The prevalence of both obesity and allergy has been increasing throughout the world, leading to the hypothesis that the two are linked to one another. This overview summarizes the results of 34 studies from 2002 to 2012 that investigated a possible contributing effect of increasing body mass on the development and prevalence of various atopic diseases. Obesity was found to clearly affect bronchial asthma. However, the correlation was stronger in the nonatopic asthma phenotype. Obesity was found to be associated with the development of atopic dermatitis in children only. No clear association was found between obesity and the prevalence of allergic rhinitis or allergic conjunctivitis or increased sensitization to food allergens. This review sums up our study results and discusses a possible role of obesity in the promotion of allergy and asthma.

Bergeron C, Boulet LP, Hamid Q: Obesity, allergy and immunology. J Allergy Clin Immunol 2005;15:1102-1104.
Wyatt SB, Winters KP, Dubbert PM: Overweight and obesity: prevalence, consequences, and causes of a growing public health problem. Am J Med Sci 2006;331:116-174.
World Health Organization: Obesity: preventing and managing the global epidemic: report of a WHO consultation. World Health Organ Tech Rep Ser 2000;894:1-253.
World Health Organization: Obesity and overweight, 2012. Fact Sheet No. 133.
World Health Organization: Asthma, 2012. Fact Sheet No. 307.
Rance K, O'Laughlen M: Obesity and asthma: a dangerous link in children. JNP 2011;7:287-292.
Hersoug LG, Linneberg A: The link between the epidemics of obesity and allergic diseases: does obesity induce decreased immune tolerance? Allergy 2007;62:1205-1213.
Mann C: Observational research methods - research design II: cohort, cross-sectional, and case-control studies. Emerg Med J 2003;20:54-60.
World Health Organization: 10 facts on obesity - BMI classification. (accessed 15 September 2012).
Barlow SE: Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics 2007;120:S164-S192.
Szumilas M: Explaining odds ratios. J Can Acad Child Adolesc Psychiatry 2010;19:227-229.
Murray CS, Canoy D, Buchan I, Woodcock A, Simpson A, Custovic A: Body mass index in young children and allergic disease: gender differences in a longitudinal study. Clin Exp Allergy 2011;41:78-85.
Wang H-Y, Pizzichini MMM, Becker AB, Duncan JM, Ferguson AC, Greene JM, Rennie DC, Senthilselvan A, Taylor BW, Sears MR: Disparate geographic prevalences of asthma, allergic rhinoconjunctivitis and atopic eczema among adolescents in five Canadian cities. Pediatr Allergy Immunol 2010;21:867-877.
Mai XM, Nilsson L, Axelson O, Brabäck L, Sandin A, Kjellman NIM, Björksten B: High body mass index, asthma and allergy in Swedish schoolchildren participating in the International Study of Asthma and Allergies in Childhood: Phase II. Acta Paediatr 2003;92:1144-1148.
Herr M, Just J, Nikasinovic L, Foucault C, Le Marec AM, Giordanella JP, Momas JI: Influence of host and environmental factors on wheezing severity in infants: findings from the PARIS birth cohort. Clin Exp Allergy 2012;42:275-283.
Visness CM, London SJ, Gergen PJ, Mitchell HE, Zeldin DC: Obesity is associated with asthma among atopic as well as non-atopic adults. J Allergy Clin Immunol 2012;125:AB191.
Black MH, Smith N, Porter AH, Jacobsen SJ, Koebnick C: Higher prevalence of obesity among children with asthma. Obesity (Silver Spring) 2012;20:1041-1047.
Suglia SF, Chambers E, Rosario A, Duarte CS: Asthma and obesity among 3-year-old urban children: the role of sex and the home environment. J Pediatr 2011;159:14-20.e1.
Nystad W, Meyer HE, Nafstad P, Tverdal A, Engeland A: Body mass index in relation to adult asthma among 135,000 Norwegian men and women. Am J Epidemiol 2004;160:969-976.
Ma J, Xiao L, Knowles SB: Obesity, insulin resistance and the prevalence of atopy and asthma in US adults. Allergy 2010;65:1455-1463.
Olafsdottir IS, Gislason T, Thjodleifsson B, Olafsson I, Gislason D, Jögi R, Janson C: C reactive protein levels are increased in non-allergic but not allergic asthma: a multicentre epidemiological study. Thorax 2005;60:451-454.
Arif AA, Delclos GL, Lee ES, Tortolero SR, Whitehead LW: Prevalence and risk factors of asthma and wheezing among US adults: an analysis of the NHANES III data. Eur Respir J 2003;21:827-833.
Huovinen E, Kaprio J, Koskenvuo M: Factors associated to lifestyle and risk of adult onset asthma. Respir Med 2003;97:273-280.
Ford ES, Mannino DM, Redd SC, Mokdad AH, Mott JA: Body mass index and asthma incidence among USA adults. Eur Respir J 2004;24:740-744.
Gunnbjörnsdóttir MI, Omenaas E, Gislason T, Norrman E, Olin A-C, Jogi R, Jensen EJ, Lindberg E, Björnsson E, Franklin K, Janson C: Obesity and nocturnal gastro-oesophageal reflux are related to onset of asthma and respiratory symptoms. Eur Respir J 2004;24:116-121.
Rönmark E, Andersson C, Nyström L, Forsberg B, Järvholm B, Lundbäck B: Obesity increases the risk of incident asthma among adults. Eur Respir J 2005;25:282-288.
Von Behren J, Lipsett M, Horn-Ross PL, Delfino RJ, McConnell R, Bernstein L, Clarke CA, Reynolds P: Obesity, waist size, and prevalence of current asthma in the California Teachers Study cohort. Thorax 2009;64:1-11.
Wang TN, Lin MC, Wu CC, Huang MS, Leung SY, Huang CC, Ho PS, Ko YC: Role of gender disparity of circulating high-sensitivity C-reactive protein concentrations and obesity on asthma in Taiwan. Clin Exp Allergy 2011;41:72-77.
Fenger RV, Gonzalez-Quintela A, Vidal C, Gude F, Husemoen LL, Aadahl M, Berg ND, Linneberg A: Exploring the obesity-asthma link: do all types of adiposity increase the risk of asthma? Clin Exp Allergy 2012;42:1237-1245.
Kusunoki T, Morimoto T, Nishikomori R, Heike T, Ito M, Hosoi S, Nakahata T: Obesity and the prevalence of allergic diseases in schoolchildren. Pediatr Allergy Immunol 2008;19:527-534.
Garcia-Marcos L, Arnedo Pena A, Busquets-Monge R, Morales Suárez-Varela M, García de Andoin N, Batlles-Garrido J, Blanco-Quirós A, Lopez-Silvarrey Varela A, Garcia-Hernandez G, Aguinaga-Ontoso I, Gonzalez-Diaz C, Garcia-Merino A: How the presence of rhinoconjunctivitis and the severity of asthma modify the relationship between obesity and asthma in children 6-7 years old. Clin Exp Allergy 2008;38:1174-1178.
Chen Y, Dales R, Tand M, Krewski D: Obesity may increase the incidence of asthma in women but not in men: longitudinal observations from the Canadian National Population Health Surveys. Am J Epidemiol 2002;155:191-197.
Chen Y, Dales R, Jiang Y: The association between obesity and asthma is stronger in nonallergic than allergic adults. Chest 2006;130:890-895.
Bråbäck L, Hjern A, Rasmussen F: Body mass index, asthma and allergic rhinoconjunctivitis in Swedish conscripts - a national cohort study over three decades. Respir Med 2005;99:1010-1014.
Mai XM, Böttcher MF, Leijon I: Leptin and asthma in overweight children at 12 years of age. Pediatr Allergy Immunol 2004;15:523-530.
Musaad SMA, Patterson T, Ericksen M, Lindsey M, Dietrich K, Succop P, Hershey GK: Comparison of anthropometric measures of obesity in childhood allergic asthma: central obesity is most relevant. J Allergy Clin Immunol 2009;123:1321-1327.
Sutherland TJT, Cowan JO, Young S, Goulding A, Grant AM, Williamson A, Brassett K, Herbison GP, Taylor DR: The association between obesity and asthma: interactions between systemic and airway inflammation. Am J Respir Crit Care Med 2008;178:469-475.
Browatzki A, Ulrik CS, Lange P: Prevalence and severity of self-reported asthma in young adults, 1976-2004. Eur Respir J 2009;34:1046-1051.
Forno E, Lescher R, Strunk R, Weiss S, Fuhlbrigge A, Celedón JC: Decreased response to inhaled steroids in overweight and obese asthmatic children. J Allergy Clin Immunol 2011;127:741-749.
Silverberg JI, Kleiman E, Lev-Tov H, Silverberg NB, Durkin HG, Joks R, Smith-Norowitz TA: Association between obesity and atopic dermatitis in childhood: a case-control study. J Allergy Clin Immunol 2011;127:1180-1186.
Sevelsted A, Bisgaard H: Neonatal size in term children is associated with asthma at age 7, but not with atopic dermatitis or allergic sensitization. Allergy 2012;67:670-675.
Chen Y, Rennie D, Cormier Y, Dosman J: Association between obesity and atopy in adults. Int Arch Allergy Immunol 2010;153:372-377.
Visness CM, London SJ, Daniels JL, Kaufman JS, Yeatts KB, Siega-Riz AM, Liu AH, Calatroni A, Zeldin DC: Association of obesity with IgE levels and allergy symptoms in children and adolescents: results from the National Health and Nutrition Examination Survey 2005-2006. J Allergy Clin Immunol 2009;123:1163-1169.
Ouyang F, Kumar R, Pongracic J, Story RE, Liu X, Wang B, Xing H, Liu X, Li Z, Zhang W, Fang Y, Zhang S, Xu X, Wang X: Adiposity, serum lipid levels, and allergic sensitization in Chinese men and women. J Allergy Clin Immunol 2009;123:940-948.e10.
Van Gysel D, Govaere E, Verhamme K, Doli E, De Baets F: Body mass index in Belgian schoolchildren and its relationship with sensitization and allergic symptoms. Pediatr Allergy Immunol 2009;20:246-253.
Yuksel H, Sogut A, Yilmaz O, Onur E, Dinc G: Role of adipokines and hormones of obesity in childhood asthma. Allergy Asthma Immunol Res 2012;4:98-103.
Arshi M, Cardinal J, Hill RJ, Davies PSW, Wainwright C: Asthma and insulin resistance in children. Respirology 2010;15:779-784.
Ward BR, Arslanian SA, Andreatta E, Schwartz LB: Obesity is not linked to increased whole-body mast cell burden in children. J Allergy Clin Immunol 2012;129:1164-1166.
Visness CM, London SJ, Daniels JL, Kaufman JS, Yeatts KB, Siega-Riz AM, Liu AH, Calatroni A, Zeldin DC: Association of obesity with IgE levels and allergy symptoms in children and adolescents: results from the National Health and Nutrition Examination Survey 2005-2006. J Allergy Clin Immunol 2009;123:1163-1169.
Van den Berge M, Heijink HI, van Oosterhout AJM, Postma DS: The role of female sex hormones in the development and severity of allergic and non-allergic asthma. Clin Exp Allergy 2009;39:1477-1481.
Holt PG, Jones CA: The development of the immune system during pregnancy and early life. Allergy 2000;55:688-697.
Chirico G: Development of the immune system in neonates. J Arab Neonatal Forum 2005;2:5-11.
Bardana EJ Jr: Immunoglobulin E- (IgE) and non-IgE-mediated reactions in the pathogenesis of atopic eczema/dermatitis syndrome (AEDS). Allergy 2004:59:25-29.
Hajer GR, van Haeften TW, Visseren FLJ: Adipose tissue dysfunction in obesity, diabetes, and vascular diseases. Eur Heart J 2008;29:2959-2971.
Tilg H, Moschen AR: Adipocytokines: mediators linking adipose tissue, inflammation and immunity. Nat Rev Immunol 2006;6:772-783.
Lam QLK, Lu L: Role of leptin in immunity. Cell Mol Immunol 2007;4:1-13.
Ali Assad N, Sood A: Leptin, adiponectin and pulmonary diseases. Biochimie 2012;94:2180-2189.
Pacifico L, Renzo LD, Anania C, Osborn JF, Ippoliti F, Schiavo E, Chiesa C: Increased T-helper interferon-G-secreting cells in obese children. Eur J Endocrinol 2006;154:691-697.
Fantuzzi G: Adipose tissue, adipokines, and inflammation. J Allergy Clin Immunol 2005;115:911-919.
Sampson HA: Atopic dermatitis: immunological mechanisms in relation to phenotype. Pediatr Allergy Immunol 2000;12:62-68.
Christie L, Hine J, Parker JG, Burks W: Food allergies in children affect nutrient intake and growth. J Am Diet Assoc 2002;102:1648-1651.
Von Mutius E, Schwartz J, Neas LM, Dockery D, Weiss ST: Relation of body mass index to asthma and atopy in children: the National Health and Nutrition Examination Study III. Thorax 2001;56:835-838.
Wisse BE: The inflammatory syndrome: the role of adipose tissue cytokines in metabolic disorders linked to obesity. J Am Soc Nephrol 2004;15:2792-2800.
Pradhan AD, Manson JE, Rifai N, Buring JE, Ridker PM: C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. JAMA 2011;286:327-334.
Wilders-Truschnig M, Mangge H, Lieners C, Gruber HJ, Mayer C, März W: IgG antibodies against food antigens are correlated with inflammation and intima media thickness in obese juveniles. Exp Clin Endocrinol Diabetes 2008;116:241-245.
Kilic H, Oguzulgen IK, Bakir F, Turktas H: Asthma in obese women: outcomes and factors involved. J Investig Allergol Clin Immunol 2011;21:290-296.
Loffreda S, Yang SQ, Lin HZ, Karp CL, Brengman ML, Wang DJ, Klein AS, Bulkley GB, Bao C, Noble PW, Lane MD, Diehl AM: Leptin regulates proinflammatory immune responses. FASEB J 1998;12:57-65.
Kryštofová J, Jeseňák M, Bánovčin P: Bronchial asthma and obesity in childhood. Acta Medica 2011;54:102-106.
Suzukawa M, Nagase H, Ogahara I, Han K, Tashimo H, Shibui A, Koketsu R, Nagase H, Ogahara I, Han K, Nakae S, Yamaguchi M, Ohta K: Leptin enhances survival and induces migration, degranulation, and cytokine synthesis of human basophils. J Immunol 2011;186:5254-5260.
Wong CK, Cheung PF, Lam CW: Leptin-mediated cytokine release and migration of eosinophils: implications for immunopathophysiology of allergic inflammation. Eur J Immunol 2007;37:2337-2348.
Conus S, Bruno A, Simon HU: Leptin is an eosinophil survival factor. J Allergy Clin Immunol 2005;116:1228-1234.
Considine RV, Sinha MK, Heiman ML, Kriauciunas A, Stephens TW, Nyce MR, Ohannesian JP, Marco CC, McKee LJ, Bauer TL, Caro J: Serum immunoreactive-leptin concentrations in normal-weight and obese humans. N Engl J Med 1996;334:292-295.
Sood A, Qualls C, Li R, Schuyler M, Beckett WS, Smith LJ, Thyagarajan B, Lewis CE, Jacobs DR Jr: Lean mass predicts asthma better than fat mass among females. Eur Respir J 2011;37:65-71.
Sutherland TJT, Goulding A, Grant AM, Cowan JO, Williamson A, Williams SM, Skinner MA, Taylor DR: The effect of adiposity measured by dual-energy X-ray absorptiometry on lung function. Eur Respir J 2008;32:85-91.
McLachlan CR, Poulton R, Car G, Cowan J, Filsell S, Greene JM, Taylor DR, Welch D, Williamson A, Sears MR, Hancox RJ: Adiposity, asthma, and airway inflammation. J Allergy Clin Immunol 2007;119:634-639.
Simpson ER: Sources of estrogen and their importance. J Steroid Biochem Mol Biol 2003;86:225-230.
Nelson LR, Bulun SE: Estrogen production and action. J Am Acad Dermatol 2001;45:S116-S124.
Kirschner MA, Schneider G, Ertel NH, Worton E: Obesity, androgens, estrogens, and cancer risk. Cancer Res 1982;42:3281s-3285s.
Kirschner MA, Samojlik E, Drejka M, Szmal E, Schneider G, Ertel N: Androgen-estrogen metabolism in women with upper body versus lower body obesity. J Clin Endocrinol Metab 1990;70:473-479.
Medoff BD, Okamoto Y, Leyton P, Weng M, Sandall BP, Raher MJ, Kihara S, Bloch KD, Libby P, Luster AD: Adiponectin deficiency increases allergic airway inflammation and pulmonary vascular remodeling. Am J Respir Cell Mol Biol 2009;41:397-406.
Lang JE, Williams ES, Mizgerd JP, Shore SA: Effect of obesity on pulmonary inflammation induced by acute ozone exposure: role of interleukin-6. Am J Physiol Lung Cell Mol Physiol 2008;294:L1013-L1020.
Todd DC, Armstrong S, D'Silva L, Allen CJ, Hargreave FE, Parameswaran K: Effect of obesity on airway inflammation: a cross-sectional analysis of body mass index and sputum cell counts. Clin Exp Allergy 2007;37:1049-1054.
Beckett WS, Jacobs DR Jr, Yu X, Iribarren C, Williams OD: Asthma is associated with weight gain in females but not males, independent of physical activity. Am J Respir Crit Care Med 2001;164:2045-2050.
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