Obesity Strongly Associated with COPD In “Never-Smokers”

Chronic Obstructive Pulmonary Disease (COPD) is much more common among never-smoking older women who are morbidly obese (having a body mass index of 40 or higher) than among their female peers in the normal weight range. Morbidly obese older men who have never smoked also had a much higher prevalence of COPD than never-smoking men who were normal weight, reported lead author professor Esme Fuller-Thomson, Sandra Rotman, endowed chair at University of Toronto's Factor-Inwentash Faculty of Social Work and Department of Family and Community and director of the Institute for Life Course and Aging.

“Surprisingly few studies have focused on never-smoking COPD patients,” said co-author Senyo Agbeyaka, a graduate of the University of Toronto's Factor-Inwentash Faculty of Social Work. “We wanted to address this gap in the literature by examining which factors are associated with COPD among never smokers aged 50 and older.”

COPD is the third leading cause of death in the U.S.

In addition to obesity, older age and lower income were associated with COPD among both men and women. Among women, but not men, height and education level were negatively associated with COPD, but being married was associated with higher odds of COPD, the report found.

The study was based on a nationally representative sample of non-Hispanic white respondents aged 50 and older who reported that they had never smoked. Data were drawn from the 2012 Center for Disease Control's Behavioral Risk Factor Surveillance System. The final sample included more than 110,000 respondents, of whom almost 4,000 were morbidly obese and 5,000 reported that they had been diagnosed with COPD.

The survey did not allow researchers to identify why older obese Americans who were never smokers had such a high prevalence of COPD. "These findings highlight the importance of health care professionals routinely screening their older obese patients for COPD, even when the patients have no history of smoking" said professor Esme Fuller-Thomson.

COPD is a group of progressive lung disorders that make breathing difficult, including emphysema and chronic bronchitis. The best-known risk factor for COPD is smoking, but one-quarter of COPD patients have never smoked.

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