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Body Mass Index and Asthma in the Military Population of the Northwestern United States
Sylvia Y. N. Young, MD, MPH;
Jeffrey D. Gunzenhauser, MD, MPH;
Kathleen E. Malone, PhD;
Anne McTiernan, MD, PhD
Arch Intern Med. 2001;161:1605-1611.
Background Patients with asthma commonly have other medical problems such as obesity,
but it is unclear if obesity independently relates to asthma occurrence.
Objective To examine the association between asthma and obesity.
Methods We studied enrollees aged 17 to 96 years in region 11 of TRICARE, a
military managed health care program encompassing Washington, Oregon, and
northern Idaho, using an enrollment questionnaire from January 1997 to December
1998. We performed case-control analyses on 2788 asthma cases and 39 637
controls. From these cases and controls, we selected a random sample of 1000
asthma cases and 1000 controls, linking them to a computerized military health
record system to verify if medications indicated for asthma therapy were prescribed.
After excluding cases not prescribed bronchodilator medications and excluding
controls prescribed bronchodilator medications or steroids, we used logistic
regression to estimate associations among asthma, body mass index, and demographic,
lifestyle, and comorbid risk factors in 386 verified cases and 744 verified
controls.
Results Increasing body mass index, younger age, female sex, non–active
duty beneficiary status, and arthritis were significant independent predictors
of asthma prevalence in both our larger analysis and our verified substudy,
whereas stomach ulcer, depression, hypertension, and white race are also independent
predictors of asthma prevalence in our larger analysis.
Conclusions Increasing body mass index is a key factor predicting prevalence of
asthma and, if determined to be etiologically related to asthma incidence,
is a potentially modifiable risk factor for asthma.
From the Department of Epidemiology, Navy Environmental and Preventive
Medicine Unit No. 7, Sigonella, Italy (Dr Young); Preventive Medicine Service,
Madigan Army Medical Center, Tacoma, Wash (Drs Young and Gunzenhauser); and
Fred Hutchinson Cancer Research Center (Drs Malone and McTiernan), Department
of Epidemiology, University of Washington School of Public Health and Community
Medicine (Drs Malone and McTiernan), and Department of Geriatrics, University
of Washington School of Medicine (Dr McTiernan), Seattle.
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