Obesity has been associated with increased risk of adult asthma, however, not all studies have found a clear association between overweight and the incidence of asthma, and data on other adiposity measures have been limited. Hence, we aimed to summarize evidence on association between adiposity and adult asthma. Relevant studies were retrieved through searches conducted in PubMed, and EMBASE up to March 2021. A total of sixteen studies (63,952 cases and 1,161,169 participants) were included in the quantitative synthesis. The summary RR was 1.32 (95% CI 1.21–1.44, I2 = 94.6%, pheterogeneity < 0.0001, n = 13) per 5 kg/m2 increase in BMI, 1.26 (95% CI 1.09–1.46, I2 = 88.6%, pheterogeneity < 0.0001, n = 5) per 10 cm increase in waist circumference and 1.33 (95% CI 1.22–1.44, I2 = 62.3%, pheterogeneity= 0.05, n = 4) per 10 kg increase in weight gain. Although the test for nonlinearity was significant for BMI (pnonlinearity < 0.00001), weight change (pnonlinearity = 0.002), and waist circumference (pnonlinearity = 0.02), there was a clear dose-response relationship between higher levels of adiposity and asthma risk. The magnitude of the associations and the consistency of the results across studies and adiposity measures provide strong evidence that overweight and obesity, waist circumference and weight gain increases asthma risk. These findings support policies to curb the global epidemic of overweight and obesity.

Obesity correlate with increasing risk of adult asthma. However, not all studies have found a clear association between overweight and the incidence of asthma, and data on other adiposity measures have been limited. Hence, we aimed to summarize evidence on association between adiposity and adult asthma. Relevant studies were retrieved through searches conducted in PubMed, and EMBASE up to March 2021. A total of fifteen studies (63,952 cases and 1,161,169 participants) were eligible for the quantitative synthesis. The pooled RR per 5 kg/m2 increase in BMI was 1.32 (95% CI 1.21–1.44, I2 = 94.6%, pheterogeneity<0.0001, n = 13), 1.26 (95% CI: 1.09–1.46, I2 = 88.6%, pheterogeneity<0.0001, n = 5) per 10 cm increase in waist circumference and 1.33 (95% CI: 1.221.44, I2 = 62.3%, pheterogeneity=0.05, n = 4) per 10 kg increase in weight gain. There was a significant on test of nonlinearity for BMI (pnonlinearity<0.00001), weight change (pnonlinearity=0.002), and waist circumference (pnonlinearity=0.02). The magnitude of the associations and the consistency of the results across studies and adiposity measures provide strong evidence that overweight and obesity, waist circumference and weight gain increases asthma risk. These findings support policies to curb the global epidemic of excess weight.