Key Finding: Childhood BMI and COPD in Adulthood
CHILDHOOD body size is linked to COPD risk in adulthood, with above-average BMI trajectories associated with higher COPD incidence. In a prospective cohort of 276,747 children with measurements at ages 6 to 15 years and follow up into later adulthood, hazard ratios increased progressively from above average to overweight and obesity BMI trajectories. Compared with average BMI in girls, the hazard for COPD rose from 1.10 to 1.65 across the upper trajectories, with similar patterns in boys. A below average BMI trajectory in girls was associated with lower COPD risk. These results suggest that persistent childhood overweight and obesity may be early indicators of later COPD development.
Study Design and Population
Researchers analyzed five childhood BMI trajectories using data from the Copenhagen School Health Records Register and linked them to COPD diagnoses from age 40 years onward through national registers. Cox proportional hazards models produced sex-specific hazard ratios with 95% confidence intervals. Over the follow up period, 18,227 females and 15,789 males received a COPD diagnosis, supporting adequate power to detect trajectory-specific differences.
Clinical Context for COPD Prevention
The association between childhood BMI and chronic obstructive pulmonary disease highlights the value of early preventive strategies and longitudinal weight management. While the study focuses on trajectories rather than single BMI cut points, the graded risk across above-average categories reinforces clinical attention to sustained patterns of excess weight during school years. In practice, counseling families on lifestyle approaches and monitoring growth curves may help reduce future respiratory morbidity, alongside established COPD risk factor assessment.
Implications for Practice and Research
For clinicians, these data encourage integrating childhood growth history when assessing adult COPD risk, particularly in patients with persistent high BMI through adolescence. Future research should evaluate whether targeted interventions in childhood can modify long-term COPD outcomes and clarify potential sex-specific effects observed in the trajectory analyses.
Reference: Hansen F et al. Childhood body size and risk of chronic obstructive pulmonary disease in adulthood: a prospective cohort study. Respir Med. 2025;108416.
