Obesity, asthma, and allergy triangle

Obesity, asthma, and allergic diseases are among the major chronic noncommunicable diseases that are rapidly increasing worldwide. These conditions are often interconnected, sharing common epidemiologic trends and pathophysiological mechanisms. In pediatric populations, substantial epidemiologic evidence demonstrates that obesity is associated with an increased risk of asthma and certain allergic diseases, greater disease severity, poorer control, and reduced quality of life. Importantly, these associations may originate early in life, with maternal obesity acting as a critical driver of offspring susceptibility. Multiple mechanisms underlie this complex interplay, including chronic low-grade inflammation, adipokine dysregulation, and alterations in gut microbiota and intestinal epithelial barrier integrity. In this scenario, diet emerges as a shared environmental driver of these conditions and consequently as a promising preventive and therapeutic target. Nutritional assessment and targeted dietary interventions from early life, including during pregnancy, offer a unique opportunity to improve both metabolic health and asthma/allergic outcomes, potentially reducing disease severity, optimizing drug effectiveness, and improving overall quality of life.