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Risk of pneumonia in relation to body mass index in Australian Aboriginal people

  • D. T. PHUNG (a1) (a2) and Z. WANG (a1)

This study examined the relationship between body mass index (BMI) and the risk of pneumonia in Aboriginal Australians. A total of 677 adults aged 20–60 years were followed up from the baseline examination during 1992–1995 to June 2012. The pneumonia events were identified through hospital records. Pneumonia incident rates were calculated according to BMI groups. Hazard ratios were computed using Cox regression adjusting for age, smoking and alcohol consumption status. The incident rate of pneumonia was 13·3/1000 person-years, and this rate was significantly higher in females than males (hazard ratio = 1·5). Compared to males with normal BMI (18·5–24·9 kg/m2), the adjusted hazard ratio was 3·5 for males with lowest BMI (P < 0·01). Low BMI was significantly associated with a higher risk of hospitalized pneumonia for Aboriginal males. However, the U-shaped trend of this association indicates that the risk of pneumonia is likely to be associated with both low and high BMI.

Corresponding author
*Author for correspondence: Dr D. T. Phung, 7 Angelina Street, Macgregor, Brisbane, QLD 4109, Queensland, Australia. (Email:
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1.Kornum JB, et al. Obesity and risk of subsequent hospitalization with pneumonia. European Respiratory Journal 2010; 36: 13301336.
2.Fry AM, et al. Trends in hospitalizations for pneumonia among persons aged 65 years or older in the United State, 1988–2002. Journal of the American Medical Association 2005; 294: 27122719.
3.Thomsen RW, et al. Rising incidence and persistently high mortality of hospitalized pneumonia: a 10-year population-based study in Denmark. Journal of Internal Medicine 2006; 259: 410417.
4.Trotter CL, et al. Increasing hospital admissions for pneumonia, England. Emerging Infectious Diseases 2008; 14: 727733.
5.Lipsky BA, et al. Risk factors for acquired pneumonococcal infections. Archives of Internal Medicine 1986; 146: 21792185.
6.Almirall J, et al. Risk factors for community-acquired pneumonia in adults: a population-based case-control study. European Respiratory Journal 1999; 13: 349355.
7.Paffenbarger RS, et al. Energy expenditure, cigarette smoking, and blood pressure level as related to death from specific diseases. In: Baik et al. 2000. A prospective study of age and lifestyle factors in relation to community-acquired pneumonia in US men and women. American Journal of Epidemiology 2000; 152: 264–171.
8.Fernadez-Sola J, et al. High alcohol intake as a risk and prognostic factor for community-acquired pneumonia. Archives of Internal Medicine 1995; 155: 16491654.
9.Adams HG, Jordan C. Infections in the alcoholic. Medical Clinics of North America 1984; 68: 179200.
10.Formiguera X, Canton A. Obesity: epidemiology and clinical aspects. Best Practice & Research: Clinical Gastroenterology 2004; 18: 11251146.
11.Baik I, et al. A prospective study of age and lifestyle factors in relation to community-acquired pneumonia in US men and women. Archives of Internal Medicine 2000; 160: 30823088.
12.Inoue Y, et al. Risk and protective factors related to mortality from pneumonia among middle-age and elderly community residents: the JACC study. Journal of Epidemiology 2007; 17: 194202.
13.Blumentals WA, et al. Body mass index and the incidence of influenza-associated pneumonia in a UK primary care cohort. Influenza and Other Respiratory Viruses 2011; 6: 2836.
14.Thomson N, et al. Overview of Australian Indigenous health status (http://healthinfonetecueduau/overview_2012pdf2011). Accessed 12 June 2012.
15.Plant AJ, Condon JR, Durling G. Northern Territory Department of Health and Community Services, 1995.
16.AIHW. Australian hospital statistics 2005–06. Health Services series no. 30, cat. no. HSE50. Canberra: Australian Institute of Health and Welfare, 2007.
17.Penm E. Cardiovascular disease and its associated risk factors in Aboriginal and Torres Strait Islander people 2004–5. AIHW cat. no. CVD41. Canberra: Australian Institute of Health and Welfare, 2008.
18.Hoy W, et al. Quantifying the excess risk for proteinuria, hypertension and diabetes in Australian Aborigines: comparisons of profiles in three remote communities in the Northern Territory with those in the AusDiab study. Indigenous Health 2007; 31: 177183.
19.Hoy WE, et al. Renal disease, the metabolic syndrome, and cardiovascular disease. Ethnicity and Disease 2006; 16: 2.
20.Wang Z, Hoy W. Hypertension, dyslipidaemia, body mass index, diabetes and smoking status in Aboriginal Australians in a remote community. Ethnicity and Disease 2003; 13: 324330.
21.Wang Z, Hoy WE. Waist circumference, body mass index, hip circumference and waist-to-hip ratio as predictors of cardiovascular disease in Aboriginal people. European Journal of Clinical Nutrition 2004; 58: 888893.
22.Wang Z, Hoy WE. Body size measurements as predictors of type 2 diabetes in Aboriginal people. International Journal of Obesity and Related Metabolic Disorders 2004; 28: 15801584.
23.NHLBI Obesity Education Innitiative. The practical guide: identification, evaluation and treatment of overweight and obesity in adults. National Institute of Health (NIH publication no. 00-4084), 2000.
24.StataCorp. Stata statistical software: release 12.0. Colleage Station, Texas 77845 USA. 2011.
25.Nieman DC. Exercise, infection, and immunity. International Journal of Sports Medicine 1994; 15: S131S141.
26.Health GW, Macera CA, Nieman DC. Exercise and upper respiratory tract infection: isthere a relationship? Sports Medicine 1992; 14: 353365.
27.Neuman MI, Willet WC, Curhan GC. Physical activity and the risk of community-acquired pneumonia in US women. American Journal of Medicine 2010; 123: 281.e287–281.e211.
28.LaCroix AZ, et al. Prospective study of pneumonia hospitalizations and mortality of U.S. older people: the role of chronic conditions, health behaviours, and nutritional status. Public Health Reports 1989; 104: 350360.
29.Saliva ME, et al. Disability and cognitive impairment are risk factors for pneumonia-related mortality on older adults. Public Health Reports 1993; 108: 314322.
30.Tanaka S, et al. Impaired immunity in obesity: suppressed but reversible lymphocyte responsiveness. International Journal of Obesity 1993; 17: 631636.
31.Gottschlich MM, et al. Significance of obesity on nutritional, immunologic, hormonal and clinical outcome parameters in burns. Journal of the American Dietetic Association 1993; 93: 12611268.
32.Amirall J, et al. New evidence of risk factors for community-acquired pneumonia: a population-based study. European Respiratory Journal 2008; 31: 12741284.
33.Schnoor M, et al. Risk factors for community-acquired pneumonia in German adults: the impact of children in the household. Epidemiology and Infection 2007; 135: 13891397.
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