{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T09:59:22Z","timestamp":1771667962664,"version":"3.50.1"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T00:00:00Z","timestamp":1744675200000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Childhood obesity is associated with a higher risk of sleep\u2010disordered breathing, but our understanding of the underlying physiologic mechanisms is limited. This study investigated the effects of obesity on lung volumes, expiratory flow limitation (EFL), and respiratory symptoms in the supine position.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ninety\u2010four children (8\u201312 years old, <jats:italic>n<\/jats:italic>\u2009=\u200958 with obesity and <jats:italic>n<\/jats:italic>\u2009=\u200936 without obesity) underwent lung volume and EFL measurements in the seated and supine positions in this repeated\u2010measures cross\u2010sectional study. Children without obesity underwent an additional condition where either a 2.3\u2009kg (<jats:italic>n<\/jats:italic>\u2009=\u200926) or 5.0\u2009kg (<jats:italic>n<\/jats:italic>\u2009=\u20098) mass was placed on their abdomen to simulate obesity. Ratings of perceived breathlessness (RPB) were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Functional residual capacity (FRC) in the supine when compared with the seated posture decreased more so in children without obesity (43.9\u2009\u00b1\u20091.0 vs. 34.4\u2009\u00b1\u20091.0% total lung capacity [TLC]) compared with children with obesity (35.5\u2009\u00b1\u20090.8 vs. 29.6\u2009\u00b1\u20090.8% TLC; <jats:italic>p<\/jats:italic>\u2009=\u20090.0048 group*posture). EFL in the supine position was present in 17% of children with obesity compared with 6% of children without obesity (<jats:italic>p<\/jats:italic>\u2009=\u20090.1218). In children without obesity, mass\u2010loading with 5.0\u2009kg produced further reductions in FRC (seated: 45.0\u2009\u00b1\u20091.7% TLC; supine: 36.7\u2009\u00b1\u20091.7% TLC; supine+5.0\u2009kg: 29.4\u2009\u00b1\u20091.7% TLC; <jats:italic>p<\/jats:italic>\u2009=\u20090.0087 seated vs. supine+ and <jats:italic>p<\/jats:italic>\u2009=\u20090.0178 supine vs. supine\u2009+\u2009) and an increase in RPB (seated: 0.38\u2009\u00b1\u20090.24; supine: 0.42\u2009\u00b1\u20090.24; supine+5.0\u2009kg: 1.25\u2009\u00b1\u20090.27; <jats:italic>p<\/jats:italic>\u2009=\u20090.0002 seated vs. supine+ and <jats:italic>p<\/jats:italic>\u2009=\u20090.0001 supine vs. supine\u2009+\u2009).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Children with obesity breathe at significantly lower lung volumes while supine, increasing the risk of EFL. A better physiologic understanding of the mechanical effects of obesity could potentially improve the management of sleep\u2010related symptoms among children with obesity.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.71061","type":"journal-article","created":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T07:37:46Z","timestamp":1744702666000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effects of Obesity and Sex on Supine Functional Residual Capacity and Expiratory Flow Limitation in Children"],"prefix":"10.1002","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3358-2169","authenticated-orcid":false,"given":"Dharini M.","family":"Bhammar","sequence":"first","affiliation":[{"name":"Division of Medical Oncology, Department of Internal Medicine, College of Medicine The Ohio State University Wexner Medical Center  Columbus Ohio USA"},{"name":"Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center The Ohio State University  Columbus Ohio USA"},{"name":"Institute for Exercise and Environmental Medicine Texas Health Presbyterian Hospital and UT Southwestern Medical Center  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel P.","family":"Wilhite","sequence":"additional","affiliation":[{"name":"Institute for Exercise and Environmental Medicine Texas Health Presbyterian Hospital and UT Southwestern Medical Center  Dallas Texas USA"},{"name":"US Department of Veterans Affairs  East Orange New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Temitayo","family":"Olojo","sequence":"additional","affiliation":[{"name":"Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center The Ohio State University  Columbus Ohio USA"},{"name":"Internal Medicine\/Pediatrics, University of Michigan Health\u2010West  Wyoming Michigan 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