New co-authored paper
We are pleased to have co-authored a new paper with several esteemed colleagues studying Chest Circumference, Stature and Body Mass Index as Determinants of 1918 Influenza Severity – Steele – 2026 – Influenza and Other Respiratory Viruses – Wiley Online Library
ABSTRACT
Background: Anthropometric traits are established determinants of chronic disease, yet their role in shaping infectious diseaseoutcomes during historical pandemics remains underexplored. During the 2009 H1N1 influenza pandemic, obesity emerged as anovel, independent risk factor for severe illness, raising questions about whether physique and nutritional state have consistentlyinfluenced pandemic outcomes across history.Methods: We present the first large-scale, systematic analysis of body size and influenza severity during the 1918 pandemic,using a newly constructed and validated cohort of World War 1 service men from the Australian Imperial Force (AIF), CanadianExpeditionary Force and New Zealand Expeditionary Force (N = 1444).Results: Multivariable regression analyses revealed that larger chest circumference was associated with reduced odds of death(odds ratio [OR] 0.90 per 1-cm increase, 95% CI 0.81–0.99). Body mass index (BMI) showed a non-linear association with mortal-ity, with BMI values below 22 kg/m2 significantly associated with lower odds of death. Length of hospital stay was shorter amongmembers of the AIF (rate ratio [RR] 0.61, 95% CI 0.54–0.70), and increasing age and height exhibited non-linear associations withlonger hospitalisation. BMI was not associated with length of hospitalisation.Conclusion: Anthropometric measures were associated with influenza outcomes during the 1918 pandemic, although effectswere context dependent. These results highlight the continued need to integrate anthropometric and nutritional factors intomodern pandemic preparedness frameworks, particularly as populations worldwide continue to face overlapping burdens ofundernutrition and obesity