Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Paper
  • Published:

Is there a causal relation between obesity and asthma? Evidence from Chile

Abstract

OBJECTIVE:

An association between obesity and asthma symptoms has been reported in the literature, but such a relationship is inconsistent if atopic status or bronchial hyper responsiveness (BHR) is considered. The objective was to assess the association between obesity and asthma symptoms or BHR in adults.

METHODS:

A study was carried out in 1232 people born between 1974 and 1978 in Chile. The participants completed the European Community Health Survey questionnaire, were skin tested and subject to a BHR challenge to methacholine.

MEASUREMENTS:

Weight, height and waist circumference were measured and body mass index (BMI) was calculated.

RESULTS:

There was a positive association between wheeze and breathlessness following exercise and BMI (both with an OR 1.03, 95% CI 1.00–1.06), the associations with wheeze tended to disappear in women who did react at least to one allergen, and persisted in those who did not react to any allergens. BMI was negatively associated with BHR (OR 0.93, 95% CI 0.89–0.97). Waist circumference was not associated with asthma symptoms and it was negatively associated with BHR.

CONCLUSION:

Although there was an association between BMI and asthma symptoms, there were weaknesses in the evidence because waist circumference, a more direct measure of obesity than BMI, was not associated with asthma symptoms, and BMI and waist circumference were negatively associated with BHR.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Shaheen SO, Sterne JAC, Montgomery SM, Azima H . Birth weight, body mass index and asthma in young adults. Thorax 1999; 54: 396–402.

    Article  CAS  Google Scholar 

  2. Chinn S . Obesity and asthma: evidence for and against a causal relation. J Asthma 2003; 40: 1–16.

    Article  Google Scholar 

  3. Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, Marks JS . Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA 2003; 289: 76–79.

    Article  Google Scholar 

  4. O’Brien PE, Dixon JB . The extent of the problem of obesity. Am J Surg 2002; 184: 4S–8S.

    Article  Google Scholar 

  5. Burney PGJ . Epidemiological trends. In: PJ Barnes, Grunstein MM, AR Leff, AJ Woolcock (eds) Asthma. Lippincott-Raven Publishers: Philadelphia; 1997. pp. 35–47.

    Google Scholar 

  6. Schachter LM, Salome CM, Peat JK, Woolcock AJ . Obesity is a risk for asthma and wheeze but not airway hyper responsiveness. Thorax 2001; 56: 4–8.

    Article  CAS  Google Scholar 

  7. Jarvis D, Chinn S, Potts J, Burney P . On behalf of the European Community Respiratory Health Survey. Association of body mass index with respiratory symptoms and atopy: results from the European Community Respiratory Health Survey. Clin Exp Allergy 2002; 32: 831–837.

    Article  CAS  Google Scholar 

  8. Chinn S, Jarvis D, Burney P . Relation of bronchial responsiveness to body mass index in the ECRHS. European Community Respiratory Health Survey. Thorax 2002; 57: 1028–1033.

    Article  CAS  Google Scholar 

  9. Mallol J, Cortéz E, Amarales L, Sánchez I, Calvo M, Soto S, Strickler A, Kyling A, Sanhueza I, Albornoz C . Prevalence of asthma in Chilean students. Descriptive study of 24,470 children. ISAAC-Chile. Rev Méd Chile 2000; 128: 279–285.

    Article  CAS  Google Scholar 

  10. Filozof C, González C, Sereday M, Mazza C, Braquinsky J . Obesity prevalence and trends in Latin-American countries. Obes Rev 2001; 2: 99–106.

    Article  CAS  Google Scholar 

  11. Kain J, Vío F, Albala C . Obesity trends and determinant factors in Latin America. Cad Saude Publica 2003; 19: S77–S86.

    Article  Google Scholar 

  12. Albala C, Vío F, Kain J, Uauy R . Nutrition transition in Chile: determinants and consequences. Public Health Nutr. 2002; 5: 123–128.

    Article  Google Scholar 

  13. Chile. Ministerio Nacional de Desarrollo y Planificación. http://www.mideplan.cl/casen3/comunal/comuna/marcocon.htm.

  14. ATS standardization of spirometry, 1987 update. Am Rev Respir Dis 1987; 136: 1285–1298.

  15. American Thoracic Society. Guidelines for methacholine and exercise challenge testing-1999 (Official statement of the American Thoracic Society). Am J Respir Crit Care Med 2000; 161: 309–329.

  16. Camargo Jr CA, Weiss ST, Zhang S, Willett WC, Splizer FE . Prospective study of body mass index, weight change, and risk of adult-onset asthma in women. Arch Intern Med 1999; 159: 2582–2588.

    Article  Google Scholar 

  17. Castro-Rodriguez JA, Holberg CJ, Morgan WJ, Wright AL, Martinez FD . Increased incidence of asthmalike symptoms in girls who become overweight or obese during the school years. Am J Respir Crit Care Med 2001; 163: 1344–1349.

    Article  CAS  Google Scholar 

  18. Siersted HC, Walker CM, O’Shaughnessy AD, Willan AR, Wiecek EM, Sears MR . Comparison of two standardized methods of methacholine inhalation challenge in young adults. Eur Respir J 2000; 15: 181–184.

    Article  CAS  Google Scholar 

  19. Crane J, Mallol J, Beasley R, Stewart A, Asher MI . Agreement between written and video questions for comparing asthma symptoms in ISAAC. Eur Respir J 2003; 21: 455–461.

    Article  CAS  Google Scholar 

  20. Janson C, Bjornsson E, Hetta J, Borman G . Anxiety and depression in relation to respiratory symptoms and asthma. Am J Respir Crit Care Med 1994; 149: 930–934.

    Article  CAS  Google Scholar 

  21. Rimington LD, Davies DH, Lowe D, Pearson MG . Relationship between anxiety, depression, and morbidity in adult asthma patients. Thorax 2001; 56: 266–271.

    Article  CAS  Google Scholar 

  22. Stunkard AJ, Faith MS, Allison KC . Depression and obesity. Biol Psychiatry 2003; 54: 330–337.

    Article  Google Scholar 

  23. Onyike CU, Crum RM, Lee HB, Lyketsos CG, Eaton WW . Is obesity associated with major depression? Results from the Third National Health and Nutrition Examination Survey. Am J Epidemiol 2003; 158: 1139–1147.

    Article  Google Scholar 

  24. Ahlberg AC, Ljung T, Rosmond R, McEwen B, Holm G, Akesson HO, Bjorntorp P . Depression and anxiety symptoms in relation to anthropometry and metabolism in men. Psychiatry Res 2002; 112: 101–110.

    Article  Google Scholar 

  25. Becker ES, Margraf J, Turke V, Soeder U, Neumer S . Obesity and mental illness in a representative sample of young women. Int J Obes Relat Metab Disord 2001; 25 (Suppl 1): S5–S9.

    Article  Google Scholar 

  26. 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.

    Article  Google Scholar 

  27. Gibson GJ . Obesity, respiratory function and breathlessness. Thorax 2000; 55 (Suppl 1): S41–S44.

    Article  Google Scholar 

  28. Locke GR, Talley NJ, Fett SL, Zinsmeister AR, Melton LJ . Risk factors associated with symptoms of gastroesophageal reflux. Am J Med 1999; 106: 642–649.

    Article  Google Scholar 

  29. Patterson PE, Harding SM . Gastroesophageal reflux disorders and asthma. Curr Opin Pulm Med 1999; 5: 63–67.

    Article  Google Scholar 

  30. Del-Rio-Navarro BE, Fanghanel G, Berber A, Sánchez-Reyes L, Estrada–Reyes E, Sienra-Monge JJ . The relationship between asthma symptoms and anthropometric markers of overweight in a Hispanic population. J Invest Allergol Clin Immunol 2003; 13: 118–123.

    CAS  Google Scholar 

  31. Kronander UN, Falkenberg M, Zetterstrom O . Prevalence and incidence of asthma related to waist circumference and BMI in a Swedish community sample. Resp Med 2004; 98: 1108–1116.

    Article  Google Scholar 

  32. Pi-Sunyer FX . Symposium on ‘Body weight and obesity: metabolic and clinical aspects’. 1st Plenary Session: ‘Obesity’. Obesity: criteria and classification. Proc Nutr Soc 2000; 59: 505–509.

    Article  CAS  Google Scholar 

  33. Schachter LM, Peat JK, Salome CM . Asthma and atopy in overweight children. Thorax 2003; 58: 1031–1035.

    Article  CAS  Google Scholar 

  34. Huang SL, Shiao G, Chou P . Association between body mass index and allergy in teenage girls in Taiwan. Clin Exp Allergy 1999; 29: 323–329.

    Article  CAS  Google Scholar 

  35. Hill AB . The environment and disease: Association or causation? Proc Roy Soc Med 1965; 58: 295–300.

    CAS  PubMed  Google Scholar 

  36. Rothman KJ, Greenland S . Causation and causal inference. In: Rothman KJ, Greenland S (eds) Modern Epidemiology, 2nd edn. Lippincott-Raven Publishers: Philadelphia; 1998.

    Google Scholar 

Download references

Acknowledgements

We are indebted to Dr E Zumelzu, Ms E Moyano, Ms E Bardian and Ms V Alvear for their dedication in collecting data for the project, and Dr J Céspedes for training our fieldworkers in the measurements of lung function including methacholine challenge. The Wellcome Trust funded the study.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to P Bustos.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bustos, P., Amigo, H., Oyarzún, M. et al. Is there a causal relation between obesity and asthma? Evidence from Chile. Int J Obes 29, 804–809 (2005). https://doi.org/10.1038/sj.ijo.0802958

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0802958

Keywords

This article is cited by

Search

Quick links