Body‐mass index as a predictor of incident asthma in a prospective cohort of children

An epidemic rise in asthma has occurred concurrently with a rise in overweight among United States children, but it is unclear whether body weight affects the risk of incident childhood asthma. We studied the prospective relation of body‐mass index (BMI) to incident asthma in a longitudinal study of 9,828 children aged 6–14 years, examined annually over a median follow‐up time of 5 years in six US cities. An increased risk of a new asthma diagnosis in girls was associated with higher BMI at entry into the study (P = 0.009) and greater increase in BMI during follow‐up (P = 0.0003). Compared with girls in the leanest quintile of BMI at entry (age taken into account), girls in the top quintile of adiposity had 2.2 times greater risk of incident asthma with any wheeze in subsequent years. Girls with the largest annual rate of increase in BMI (top compared to bottom quintile, age taken into account) had 1.5 times the risk of asthma with any wheeze, and 2.2 times the risk of asthma with persistent wheeze. Boys with the largest and smallest annual changes in BMI also had an increased risk of asthma. For girls, overweight contributes to development of asthma. For boys and girls, extremes of annual BMI growth rates increase the risk of asthma. Pediatr Pulmonol. 2003; 36:514–521. © 2003 Wiley‐Liss, Inc.

[1]  L. Palmer,et al.  Body mass index and asthma in adults in families of subjects with asthma in Anqing, China. , 2001, American journal of respiratory and critical care medicine.

[2]  D. Dockery,et al.  Relation of body mass index to asthma and atopy in children: the National Health and Nutrition Examination Study III , 2001, Thorax.

[3]  J. Castro‐Rodriguez,et al.  Increased incidence of asthmalike symptoms in girls who become overweight or obese during the school years. , 2001, American journal of respiratory and critical care medicine.

[4]  G. Colditz,et al.  Activity, Dietary Intake, and Weight Changes in a Longitudinal Study of Preadolescent and Adolescent Boys and Girls , 2000, Pediatrics.

[5]  W. Willett,et al.  Prospective study of body mass index, weight change, and risk of adult-onset asthma in women. , 1999, Archives of internal medicine.

[6]  M. Thun,et al.  Body-mass index and mortality in a prospective cohort of U.S. adults. , 1999, The New England journal of medicine.

[7]  J. Dixon,et al.  Marked Improvement in Asthma after Lap-Band® Surgery for Morbid Obesity , 1999, Obesity surgery.

[8]  H. Burge,et al.  Predictors of repeated wheeze in the first year of life: the relative roles of cockroach, birth weight, acute lower respiratory illness, and maternal smoking. , 1999, American journal of respiratory and critical care medicine.

[9]  W. Dietz,et al.  Introduction: the use of body mass index to assess obesity in children. , 1999, The American journal of clinical nutrition.

[10]  A. Litonjua,et al.  The FEF25-75/FVC ratio is associated with methacholine airway responsiveness. The normative aging study. , 1999, American journal of respiratory and critical care medicine.

[11]  J. Sterne,et al.  Birth weight, body mass index and asthma in young adults , 1999, Thorax.

[12]  Huang,et al.  Association between body mass index and allergy in teenage girls in Taiwan , 1999, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[13]  R. Considine,et al.  Effect of obesity on estradiol level, and its relationship to leptin, bone maturation, and bone mineral density in children. , 1998, The Journal of clinical endocrinology and metabolism.

[14]  B. Rosner,et al.  Percentiles for body mass index in U.S. children 5 to 17 years of age. , 1998, The Journal of pediatrics.

[15]  P. Kern Potential Role of TNFα and Lipoprotein Lipase as Candidate Genes for Obesity , 1997 .

[16]  J Van den Broeck,et al.  Anthropometry and body composition in children. , 1997, Hormone research.

[17]  D. Dockery,et al.  Effects of cigarette smoking on lung function in adolescent boys and girls. , 1996, The New England journal of medicine.

[18]  G A Colditz,et al.  Television viewing as a cause of increasing obesity among children in the United States, 1986-1990. , 1996, Archives of pediatrics & adolescent medicine.

[19]  W. Willett,et al.  Menopause, postmenopausal estrogen preparations, and the risk of adult-onset asthma. A prospective cohort study. , 1995, American journal of respiratory and critical care medicine.

[20]  G A Colditz,et al.  Alcohol, height, and adiposity in relation to estrogen and prolactin levels in postmenopausal women. , 1995, Journal of the National Cancer Institute.

[21]  D. Dockery,et al.  Gender- and race-specific effects of asthma and wheeze on level and growth of lung function in children in six U.S. cities. , 1994, American journal of respiratory and critical care medicine.

[22]  D. Dockery,et al.  Race and gender differences in respiratory illness prevalence and their relationship to environmental exposures in children 7 to 14 years of age. , 1993, The American review of respiratory disease.

[23]  David Wypij,et al.  Pulmonary function between 6 and 18 years of age , 1993, Pediatric pulmonology.

[24]  R. Kuczmarski Trends in body composition for infants and children in the U.S. , 1993, Critical reviews in food science and nutrition.

[25]  D. Dockery,et al.  Predictors of asthma and persistent wheeze in a national sample of children in the United States. Association with social class, perinatal events, and race. , 1990, The American review of respiratory disease.

[26]  B. Macmahon,et al.  Obesity, serum cholesterol, and estrogens in premenopausal women. , 1983, Oncology.