to limited sample sizes.

“Our research shows that to truly understand and prevent childhood asthma, we need to look at a child’s full environment—both the air they breathe outside and the conditions inside their home,” said Akihiro Shiroshita, a study author from Vanderbilt University School of Medicine. “Considering these factors together gives us a much clearer picture of what puts children at risk and how we can better protect them.”

Key Findings

  • Outdoor air pollution matters: Higher early life exposure to PM2.5 was associated with increased asthma risk.
  • Indoor environments matter too: Home dampness or water damage independently raised asthma risk, even after accounting for pollution exposure.
  • Pets may offer protection: Having a dog in the home during infancy was linked to a lower risk of developing asthma.
  • Large, diverse dataset: The study combines data from multiple U.S. ECHO Study Sites, offering a comprehensive view of environmental impacts on children’s respiratory health.

Researchers evaluated children’s exposure to PM2.5 during the first three years of life and combined that information with detailed data on early life housing conditions — including water damage, dampness, pet exposure, and dust mites. Childhood asthma was identified based on caregiver reports or physician diagnosis between birth and age five. The analysis also controlled for family and neighborhood factors to isolate the effects of environmental exposures.

The findings signal the need for additional research into how indoor and outdoor exposures interact and how early life interventions could help reduce asthma risk in children nationwide.

This collaborative research was published in Environmental Epidemiology.

About ECHO
The ECHO Cohort Consortium is a research program supported by the National Institutes of Health (NIH) with the mission to enhance the health of children for generations to come. ECHO Cohort investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.

Media Contacts

For information or to request an interview, contact Rebekah Yeager,  rebekah.yeager@nih.gov.

If you are not a member of the media, but have a general inquiry, please contact  NIHKidsandEnvironment@od.nih.gov.

Connect With Us

echo connector

Check out the recent issues of our bi-monthly newsletter, the ECHO Connector, for program news and the latest research findings.

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Follow the ECHO Program on LinkedIn and X for the latest updates.

Home Conditions and Outdoor Air Pollution May Together Influence Children’s Asthma Risk, ECHO Study Finds

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Home Conditions and Outdoor Air Pollution May Together Influence Children’s Asthma Risk, ECHO Study Finds

Authors: Akihiro Shiroshita, et al.

 

Who sponsored this study?

The Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health supported this research.

 

Why was this study needed?

Childhood asthma may be influenced by multiple indoor and outdoor environmental exposures. Prior research has examined indoor and outdoor exposures separately and frequently lacked the power to fully evaluate their cumulative or interacting effects on childhood asthma. The ECHO Cohort allowed researchers to bring together data from many sites across the country, providing a clearer picture of how different environmental factors may influence childhood asthma.

 

What were the study results?

The study found that several environmental exposures during early childhood were linked to asthma risk. First, exposure to ambient fine particulate air pollution (PM2.5) was associated with an increased risk of developing asthma. In addition, water damage or dampness in the home was also linked to a higher asthma risk, even after accounting for PM2.5 exposure, indicating an independent effect. In contrast, having a dog in the home during infancy was associated with a reduced risk of childhood asthma.

 

What was this study's impact?

The study demonstrated the importance of considering multiple early-life exposures together when assessing risk factors for childhood asthma. It highlighted that both indoor (home dampness, pets) and outdoor (PM2.5) exposures should be considered in prevention strategies.

 

Who was involved?

Participants included 6,413 children born between 1987 and 2016, enrolled in nine ECHO Study Sites across the United States. These sites included both general-risk and high-risk populations at higher risk, defined by a parental history of asthma or allergy.

 

What happened during the study?

The study looked at children’s early-life environments to understand how they relate to asthma risk. Researchers examined levels of outdoor air pollution during the first three years of life, along with conditions inside the home, such as water damage or dampness, whether dogs or cats were present during infancy, and exposure to dust mites. Childhood asthma was identified based on reports from caregivers or a doctor’s diagnosis between birth and age five. The analysis considered differences in family and neighborhood factors that could also affect asthma risk, helping to isolate the role of these environmental exposures.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

 

What happens next?

Additional studies examining how indoor and outdoor exposures interact could help researchers better understand their role in childhood asthma risk. Future research could also explore ways to reduce or prevent harmful exposures in early life.

 

Where can I learn more?

Access the full journal article, titled “Individual and combined effects of indoor home exposures and ambient PM2.5 during early life on childhood asthma in US birth cohort studies,” in Environmental Epidemiology.

 

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

 

Published December 23, 2025

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Home Conditions and Outdoor Air Pollution May Together Influence Children’s Asthma Risk, ECHO Study Finds

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Study Links Higher Air Pollution to Increased Childhood Asthma, Highlights Unequal Burden in Black and Urban Communities

Posted on by Jodi Snare

Higher exposure to fine particulate matter, nitrogen dioxide, and ground-level ozone was associated with increased asthma incidence in children up to age 10, according to a new study funded by the Environmental influences on Child Health Outcomes (ECHO) Program at the National Institutes of Health. Notably, children living in areas with higher proportions of Black residents or higher population density faced greater pollution-related asthma risk, despite overall air quality improvements in the U.S.

“Our findings show why it’s so important to keep reducing air pollution everywhere in the U.S. They also highlight the need to understand and tackle the deeper reasons why some communities are more affected than others,” said Veronica Wang, research fellow at the Harvard T.H. Chan School of Public Health.

Key Takeaways:

  • Higher levels of fine particulate matter, nitrogen dioxide, and ground ozone were each linked to more new cases of asthma in early childhood.
  • Fine particulate matter and nitrogen dioxide posed a greater asthma risk for children living in areas with more Black residents.
  • Children in more densely populated neighborhoods were also at higher risk from these pollutants.
  • The study looked at data from over 23,000 children born between 1981 and 2021 to find out which groups are more likely to develop asthma from air pollution exposure in early childhood.

The study analyzed extensive environmental and community data, highlighting the importance of reducing harmful exposures in the most affected neighborhoods.

This collaborative research was published in Environmental Epidemiology.

ECHO Study Observes Health Disparities in Air Pollution-associated Risk of Childhood Asthma

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ECHO Study Observes Health Disparities in Air Pollution-associated Risk of Childhood Asthma

Authors: Veronica A. Wang, Rima Habre, Diane R. Gold, Antonella Zanobetti, et al.

 

Who sponsored this study?

The Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health supported this research.

 

Why was this study needed?

Asthma is one of the most common chronic childhood diseases in the United States, affecting over 4.5 million children. Although air pollution levels have decreased over the past decades, individuals living in certain areas have seen lower reductions in air pollution and may also be more vulnerable to its effects. For this study, researchers examined sociodemographic disparities in the association between air pollution and incident childhood asthma until age 10.

 

What were the study results?

The study found that higher exposures to fine particulate matter, nitrogen dioxide, and ground ozone were associated with a higher incidence of asthma in the first 10 years of a child’s life. For fine particulate matter and nitrogen dioxide, children from areas with a higher proportion of Black residents or higher population density were identified being at a higher risk for air pollution-associated asthma.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

 

What was the study's impact?

This study showed that sociodemographic disparities in air pollution-associated asthma persist despite reductions in the overall air pollution levels. The study highlighted the potential to mitigate childhood asthma risk by reducing air pollution and addressing the root causes of these disparities.

 

Who was involved?

The study involved over 23,000 children, born between 1981-2021, from 34 sites in the Environmental influences on Child Health Outcomes (ECHO) Program with data on asthma diagnosis until age 10 in the contiguous US.

 

What happened during the study?

During the study, the study team collected data on each participant’s asthma status, month of diagnosis, and length of their follow-up. They also collected sociodemographic data that included sex, race/ethnicity, maternal education, and more. Lastly, they used area-level data from the 1980-2019 Census Bureau and the American Community Survey on the percent of low-income residents, Black residents, residents with less than a high school education, unemployed residents, and female residents, and overall population density. The study team then analyzed this data, first examining the association between air pollution exposures (fine particulate matter, nitrogen dioxide, and ground ozone) and childhood asthma, then determining whether the sociodemographic and economic variables modified the air pollution-asthma association.

 

What happens next?

Future studies could help researchers better understand the root causes of susceptibility to air pollution. Additional studies with longer follow-up could also help researchers understand how asthma risk may change throughout childhood as the climate and environmental conditions change. Lastly, additional studies may help researchers understand how personal exposures affect asthma in children, including indoor sources of air pollution.

 

Where can I learn more?

Access the full journal article, titled “Disparities in the Association of Ambient Air Pollution with Childhood Asthma Incidence in the ECHO Consortium: a US-wide Multi-cohort Study,” in Environmental Epidemiology.

 

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published August 2025

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Living in Low-income-low-food-access Neighborhoods Linked to Higher Risk of Childhood Asthma

Posted on by Jodi Snare

Living in a low-income neighborhood with low food access was associated with higher risks of developing asthma, according to a recent ECHO Cohort study led by Veronica A. Wang, PhD, Antonella Zanobetti, PhD, and Diane Gold, MD of Harvard T. H. Chan School of Public Health and Rima Habre, ScD of the University of Southern California.

Asthma is characterized by chronic inflammation in the lungs, and prior research shows that a nutritious diet can reduce airway inflammation. However, access to affordable and healthy foods is often difficult for many communities that have limited access to supermarkets or grocery stores. In this study, the researchers wanted to learn whether living in a low-income-low-food access neighborhood was associated with childhood asthma and whether this association was modified by sociodemographic factors.

The study included 16,012 children from 35 ECHO Cohort study sites across the U.S., and the investigators used low-income-low-food-access (LILA) neighborhood metrics from the U.S. Department of Agriculture’s Food Access Research Atlas to evaluate each child’s neighborhood food access.

Key Takeaways include:

  • Living in a low-income neighborhood with low food access was associated with higher risks of developing asthma for both cumulative early (age 0-5 years) and cumulative middle (age 0-11 years) childhood, which stronger associations observed for cumulative early childhood.
  • The increased risk of asthma was more noticeable among girls, Hispanic children, and children whose mothers had less than a high school education.
  • The findings suggest that food access in the immediate vicinity of residence and that vehicle access may be important and may contribute to disparities in childhood asthma development.

This collaborative research, titled “Residing in a low-income-low-food-access neighbourhood and asthma in early and middle childhood in the Environmental influences on Child Health Outcomes (ECHO) program: a multisite cohort study,” is published in BMJ Open.

Children Living in Low-income Neighborhoods with Low Food Access at Higher Risk of Developing Asthma, ECHO Study Finds

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Children Living in Low-income Neighborhoods with Low Food Access at Higher Risk of Developing Asthma, ECHO Study Finds

Authors: Veronica Wang, Antonella Zanobetti, Diane Gold, Rima Habre, et al.

 

Who sponsored this study?

The Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health supported this research.

 

Why was this study needed?

Asthma is characterized by chronic inflammation in the lungs, and prior research shows that a nutritious diet can reduce airway inflammation. However, access to affordable and healthy foods is often difficult for many communities that have limited access to supermarkets or grocery stores. In this study, the researchers wanted to learn whether residing in a low-income-low-food access neighborhood was associated with childhood asthma and whether this association was modified by sociodemographic factors.

 

What were the study results?

This study found that living in a low-income neighborhood with low food access was associated with higher risks of developing asthma in both cumulative early (age 0-5 years) and cumulative middle (age 0-11 years) childhood, with stronger associations observed in cumulative early childhood. The increased risk of asthma was more prominent among girls, Hispanic children, and children whose mothers had less than a high school education.

 

What was the study's impact?

This study demonstrates the importance of the neighborhood food environment to children’s respiratory health, particularly in early childhood. The findings suggest that food access in the immediate vicinity of residence and that vehicle access may be important and may contribute to disparities in childhood asthma development.

 

Who was involved?

The study included 16,012 children from 35 ECHO Cohort study sites, born between 1998 and 2021, from across the United States.

 

What happened during the study?

During the study, researchers collected information on participants’ residential addresses and whether they were diagnosed with asthma in cumulative early childhood (by age 5) or middle childhood (by age 11). Using the U.S. Department of Agriculture’s Food Access Research Atlas, the researchers evaluated whether each child lived in a low-income neighborhood that was within 0.5-1 mile of a supermarket (for urban areas) or 10-20 miles (for rural areas). They also evaluated whether each child lived in a low-income area where more than 100 households do not have a vehicle or a nearby supermarket. Using this data, researchers looked at how living in a low-income-low-food-access neighborhood might affect childhood asthma incidence. They also took into account factors like the child's sex, race/ethnicity, mother's education, whether the mother smoked during pregnancy, and whether the parents had asthma.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What happens next?

Additional studies could help researchers better understand how community access to healthy, nutritious foods affects asthma development. Future studies could also consider how other influences, such as the affordability of healthy foods and school-based food programs, might influence child health outcomes.

 

Where can I learn more?

Access the full journal article, titled “Residing in a low-income-low-food-access neighbourhood and asthma in early and middle childhood in the Environmental influences on Child Health Outcomes (ECHO) program: a multisite cohort study,” in BMJ Open.

 

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published June 30, 2025

 

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Children Living in Low-income Neighborhoods with Low Food Access at Higher Risk of Developing Asthma, ECHO Study Finds

 

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Children Born in Lower-Opportunity Neighborhoods May Face Higher Incidence Rates of Asthma with Recurrent Exacerbations, NIH Study Finds

Posted on by Jodi Snare

Children born in neighborhoods with fewer opportunities are more likely to experience repeated asthma flares requiring emergency care or medical treatment, with non-Hispanic Black children having the highest incidence rates of asthma with recurrent exacerbations, according to a new study funded by the Environmental influences on Child Health Outcomes (ECHO) Program at the National Institutes of Health.

Asthma with recurring exacerbations (AREs) is a more severe form of childhood asthma linked to worsened health, high medical costs, and significant challenges for both the patient and their family, especially compared to well-controlled asthma. ARE affects many children in the U.S., with about 6 and a half cases per 1,000 children per year in the nationwide ECHO program.

Neighborhood factors—such as access to housing, healthy food, transportation, and education—can impact childhood asthma development. The Child Opportunity Index (COI) is one measure used to assess these conditions, connecting residential addresses at different early-life stages to data on neighborhood resources. This index combines information from 29 factors, such as access to good schools, healthy food, parks, clean air, and job opportunities. Studies have shown that neighborhoods with higher COI scores tend to have better conditions that help children grow up healthier and have more opportunities for economic success.

ECHO researchers used the COI to analyze how these factors influenced the development of this severe type of childhood asthma. The study included data from 15,877 children born between 1990 and 2018 across 60 ECHO study sites in the U.S.

“This study suggests that individual- and neighborhood-level exposures may affect the risk for developing childhood ARE,” said Rachel Miller, MD, of the Icahn School of Medicine at
Mount Sinai.

Researchers found that:

  • Children from low-opportunity neighborhoods had significantly higher incidence rates of asthma with recurrent exacerbations (ARE) than those from higher-opportunity areas.
  • Non-Hispanic Black children had the higher rates across all neighborhood categories when compared to Non-Hispanic White children.
  • Among children in very low-opportunity neighborhoods, non-Hispanic Black and Hispanic Black children had rates of ARE several times higher than non-Hispanic White children.
  • Young children (ages 2 to 4) and those with a parent who had asthma had a higher risk of ARE. .

What happened during the study

In this study, researchers followed children from ages 2 to at least 5, and up to age 19. They collected information on asthma diagnoses and the use of corticosteroids, a medication that helps reduce inflammation in the body. ARE was identified if a child used corticosteroids at least twice during the follow-up period while being monitored by ECHO researchers.

The study also examined the link between COI scores and children's birth addresses. Researchers analyzed how neighborhood conditions influenced the development of asthma with recurrent exacerbations while accounting for individual health history and other factors.

“This study adds to the mounting evidence that investing in neighborhood resources may have a myriad of respiratory health benefits for children,” said Dr. Miller.

Additional studies could help researchers further understand the prenatal and early childhood determinants of ARE at both the individual and neighborhood levels.

This collaborative research was published in the Journal of Allergy and Clinical Immunology.

About ECHO
The ECHO Cohort Consortium is a research program supported by the National Institutes of Health (NIH) with the mission to enhance the health of children for generations to come. ECHO Cohort investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.

Miller, R. and Johnson, C. Child Opportunity Index at Birth and Asthma with Recurrent Exacerbations in the U.S. ECHO Program. Journal of Allergy and Clinical Immunology, DOI: 10.1016/j.jaci.2025.02.036

Media Contacts

For information or to request an interview, contact Rebekah Yeager,  rebekah.yeager@nih.gov.

If you are not a member of the media, but have a general inquiry, please contact  NIHKidsandEnvironment@od.nih.gov.

Connect With Us

echo connectorCheck out the recent issues of our bi-monthly newsletter, the ECHO Connector, for program news and the latest research findings.

To receive the ECHO Connector through email, subscribe here.

Follow @ECHOChildHealth for the latest ECHO Program updates on X.

Children Born in Lower-Opportunity Neighborhoods Had Higher Rates of Asthma with Recurrent Exacerbations

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Children Born in Lower-Opportunity Neighborhoods Had Higher Rates of Asthma with Recurrent Exacerbations

Authors: Rachel Miller, Christine C. Johnson, et al.

 

Who sponsored this study?

The Environmental influences on Child Health Outcomes (ECHO) Program at the National Institutes of Health supported this research.

 

Why was this study needed?

Neighborhood conditions—such as access to housing, healthy food, transportation, and education—can influence the development of childhood asthma. Researchers often use the Child Opportunity Index (COI) to measure these conditions, linking residential addresses at different stages of early life to data about the resources available in the surrounding neighborhood. This index looks at various aspects of a neighborhood to see how they might affect children's chances of success and health. It combines information from 29 indicators, such as access to good schools, healthy food, parks, clean air, and job opportunities. Studies have shown that neighborhoods with higher COI scores tend to have better conditions that help children grow up healthier and have more opportunities for economic success. So, the higher the COI score, the better the neighborhood is believed to be for children's development and future prospects. Previous research suggests that these factors can all play a role in shaping different types of childhood asthma. This ECHO study was needed to explore how conditions before and at the time of birth can affect children’s rates of asthma with recurrent exacerbations (ARE)—a type of asthma where children experience frequent, severe episodes of asthma.

 

What were the study results?

The study found that children born in neighborhoods with low community opportunity, when measured at birth and as measured by the COI, had a much higher incidence rate of asthma with recurrent exacerbations compared to those from other neighborhoods. Non-Hispanic Black children had significantly higher rates than non-Hispanic White children across all neighborhood categories. Among children from very low-opportunity neighborhoods, the rates were several times higher for non-Hispanic Black and Hispanic Black children compared to White children. Even after accounting for individual factors, children from these low-opportunity areas had higher adjusted incidence rates for asthma with recurrent exacerbations, especially those aged 2 to 4 years or those who had a parent with asthma.

 

What was the study's impact?

Earlier ECHO research found that living in a neighborhood with higher opportunity at birth was associated with lower asthma incidence than living in a neighborhood with lower opportunity. This study highlights the importance of addressing neighborhood-level conditions to help prevent asthma flare-ups in children. It supports the idea that improving conditions in under-resourced areas can positively impact children’s health.

 

Who was involved?

The study used data from 15,877 children born between 1990 and 2018. These children were from 60 ECHO cohorts across the U.S.

 

What happened during the study?

In this study, researchers followed children from ages 2 to at least 5, and up to age 19. They collected information on asthma diagnoses and the use of corticosteroids, a medication that helps reduce inflammation in the body. ARE was identified if a child used corticosteroids at least twice while being monitored by ECHO researchers. The study also looked at the connection between the COI and the children's birth addresses, examining how neighborhood conditions influenced the rates of asthma flare-ups while considering individual factors like child race and ethnicity, sex and parental history of asthma.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What happens next?

Additional studies could help researchers further understand the prenatal and early childhood determinants of ARE at both the individual and neighborhood levels.

 

Where can I learn more?

Access the full journal article, titled “Child Opportunity Index at Birth and Asthma with Recurrent Exacerbations in the U.S. ECHO Program,” in the Journal of Allergy and Clinical Immunology.

 

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published March 13, 2025

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Children Born in Lower-Opportunity Neighborhoods Had Higher Rates of Asthma with Recurrent Exacerbations

 

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Black Children May Benefit from Race-Neutral Assessments for Asthma Diagnosis, Study Finds

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Black Children May Benefit from Race-Neutral Assessments for Asthma Diagnosis, Study Finds

Authors: Amy Non, James Gern, et al.

 

Who sponsored this study?

The Environmental influences on Child Health Outcomes (ECHO) Program, National Institutes of Health supported this research.

 

Why was this study needed?

Spirometry (spy-ROM-uh-tree) is a test used to check how well your lungs work. It measures how much air you breathe in, how much you breathe out, and how quickly you breathe out. Healthcare professionals use spirometry to diagnose asthma and other respiratory conditions. Historically, healthcare providers have used different spirometry equations based on a person’s race for interpreting test results, relying on the assumption that Black and White bodies are biologically different. For this study, researchers wanted to know whether using the same spirometry equations for everyone (race-neutral) or different ones for specific races (race-specific) changes the reliability of lung function tests used to check for asthma in children. This research addresses concerns that race-specific test interpretations might hide lung problems in children from certain backgrounds and could lead to differences in how asthma is diagnosed and treated in kids from racial and ethnic minority groups.

 

What were the study results?

Black children may be more likely to be identified as having reduced lung function when doctors use the same spirometry equations to interpret test results for everyone (race-neutral) instead of race-specific ones.  The study found that using the race-neutral equations resulted in significantly lower lung function scores for Black children compared to the race-specific equations. This led to a higher percentage of Black children being classified as having low lung function. Furthermore, Black children were more likely to be diagnosed with asthma, regardless of the equation The way lung function was measured did not seem to make much difference in how often children needed asthma-related healthcare, like emergency room visits or hospital stays.

 

What was the study's impact?

The study's findings support using race-neutral equations when evaluating children for asthma, as they may provide a more uniform assessment of lung function across different racial and ethnic groups.

 

Who was involved?

The research included 8,719 children aged 5 to 12 years from 27 research sites across the United States. These children were grouped by parent-reported race and ethnicity, including Black, non-White Hispanic, and White children, with a smaller percentage classified as "Other Race."

 

What happened during the study?

The study examined how using the same equations for everyone changes how lung function tests are understood. These tests measure how much air a child can blow out in one second, the total amount of air they can blow out in one breath, and the balance between the two. Researchers also checked if the test results matched real-life asthma problems, like being diagnosed with asthma, needing emergency care, or staying in the hospital.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What happens next?

Further research is needed to better understand the racial differences in lung function and asthma outcomes. Future studies could also explore the impact of environmental and social factors affect respiratory health in children from different racial and ethnic groups.

 

Where can I learn more?

Access the full journal article, titled “Comparison of Race-neutral Versus Race-specific Spirometry Equations for Evaluation of Child Asthma,” in American Journal of Respiratory and Critical Care Medicine.

 

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published December 3, 2024

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Black Children and Especially Black Girls May Be Less Likely to Receive an Autism Diagnosis

Authors: Kristen Lyall, Bob Joseph, et al.

ECHO Study Suggests Maternal Sleep During Second Trimester of Pregnancy May be Associated with ADHD Symptoms and Sleep Quality in Early Childhood

Authors: Claudia Lugo-Candelas, Tse Hwei, Seonjoo Lee, Cristiane Duarte, et al.

Patterns of Substance Use during Pregnancy Predict Child Behavior Problems

Authors: Sarah Maylott, et al.

How Does Phthalate Exposure During Pregnancy Affect Newborn Brain Development?

Authors: Authors: Leny Matthew, Craig Newschaffer, et al.

Does Prenatal PFAS Exposure Affect a Child’s Risk for Developing Autism-related Traits?

Authors: Jennifer Ames, Ghassan Hamra, et al.

 

How Much Vitamin D do Children with Asthma and Increased Body Weight Need to Correct Low Vitamin D Levels?

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How much vitamin D do children with asthma and increased body weight need to correct low vitamin D levels?

Study title: Pharmacokinetics of Oral Vitamin D in Children with Obesity and Asthma

Author(s): Jason E. Lang, Rodrigo Gonzalez Ramirez, Stephen Balevic, Brian O’Sullivan, Scott Bickel, Christoph P. Hornik, J. Marc Majure, Saranya Venkatachalam, Jessica Snowden, Laura James

 

Why was this study conducted?

Among children with asthma, children who also have increased body weight for their height (body mass index (BMI) of ≥85 percentile) tend to have more severe asthma symptoms than their healthy weight peers. Children with asthma and increased body weight also tend to have lower vitamin D levels than other children. Helping children with asthma and increased body weight reach higher vitamin D levels may help their asthma symptoms by lowering inflammation in the lungs. However, there is not enough information on how much vitamin D children with asthma and increased body weight should take to safely raise their vitamin D levels.

 

What was done?

ECHO ISPCTN research teams in 15 states enrolled children ages 6‑18 years with asthma and increased body weight in a clinical trial. The children took vitamin D capsules for 16 weeks and gave blood samples every month so researchers could check their vitamin D levels. The goal of the study was to find a vitamin D dose that helped children raise their vitamin D levels in their blood to 40 ng/mL, a level that might lower inflammation.

There were two parts of the study. In the first part, children were split into four groups that each took one of four different doses of vitamin D to find a dose that raised children’s vitamin D levels over 16 weeks without causing side effects. All four dosing options were higher than what is usually recommended to raise vitamin D levels. Then, researchers compared the vitamin D dose from part 1 that raised vitamin D levels quickly and safely to the usually recommended daily vitamin D dose to confirm that the higher dose could safely help children reach vitamin D levels that may decrease inflammation. This study was approved by the Institutional Review Board and all participants consented to participate in the study.

 

What was found?

The first part of the study found that taking a 50,000 international units (IU) vitamin D dose on the first day of treatment and then an 8,000 IU vitamin D dose every day for 16 weeks was most effective at raising vitamin D levels safely. In the second part of the study, researchers confirmed that using this approach raised vitamin D levels in most children to the recommended level while avoiding undesired higher levels. In contrast, no children who followed the current standard-of-care dosing of 600 IU each day achieved the target vitamin D level sufficient to potentially reduce inflammation.

 

What do the results mean?

Most children with asthma and increased body weight who take vitamin D the vitamin D dose used in this study (50,000 IU vitamin D on day one, then 8,000 IU each day) can safely raise their vitamin D level in a short period of time. The newly determined dose is much greater than the typically recommended dose. This study shows how important it is that children and adolescents with increased body weight get enough vitamin D in their diet or in vitamin supplements every day since the higher the body weight, the faster vitamin D was processed and removed from the body. The results of this study may help children with asthma or other illnesses if having enough Vitamin D lowers inflammation.

 

Who sponsored the study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) program, Office of The Director, National Institutes of Health.

 

Appreciation

All of the families in ECHO ISPCTN trials help study teams across the country learn more every day about how to bring rural and underserved families into research studies. This is critical to ensure that families that are not near large academic centers still get the benefits of research and that the “answers” research studies find are meaningful for children and families across all parts of the country, not just those who live in large cities.

 

You may learn more about this publication here: https://link.springer.com/article/10.1007/s40262-023-01285-9

 

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

 

Published: August 30, 2023

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How much vitamin D do children with asthma and increased body weight need to correct low vitamin D levels?

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