Obesity and overweight are significant health problems worldwide, with a rapidly rising prevalence [1]. Obesity and overweight have serious consequences, including higher rates of metabolic syndrome, diabetes, cardiovascular and cerebrovascular diseases, joint disorders and sleep problems. Breathlessness is common in the general adult population, with one study showing that nearly one in 10 had experienced breathlessness sufficient to limit exertion for at least 3 months out of the previous 6 months [2]. Factors contributing to the subjective sensation of breathlessness include respiratory, cardiovascular and neuromuscular disorders. The most frequently attributed underlying aetiology is respiratory disease secondary to smoking [3]. Obesity/overweight and breathlessness share important features: lifestyle factors, prevalence, and cycles of decreasing function, leading to deconditioning that creates synergistic detriment. While the physiological mechanisms of breathlessness in overweight obese adults are unclear, the combination of changes in ventilatory drive and pulmonary mechanics are probably contributory [4]. Understanding the relationship between breathlessness and obesity/overweight is the first step to improving clinical management. The aim of this study was to determine whether obesity/overweight were independently associated with breathlessness in community-dwelling adults. The null hypothesis was that there was no relationship between body mass index (BMI) and breathlessness. We used 2 years of data from the South Australian Health Omnibus Survey (HOS) [5], a multistage, systematic, clustered area sample of households conducted face-to-face annually in spring in participants' homes. Australian Bureau of Statistics (ABS) census collector districts (CCDs) were randomly selected from Adelaide and from country towns with populations of more than 1000 people. Within each CCD, a random starting point was selected, and 10 properties were identified using a fixed skip interval. One person in each household was interviewed by trained interviewers after an introductory letter was sent. Each respondent was asked if he/she had "experienced breathlessness most days for more than 3 months in the past 6 months". To assess the level of exertion needed to induce breathlessness, the survey used the modified Medical Research Council Scale (mMRC) [6], a tool suitable for assessing breathlessness in obese people [7, 8]. Existing evidence has also established a correlation between mMRC and expiratory reserve volume (ERV), forced expiratory volume in 1 s and 6-min walking test distances [7]. Calculation of BMI was performed using respondents' self-reported height and weight, and coded into four World Health Organization (WHO) categories (normal weight (BMI 20-25 kg•m −2); overweight (>25-30 kg•m −2); obese (>30-35 kg•m −2); and severe (>35-40 kg•m −2)/morbid obesity (>40 kg•m −2)) [9]. Adults with a BMI of <20 kg•m −2 were excluded, given the greater likelihood that other pathologies would account for these levels. Data were ...

No abstract

No abstract