American Journal of Respiratory and Critical Care Medicine Vol 175. pp. 661-666, (2007)
© 2007 American Thoracic Society
Overweight, Obesity, and Incident Asthma
A Meta-analysis of Prospective Epidemiologic Studies
David A. Beuther1,2 and E. Rand Sutherland1,2
1 Department of Medicine, National Jewish Medical and Research Center, Denver, Colorado; and 2 University of Colorado at Denver and Health Sciences Center, Denver, Colorado
Correspondence and requests for reprints should be addressed to E. Rand Sutherland, M.D., M.P.H., National Jewish Medical and Research Center, 1400 Jackson Street, J220, Denver, CO 80206. E-mail: email@example.com
Rationale: Although obesity has been implicated as an asthma risk factor, there is heterogeneity in the published literature regarding its role in asthma incidence, particularly in men.
Objectives: To quantify the relationship between categories of body mass index (BMI) and incident asthma in adults and to evaluate the impact of sex on this relationship.
Methods: Online bibliographic databases were searched for prospective studies evaluating BMI and incident asthma in adults. Independent observers extracted data regarding annualized asthma incidence from studies meeting predetermined criteria, within defined categories of normal weight (BMI < 25), overweight (BMI, 25–29.9), and obesity (BMI 30). Data were analyzed by inverse-variance–weighted, random-effects meta-analysis. Stratified analysis between BMI categories and within sex was performed.
Results: Seven studies (n = 333,102 subjects) met inclusion criteria. Compared with normal weight, overweight and obesity (BMI 25) conferred increased odds of incident asthma, with an odds ratio (OR) of 1.51 (95% confidence interval [CI], 1.27–1.80). A dose–response effect of elevated BMI on asthma incidence was observed; the OR for incident asthma for normal-weight versus overweight subjects was 1.38 (95% CI, 1.17–1.62) and was further elevated for normal weight versus obesity (OR, 1.92; 95% CI, 1.43–2.59; p < 0.0001 for the trend). A similar increase in the OR of incident asthma due to overweight and obesity was observed in men (OR, 1.46; 95% CI, 1.05–2.02) and women (OR, 1.68; 95% CI, 1.45–1.94; p = 0.232 for the comparison).
Conclusions: Overweight and obesity are associated with a dose-dependent increase in the odds of incident asthma in men and women, suggesting asthma incidence could be reduced by interventions targeting overweight and obesity.
- Beuther DA, Weiss ST, Sutherland ER. Obesity and asthma. Am J Respir Crit Care Med 2006;174:112–119.[Abstract/Free Full Text]
- Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002. JAMA 2004;291:2847–2850.[Abstract/Free Full Text]
- Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL. Overweight and obesity in the United States: prevalence and trends, 1960–1994. Int J Obes Relat Metab Disord 1998;22:39–47.[CrossRef][Medline]
- Schiller JS, Bernadel L. Summary health statistics for the US population: National Health Interview Survey, 2002. Vital Health Stat 10 2004;220:1–101.
- 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.[Abstract/Free Full Text]
- Chen Y, Dales R, Krewski D, Breithaupt K. Increased effects of smoking and obesity on asthma among female Canadians: the National Population Health Survey, 1994–1995. Am J Epidemiol 1999;150:255–262.[Abstract/Free Full Text]
- Guerra S, Sherrill DL, Bobadilla A, Martinez FD, Barbee RA. The relation of body mass index to asthma, chronic bronchitis, and emphysema. Chest 2002;122:1256–1263.
- Shaheen SO, Sterne JA, Montgomery SM, Azima H. Birth weight, body mass index and asthma in young adults. Thorax 1999;54:396–402.[Abstract/Free Full Text]
- Ford ES. The epidemiology of obesity and asthma. J Allergy Clin Immunol 2005;115:897–909.[CrossRef][Medline]
- Camargo CA Jr, Weiss ST, Zhang S, Willett WC, Speizer FE. Prospective study of body mass index, weight change, and risk of adult-onset asthma in women. Arch Intern Med 1999;159:2582–2588.[Abstract/Free Full Text]
- 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.[Abstract/Free Full Text]
- Gunnbjornsdottir MI, Omenaas E, Gislason T, Norrman E, Olin AC, Jogi R, Jensen EJ, Lindberg E, Bjornsson E, Franklin K, et al. Obesity and nocturnal gastro-oesophageal reflux are related to onset of asthma and respiratory symptoms. Eur Respir J 2004;24:116–121.[Abstract/Free Full Text]
- Chen Y, Dales R, Tang 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.[Abstract/Free Full Text]
- 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.[Abstract/Free Full Text]
- Huovinen E, Kaprio J, Koskenvuo M. Factors associated to lifestyle and risk of adult onset asthma. Respir Med 2003;97:273–280.[CrossRef][Medline]
- Beuther DA, Sutherland ER. Obesity, overweight and the odds of incident asthma: a meta-analysis. Proc Am Thorac Soc 2006;3:A527.
- Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB. Meta-analysis of observational studies in epidemiology: a proposal for reporting: Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 2000;283:2008–2012.[Abstract/Free Full Text]
- Sterne JAC, Bradburn MJ, Egger M. Meta-analysis in Stata. In: Egger M, Altman DG, Smith GD, editors. Systematic reviews in health care: meta-analysis in context. London, UK: BMJ Publishing Group; 2001. pp. 347–372.
- Cochran WG. The combination of estimates from different experiments. Biometrics 1954;10:101–129.[Medline]
- DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials 1986;7:177–188.[CrossRef][Medline]
- Light RJ, Singer JD, Willett JB. The visual presentation and interpretation of meta-analysis. In: Cooper H, Hedges LV, editors. The handbook of research synthesis. New York: Russell Sage Foundation; 1994. pp. 439–454.
- Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics 1994;50:1088–1101.[CrossRef][Medline]
- Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997;315:629–634.[Abstract/Free Full Text]
- Romieu I, Avenel V, Leynaert B, Kauffmann F, Clavel-Chapelon F. Body mass index, change in body silhouette, and risk of asthma in the E3N cohort study. Am J Epidemiol 2003;158:165–174.[Abstract/Free Full Text]
- Kim S, Camargo CA Jr. Sex-race differences in the relationship between obesity and asthma: the behavioral risk factor surveillance system, 2000. Ann Epidemiol 2003;13:666–673.[CrossRef][Medline]
- Luder E, Ehrlich RI, Lou WY, Melnik TA, Kattan M. Body mass index and the risk of asthma in adults. Respir Med 2004;98:29–37.[CrossRef][Medline]
- Huovinen E, Kaprio J, Laitinen LA, Koskenvuo M. Incidence and prevalence of asthma among adult Finnish men and women of the Finnish Twin Cohort from 1975 to 1990, and their relation to hay fever and chronic bronchitis. Chest 1999;115:928–936.
- Sama SR, Hunt PR, Cirillo CI, Marx A, Rosiello RA, Henneberger PK, Milton DK. A longitudinal study of adult-onset asthma incidence among HMO members. Environ Health 2003;2:10.[CrossRef][Medline]
- Gilliland FD, Berhane K, Islam T, McConnell R, Gauderman WJ, Gilliland SS, Avol E, Peters JM. Obesity and the risk of newly diagnosed asthma in school-age children. Am J Epidemiol 2003;158:406–415.[Abstract/Free Full Text]
- Hu FB, Willett WC, Li T, Stampfer MJ, Colditz GA, Manson JE. Adiposity as compared with physical activity in predicting mortality among women. N Engl J Med 2004;351:2694–2703.[Abstract/Free Full Text]
- Ochs-Balcom HM, Grant BJ, Muti P, Sempos CT, Freudenheim JL, Trevisan M, Cassano PA, Iacoviello L, Schunemann HJ. Pulmonary function and abdominal adiposity in the general population. Chest 2006;129:853–862.
- Larsson I, Henning B, Lindroos AK, Naslund I, Sjostrom CD, Sjostrom L. Optimized predictions of absolute and relative amounts of body fat from weight, height, other anthropometric predictors, and age. Am J Clin Nutr 2006;83:252–259.[Abstract/Free Full Text]
- Beuther DA, Sutherland ER. Obesity and pulmonary function testing. J Allergy Clin Immunol 2005;115:1100–1101.[CrossRef][Medline]
- Peters-Golden M, Swern A, Bird SS, Hustad CM, Grant E, Edelman JM. Influence of body mass index on the response to asthma controller agents. Eur Respir J 2006;27:495–503.[Abstract/Free Full Text]
- Biring MS, Lewis MI, Liu JT, Mohsenifar Z. Pulmonary physiologic changes of morbid obesity. Am J Med Sci 1999;318:293–297.[CrossRef][Medline]
- Naimark A, Cherniack RM. Compliance of the respiratory system and its components in health and obesity. J Appl Physiol 1960;15:377–382.[Abstract/Free Full Text]
- Cournand A, Richards DW Jr, Bader RA, Bader ME, Fishman AP. The oxygen cost of breathing. Trans Assoc Am Physicians 1954;67:162–173.[Medline]
- Hampel H, Abraham NS, El-Serag HB. Meta-analysis: obesity and the risk for gastroesophageal reflux disease and its complications. Ann Intern Med 2005;143:199–211.[Abstract/Free Full Text]
- Jacobson BC, Somers SC, Fuchs CS, Kelly CP, Camargo CA Jr. Body-mass index and symptoms of gastroesophageal reflux in women. N Engl J Med 2006;354:2340–2348.[Abstract/Free Full Text]
- Sin DD, Jones RL, Man SF. Obesity is a risk factor for dyspnea but not for airflow obstruction. Arch Intern Med 2002;162:1477–1481.[Abstract/Free Full Text]
- Schachter LM, Salome CM, Peat JK, Woolcock AJ. Obesity is a risk for asthma and wheeze but not airway hyperresponsiveness. Thorax 2001;56:4–8.[Abstract/Free Full Text]
- Hakala K, Stenius-Aarniala B, Sovijarvi A. Effects of weight loss on peak flow variability, airways obstruction, and lung volumes in obese patients with asthma. Chest 2000;118:1315–1321.
- Aaron SD, Fergusson D, Dent R, Chen Y, Vandemheen KL, Dales RE. Effect of weight reduction on respiratory function and airway reactivity in obese women. Chest 2004;125:2046–2052.
- National Task Force on the Prevention and Treatment of Obesity. Overweight, obesity, and health risk. Arch Intern Med 2000;160:898–904.[Abstract/Free Full Text]
- Must A, Spadano J, Coakley EH, Field AE, Colditz G, Dietz WH. The disease burden associated with overweight and obesity. JAMA 1999;282:1523–1529.[Abstract/Free Full Text]
children’s ALLERGY CENTER online
JL TAMAN BENDUNGAN ASAHAN 5 JAKARTA PUSAT, JAKARTA INDONESIA 10210
PHONE : (021) 70081995 – 5703646
email : firstname.lastname@example.org\
Information on this web site is provided for informational purposes only and is not a substitute for professional medical advice. You should not use the information on this web site for diagnosing or treating a medical or health condition. You should carefully read all product packaging. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.
Copyright © 2010, Children Allergy Center Information Education Network. All rights reserved