Thorax 64:889-893 doi:10.1136/thx.2009.114579
  • Asthma

Obesity, waist size and prevalence of current asthma in the California Teachers Study cohort

  1. J Von Behren1,
  2. M Lipsett2,
  3. P L Horn-Ross1,3,
  4. R J Delfino4,
  5. F Gilliland5,
  6. R McConnell5,
  7. L Bernstein6,
  8. C A Clarke1,3,
  9. P Reynolds1,3
  1. 1
    Northern California Cancer Center, Berkeley and Fremont, California, USA
  2. 2
    Environmental Health Investigations Branch, California Department of Public Health, Richmond, California, USA
  3. 3
    Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California, USA
  4. 4
    Department of Epidemiology, School of Medicine, University of California, Irvine, California, USA
  5. 5
    Keck School of Medicine, University of Southern California, Los Angeles, California, USA
  6. 6
    Department of Cancer Etiology, City of Hope National Medical Center, Duarte, California, USA
  1. Correspondence to Ms J Von Behren, Northern California Cancer Center, 2001 Center Street, Suite 700, Berkeley, CA 94704, USA; jvonbehren{at}
  • Received 29 January 2009
  • Accepted 6 July 2009
  • Published Online First 25 August 2009


Background: Obesity is a risk factor for asthma, particularly in women, but few cohort studies have evaluated abdominal obesity which reflects metabolic differences in visceral fat known to influence systemic inflammation. A study was undertaken to examine the relationship between the prevalence of asthma and measures of abdominal obesity and adult weight gain in addition to body mass index (BMI) in a large cohort of female teachers.

Methods: Prevalence odds ratios (ORs) for current asthma were calculated using multivariable linear modelling, adjusting for age, smoking and race/ethnicity.

Results: Of the 88 304 women in the analyses, 13% (n = 11 500) were obese (BMI ⩾30 kg/m2) at baseline; 1334 were extremely obese (BMI ⩾40 kg/m2). Compared with those of normal weight, the adjusted OR for adult-onset asthma increased from 1.40 (95% confidence interval (CI) 1.31 to 1.49) for overweight women to 3.30 (95% CI 2.85 to 3.82) for extremely obese women. Large waist circumference (>88 cm) was associated with increased asthma prevalence, even among women with a normal BMI (OR 1.37, 95% CI 1.18 to 1.59). Among obese women the OR for asthma was greater in those who were also abdominally obese than in women whose waist was ⩽88 cm (2.36 vs 1.57). Obese and overweight women were at greater risk of severe asthma episodes, measured by urgent medical visits and hospital admissions.

Conclusions: This study confirms the association between excess weight and asthma severity and prevalence, and showed that a large waist was associated with increased asthma prevalence even among women considered to have normal body weight.


  • Funding National Cancer Institute (R01 CA77398, R01 CA105224).

  • Competing interests None.

  • Provenance and Peer review Not commissioned; not externally peer reviewed.

  • Ethics approval The use of human subject data was approved by the California Committee for the Protection of Human Subjects and the institutional review boards of the participating institutions.