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Obesity May Be Linked to Adult-Onset Asthma in Women

WebMD Health News

Dec. 1, 1999 (New York) -- Have researchers uncovered yet one more reason to lose weight? According to a report in the Nov. 22 Archives of Internal Medicine, investigators have found a link between high body mass index in women and an increased risk of developing adult-onset asthma.

The association is strongest using the most stringent criteria for diagnosing asthma, the study's lead researcher tells WebMD. But some commentators say that the association may not be strong enough for physicians to act upon, and, as is typical in the field of research, they say more studies are needed to confirm the findings.

The study is yet one more piece of data showing that asthma is more prevalent in populations where obesity is widespread, according to Carlos A. Camargo Jr., MD, who led the study. Researchers analyzed data from the Nurses' Health Study, a study of female U.S. registered nurses between the ages of 25 and 46. The Nurses' Health Study permits analysis of a wide variety of variables and has been used for years to assess risk factors for a variety of diseases.

Camargo, an assistant professor of medicine at Harvard Medical School, tells WebMD that the analysis used high-quality techniques to eliminate the possibility that other variables -- such as smoking, physical activity, or race -- might be the more likely explanation for their finding.

Analyzing data on nearly 86,000 nurses, the researchers found that "body mass index had a strong, independent, and positive association with the risk of developing adult-onset asthma," says Camargo. Body mass index (BMI) is a measurement of weight related to height.

He also points out that in many of the communities where asthma is prevalent in children, such as the South Bronx and Harlem, those same children are often overweight. He says that new data will show the association that his group found in other populations. It will also demonstrate a link between obesity and inflammation, perhaps the most widely recognized mechanism that causes asthma.

But experts tell WebMD that while the results are provocative, there is a question whether obesity really is a major culprit for adult-onset asthma. There is also question over whether weight control for asthmatics should be embraced as a key prevention strategy.

"In a study like the Nurses' Health Study, there are more than 900 variables," says Albert Wu, MD, MPH, in an interview seeking objective commentary on the study. "There are many, many predictive variables and there is the possibility of a spurious association." Wu is associate professor of healthy policy and management and medicine at Johns Hopkins University in Baltimore.

Before recommending weight loss as a strategy to prevent adult-onset asthma, Wu tells WebMD that "the finding needs to be replicated in a study intended to answer the question." In the Nurses' Health Study, Wu says, "there are so many potential associations that there is always the risk of chance, and that it is not a true association." Because the Nurses' Health Study has such a "large number of candidate variables and an equally large number of disease and other health outcomes," he says, "that a finding like this deserves to be replicated."

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