Association between obesity and asthma among Arab Israeli adolescents compared with Jewish Israeli peers.

BACKGROUND

Ethnic differences in the health implications of adolescent obesity, including asthma, are understudied in Israel. We compared associations between adolescent weight categories and asthma among Arab Israeli and Jewish Israeli adolescents.

METHODS

This retrospective cross-sectional study used the computerized database of Clalit Health Services (CHS). It included Arab Israeli adolescents aged 14-19 years with at least one recorded height and weight measurement between 2007 and 2022. A Jewish Israeli comparison group meeting the same eligibility criteria was selected, with a socioeconomic status distribution corresponding to that of Arab Israeli adolescents. The final sample included 313,936 Arab Israeli and 289,616 Jewish Israeli adolescents. Logistic regression assessed associations between weight categories and asthma overall and asthma with inhaled corticosteroid (ICS), inhaled bronchodilator (IBD), or systemic corticosteroid (SCS) use, separately by group.

RESULTS

Higher weight categories were associated with higher odds of asthma, with similar patterns in both groups. Among adolescents with class 3 obesity, adjusted odds ratios (95% CI) were 1.52 (1.35-1.70) for asthma overall, 2.02 (1.23-3.10) for asthma with ICS use, 2.81 (1.49-4.78) for asthma with IBD use, and 3.81 (2.16-6.19) for asthma with SCS use. Jewish Israeli adolescents had higher ICS use, whereas Arab Israeli adolescents had higher SCS use.

CONCLUSIONS

Asthma management should address obesity through healthy diet and physical activity while considering lifestyle differences between Arab Israeli and Jewish Israeli adolescents. Greater ICS use and reduced SCS use among Arab Israeli adolescents may warrant attention.