Respiratory decline associated with BMI, weight gain in adulthood
Respiratory function decline is associated with weight gain and high BMI in adulthood but can be reversed through maintaining a healthy BMI and losing weight, according to a study published in Thorax.
“Our study reinforces the public health message that overweight, obesity and excessive weight gain in adulthood have deleterious effects on respiratory health,” Gabriela P. Peralta, MA, and Judith Garcia Aymerich, PhD, researchers at the Barcelona Institute for Global Health, a center supported by La Caixa Foundation in Barcelona, Spain, wrote in an email to Healio Pulmonology. “However, we also show that the negative effects of obesity on lung capacity can be reversed by weight loss even in adult life.”
A total of 3,673 participants aged 20 to 44 years were enrolled from 1991 to 1993 in the 20-year study. Follow-up evaluations occurred from 1999 and 2003 when participants were aged 27 to 57 years and from 2010 to 2014 when participants were aged 39 to 67 years. Measurements of each participant’s weight, FVC and FEV1 were taken during the three study waves. At baseline, 12% of participants were underweight, 57% were normal weight, 24% were overweight and 6% were obese.
During follow-up, 4% of participants lost weight, 34% maintained weight, 53% had moderate weight gain and 9% had high weight gain. Normal-weight, overweight and obese participants with moderate and high weight gain exhibited significant increases in FVC and FEV1 decline than those who maintained weight.
The researchers also estimated differences in FVC at ages 25 and 65 years according to weight change profile. Results showed that when compared with normal-weight participants who maintained weight, overweight and obese participants would have lower FVC at 65 years despite having similar estimated FVC levels at 25 years. The researchers also estimated that obese participants had lower FVC at age 25 years than normal-weight participants. However, estimated FVC at age 65 years did not differ significantly between obese participants who lost weight during follow-up and normal-weight participants who maintained weight during follow-up.
“We observed that in participants with obesity in young adulthood, weight loss during the study period was associated with attenuated decline in lung capacity. Therefore, our study suggests that the negative effects of obesity on lung function can be reversed by weight loss,” Peralta and Aymerich said.
Potential mechanisms to explain the association between weight loss and reduction of lung function in obese individuals is weight gain affecting lung function mechanics through decreasing room for lung expansion and causing lung function decline through inflammatory processes caused by adipose tissue, according to researchers.
“Further research is needed to understand the mechanisms underlying the association of weight change with lung function,” Peralta and Aymerich told Healio Pulmonology. “Also, it is important that future research investigates the role of body composition change on lung function decline. Weight change during adult life may be a consequence of changes in muscle mass and/or fat mass, which may have different effects on respiratory health.” – by Erin T. Welsh
Disclosures: Peralta reports no relevant financial disclosures. Aymerich reports receiving fees from Esteve, Chiesi and AstraZeneca. Please see the study for all other authors’ relevant financial disclosures.