Introduction: Asthma in patients with obesity is often difficult to control. Limited data are available about the benefit of lifestyle programs in the treatment of obese asthmatics. Objective: To determine the effect of a lifestyle program on asthma control, body composition, lung function and exercise capacity in obese patients with asthma.
Methods: Patients with obesity (BMI > 30kg/m2) and suboptimal controlled asthma (Asthma Control Questionnaire (ACQ) > 0.75) were randomly assigned to a 3-month lifestyle intervention or usual care. Life style intervention program included high intensity interval training (3x/week), nutritional intervention (caloric restriction 1500 kcal/dag) and psychological group sessions. Patients in the usual care group were advised to lose weight and to exercise. Asthma control was the primary outcome.
Results: Thirty-one patients were included in the study (21 intervention, 10 control). The primary outcome could be assessed in 30 patients after 3 months. Compared to usual care, patients in the intervention group had a significant improvement in asthma control (mean ∆ACQ -0.70 vs +0.06, p=0.044), a higher percentage of weight loss (-6.82% vs. +0.04%, p<0.005) and a significant reduction in waist circumference (mean ∆-6.79 vs +4.67 cm, p=0.012). Exercise capacity (mean ∆6MWD +55.83 vs -14.03 m, p<0.005) improved statistically and clinically relevant. Patients in the intervention group had also significant fewer exacerbations than in the control group (11.1% vs. 77.8%, p=0.027).
Conclusion: A lifestyle intervention program is effective and feasible in obese asthmatics that are not optimally controlled and should be a part of the standard treatment.