The association between obesity markers and peak expiratory flow rate among the older adults in Southern West Bengal, India

Population ageing in India is accompanied by a rising burden of obesity and age-related respiratory decline. Peak Expiratory Flow Rate or PEFR is a simple and practical indicator of lung ventilation; however, evidence on the association between obesity markers and PEFR among older adults of southern West Bengal, India remains limited. The study aimed to investigate whether there is any association between obesity markers and PEFR among older adults of southern West Bengal, India. A community-based cross-sectional study was conducted among 396 older adults (≥ 60 years) selected through simple random sampling (2024–2025). The participants were categorized into “good” and “poor” PEFR groups based on the median value (216.7 L min⁻¹) of PEFR. Obesity markers included body mass index (BMI), waist circumference, and waist-hip ratio (WHR) along with other demographic variables. Unadjusted and adjusted (for age, sex, body height, socio-economic score, and physical activity level) logistic regressions were performed. Multicollinearity was assessed using Variance Inflation Factor (VIF < 5). Among the participants, 57.1% were females and 42.9% were males. Central adiposity was more prevalent among females. Significant differences were observed between good and poor PEFR groups with respect to age, sex, socio-economic status, physical activity, body height, body weight, BMI, and WHR ( p < 0.05). In unadjusted analysis, age (OR = 0.929), male sex (OR = 4.216), socio-economic status, physical activity, body height, BMI categories (normal and obese), and WHR were significantly associated with PEFR ( p < 0.05). However, waist circumference, smoking status, and sitting duration were not significant. After adjustment for confounders, age remained negatively associated with PEFR (AOR = 0.941, p < 0.001), while males had higher odds of good PEFR (AOR = 3.817, p < 0.001). Among obesity markers, BMI (normal, obese I and II) and WHR showed significant positive associations with PEFR, whereas waist circumference showed marginal significance ( p = 0.053). Heavy physical activity was also independently associated with better PEFR (AOR = 3.750, p = 0.012). The obesity markers like BMI, waist circumference and WHR have significant ( p < 0.05) association with PEFR among the older adults of southern West Bengal, India.