Abstract
Studies focusing on obesity and asthma frequently consider the weight at a given time; thus, modeling pathways through lifetime overweight may contribute to elucidate temporal aspects in this relationship. This study modeled the pathways in the association of lifetime overweight with asthma in adult life, using data from the 1978/1979 Birth Cohort, Ribeirão Preto, São Paulo, Brazil (n = 2,063) at birth (baseline), school age (9/11 years) and adult age (23/25 years). A theoretical model was proposed to explore the effects of lifetime overweight on asthma in adult life analyzed by structural equation modeling. Parental obesity (SC - standardized coefficenttotal = 0.211, p < 0.001; SCdirect = 0.115, p = 0.007) and overweight at school age (SCtotal = 0.565, p < 0.0001; SCdirect = 0.565, p < 0.0001) were associated with overweight in adult life. Parental obesity (SCdirect = 0.105, p = 0.047) and nutritional status at birth (SCtotal = -0.124, p = 0.009; SCdirect = -0.131, p = 0.007) were associated with asthma in adult life. A higher "current adult socieconomic situation" was inversely associated to overweight (SCdirect = -0.171, p = 0.020) and to asthma in adult life (SCtotal = -0.179, p = 0.041; SCdirect = -0.182, p = 0.039). Parental obesity showed a transgenerational effect in weight, triggering to childhood and adulthood overweight. Parallel to underweight at birth, parental obesity was also a risk to asthma in adult life. While, the socioeconomic status in adult life protected from both, overweight and asthma.
Highlights
IntroductionAsthma is a chronic disease that affects 235 million people all over the world 1; and that is being consistently associated with other non-communicable chronic diseases (NCCD) 2 with which it appears to share physiopathological mechanisms that need to be better explored [3,4]
Asthma is a chronic disease that affects 235 million people all over the world 1; and that is being consistently associated with other non-communicable chronic diseases (NCCD) 2 with which it appears to share physiopathological mechanisms that need to be better explored [3,4].Obesity is an important risk factor for NCCD, which is being associated with asthma from birth to adulthood [5,6,7,8,9]
Indicators being used in the formation of the latent variable “Asthma” in the Structural equation modeling (SEM) analysis
Summary
Asthma is a chronic disease that affects 235 million people all over the world 1; and that is being consistently associated with other non-communicable chronic diseases (NCCD) 2 with which it appears to share physiopathological mechanisms that need to be better explored [3,4]. Obesity is an important risk factor for NCCD, which is being associated with asthma from birth to adulthood [5,6,7,8,9]. Overweight and obesity have been associated with asthma in adults, with a dose-response effect on body mass index (BMI) 9. Studies focusing on obesity and asthma frequently consider overweight at a given time [13,14,15,16]. Few prospective studies on the association between obesity and asthma have adjusted the model for birth variables using regression models [17,18]
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