Body mass index trajectory classes and incident asthma in childhood: Results from 8 European Birth Cohorts-a Global Allergy and Asthma European Network initiative

Peter Rzehak*, Alet H. Wijga, Thomas Keil, Esben Eller, Carsten Bindslev-Jensen, Henriette A. Smit, Joost Weyler, Sandra Dom, Jordi Sunyer, Michelle A. Mendez, Maties Torrent, Oriol Vall, Carl-Peter Bauer, Dietrich Berdel, Beate Schaaf, Chih-Mei Chen, Anna Bergstroem, Maria P. Fantini, Monique Mommers, Ulrich WahnSusanne Lau, Joachim Heinrich

*Corresponding author for this work

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Background: The causal link between body mass index (BMI) or obesity and asthma in children is still being debated. Analyses of large longitudinal studies with a sufficient number of incident cases and in which the time-dependent processes of both excess weight and asthma development can be validly analyzed are lacking. Objective: We sought to investigate whether the course of BMI predicts incident asthma in childhood. Methods: Data from 12,050 subjects of 8 European birth cohorts on asthma and allergies were combined. BMI and doctor-diagnosed asthma were modeled during the first 6 years of life with latent growth mixture modeling and discrete time hazard models. Subpopulations of children were identified with similar standardized BMI trajectories according to age-and sex-specific "World Health Organization (WHO) child growth standards" and "WHO growth standards for school aged children and adolescents" for children up to age 5 years and older than 5 years, respectively (BMI-SDS). These types of growth profiles were analyzed as predictors for incident asthma. Results: Children with a rapid BMI-SDS gain in the first 2 years of life had a higher risk for incident asthma up to age 6 years than children with a less pronounced weight gain slope in early childhood. The hazard ratio was 1.3 (95% CI, 1.1-1.5) after adjustment for birth weight, weight-for-length at birth, gestational age, sex, maternal smoking in pregnancy, breastfeeding, and family history of asthma or allergies. A rapid BMI gain at 2 to 6 years of age in addition to rapid gain in the first 2 years of life did not significantly enhance the risk of asthma. Conclusion: Rapid growth in BMI during the first 2 years of life increases the risk of asthma up to age 6 years.
Original languageEnglish
Pages (from-to)1528-1536
JournalJournal of Allergy and Clinical Immunology
Issue number6
Publication statusPublished - Jun 2013


  • Body mass index
  • rapid growth
  • asthma
  • child
  • latent growth mixture model
  • European birth cohorts
  • Global Allergy and Asthma European Network

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