The association of body mass index, weight gain and central obesity with activity-related breathlessness: The Swedish Cardiopulmonary Bioimage Study

Research output: Contribution to journalArticle


Introduction: Breathlessness is common in the population, especially in women and associated with adverse health outcomes. Obesity (body mass index (BMI) >30 kg/m2) is rapidly increasing globally and its impact on breathlessness is unclear. Methods: This population-based study aimed primarily to evaluate the association of current BMI and self-reported change in BMI since age 20 with breathlessness (modified Research Council score ≥1) in the middle-aged population. Secondary aims were to evaluate factors that contribute to breathlessness in obesity, including the interaction with spirometric lung volume and sex. Results: We included 13 437 individuals; mean age 57.5 years; 52.5% women; mean BMI 26.8 (SD 4.3); mean BMI increase since age 20 was 5.0 kg/m2; and 1283 (9.6%) reported breathlessness. Obesity was strongly associated with increased breathlessness, OR 3.54 (95% CI, 3.03 to 4.13) independent of age, sex, smoking, airflow obstruction, exercise level and the presence of comorbidities. The association between BMI and breathlessness was modified by lung volume; the increase in breathlessness prevalence with higher BMI was steeper for individuals with lower forced vital capacity (FVC). The higher breathlessness prevalence in obese women than men (27.4% vs 12.5%; p<0.001) was related to their lower FVC. Irrespective of current BMI and confounders, individuals who had increased in BMI since age 20 had more breathlessness. Conclusion: Breathlessness is independently associated with obesity and with weight gain in adult life, and the association is stronger for individuals with lower lung volumes.


  • Anders Blomberg
  • Göran Bergström
  • John Brandberg
  • Kenneth Caidahl
  • Jan Engvall
  • Maria Eriksson
  • Tomas Hansen
  • Tomas Jernberg
  • Lars Nilsson
  • Ulf Nilsson
  • Anna-Carin Olin
  • Lennart Persson
  • Annika Rosengren
  • Martin Sandelin
  • Magnus Sköld
  • Johan Sundström
  • Eva Swahn
  • Stefan Söderberg
  • Kjell Torén
  • Carl Johan Östgren
  • Eva Lindberg
External organisations
  • Umeå University
  • Sahlgrenska University Hospital, Wallenberg Laboratory
  • Sahlgrenska Academy
  • Linköping University
  • Karolinska Institutet
  • Uppsala University
  • Danderyd Hospital
  • Skåne University Hospital
  • Sahlgrenska University Hospital
  • University of Gothenburg
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Respiratory Medicine and Allergy


  • dyspnoea, lung function, lung volume, sex, weight
Original languageEnglish
Pages (from-to)958-964
Issue number10
Early online date2019 Aug 21
Publication statusPublished - 2019
Publication categoryResearch