| Summary: | <b>Background:</b> Asthma physiology affects respiratory function and inflammation, factors that may contribute to elevated resting energy expenditure (REE) and altered body composition. <b>Objective:</b> We hypothesized that asthma would present with elevated REE compared to weight-matched healthy controls. <b>Methods:</b> Adults with asthma (<i>n</i> = 41) and healthy controls (<i>n</i> = 20) underwent indirect calorimetry to measure REE, dual-energy X-ray absorptiometry (DEXA) to measure body composition, and 3-day diet records. Clinical assessments included spirometry, fractional exhaled nitric oxide (FENO), and a complete blood count. <b>Results:</b> Asthmatics had greater REE than controls amounting to an increase of ~100 kcals/day, even though body mass index (BMI) and body composition were similar between groups. Inclusion of asthma status and FENO in validated REE prediction equations led to improved estimates. Further, asthmatics had higher white blood cell (control vs. asthma (mean ± SD): 4.7 ± 1.1 vs. 5.9 ± 1.6, <i>p</i> < 0.01) and neutrophil (2.8 ± 0.9 vs. 3.6 ± 1.4, <i>p</i> = 0.02) counts that correlated with REE (both <i>p</i> < 0.01). Interestingly, despite higher REE, asthmatics reported consuming fewer calories (25.1 ± 7.5 vs. 20.3 ± 6.0 kcals/kg/day, <i>p</i> < 0.01) and carbohydrates than controls. <b>Conclusion:</b> REE is elevated in adults with mild asthma, suggesting there is an association between REE and the pathophysiology of asthma.
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