Weight gain from early to middle adulthood increases the risk of incident asthma later in life in the United States: a retrospective cohort study

Abstract

Background Data describing the effects of weight change across adulthood on asthma are important for the prevention of asthma. This study aimed to investigate the association between weight change from early to middle adulthood and risk of incident asthma. Methods Using data from the National Health and Nutrition Examination Survey (NHANES), we performed a nationally retrospective cohort study of the U.S. general population. A total of 20,771 people aged 40–74 years with recalled weight at young and middle adulthood were included in the cohort. Four weight change groups were categorized: stable non-obesity, non-obesity to obesity, obesity to non-obesity, and stable obesity. Hazard ratios (HRs) and 95% confidence intervals (CIs) relating weight change to incident asthma over 10 years of follow-up were calculated using Cox models adjusting for covariates. Results Compared with the stable non-obesity group, the HRs of incident asthma were 1.63 (95% CI = 1.29 to 2.07, P < 0.001) for the non-obesity to obesity group, 1.41 (95% CI = 0.97 to 2.05, P = 0.075) for stable obesity group, and 1.21 (95% CI = 0.41 to 3.62, P = 0.730) for the obesity to non-obesity group. In addition, participants who gained more than 20 kg from young to middle adulthood had a HR of 1.53 (95% CI = 1.15 to 2.03, P = 0.004), compared with those whose weight remained stable (weight change within 2.5 kg). Conclusions Weight gain from early to middle adulthood was associated with higher risk of incident asthma as compared to those who maintained normal weight. Thus, maintaining normal weight throughout adulthood might be important for the primary prevention of adult-onset asthma.

Association of weight change patterns across adulthood with incident asthma: a retrospective cohort study

“…Secondly, they used different reference groups, included different number of cases and there were also some differences in the definitions of weight change patterns 14 . Wang et al found the risk of developing asthma increased 1.61 and 1.43 in the non-obese to obese group and the stable obese group, respectively by using the data from NHANES (1999–2016) 15 . Their study focused on obese participants.…”

“…Then, we divided the absolute weight changes into five groups: weight loss > 2.5 kg, weight change within 2.5 kg (the absolute weight loss or weight gain ≤ 2.5 kg), 2.5 kg < weight gain ≤ 9.9 kg, 10 kg ≤ weight gain ≤ 19.9 kg, and weight gain ≥ 20.0 kg, weight change within 2.5 kg was used as the reference group. We chose these categories for comparison with the previous studies 15 , 36 – 38 .…”

“…Two recent studies used KNHANES and NHANES data to analyze the association between weight change from young adulthood to midlife and incident asthma, the results of the two studies were inconsistent 14 , 15 . In addition, there were more overweight participants than obese participants.…”

“…In addition, there were more overweight participants than obese participants. In the previous study, weight status was divided into obese and non-obese, with overweight included in the non-obese group as a reference group 15 . The relationship between weight changed in overweight participants and the risk of asthma was unclear.…”

The association between body mass index, abdominal fatness, and weight change and the risk of adult asthma: a systematic review and meta-analysis of cohort studies

“…Most of the available studies have reported a dose–response relation between increasing BMI and asthma incidence, but studies have differed somewhat with regard to what BMI level risk of asthma starts to increase 6 – 21 . Fewer studies have been published on other measures of adiposity and risk of asthma, but four studies reported increased asthma risk with increasing waist circumference 7 , 11 , 13 , 21 , while three studies reported an increased risk with greater weight gain 10 , 16 , 22 , and a fourth study found no clear association 18 . In contrast, studies have generally reported no association between weight loss and asthma 10 , 16 , 18 , 22 .…”