Published on: May 16, 2025
A study led by the Barcelona Institute for Global Health (ISGlobal), a centre supported by the ”la Caixa” Foundation and conducted in collaboration with Clínic-IDIBAPS, has, for the first time, mapped how lung capacity changes from childhood through old age. Published in The Lancet Respiratory Medicine, the study offers a new foundational framework for evaluating lung health across the lifespan.
Until now, the prevailing view held that lung function increased until it peaked between the ages of 20 and 25, followed by a period of stability, and then began declining later in adulthood due to aging. However, this model was based on studies that did not span the full human life course.
In contrast, this study applied an accelerated cohort design by combining data from multiple cohort studies to cover a broader age range. “We included data from more than 30,000 individuals aged 4 to 82, drawn from eight population-based cohorts in Europe and Australia, explains Judith Garcia-Aymerich, first author of the study and co-director of ISGlobal’s Environment and Health over the Life Course programme. Lung function was assessed using forced spirometry—a test in which individuals exhale forcefully after a deep breath. Additional data were collected on smoking status and asthma diagnosis.
Two Phases of Growth, Followed by Early Decline
The findings revealed that lung function develops in two distinct stages: an initial period of rapid growth in childhood, followed by a slower phase of growth that continues until peak function is reached. Lung capacity was measured using two key indicators: forced expiratory volume in one second (FEV1)—the volume of air expelled in the first second of a forced breath—and forced vital capacity (FVC)—the total amount of air exhaled after a deep inhalation without a time constraint.
In women, FEV1 peaked around age 20; in men, around age 23. Notably, the study found no evidence of a plateau phase following this peak. Previous models proposed a stable phase up to age 40, but our data show that lung function begins to decline immediately after the peak, says Garcia-Aymerich.
Influences on Lung Function
The study also showed that persistent asthma and smoking impact lung function differently than previously thought. Individuals with persistent asthma tend to reach peak FEV1 earlier and maintain lower levels of lung function throughout life. Meanwhile, smoking is linked to a more rapid decline in lung function starting around age 35.
Implications for Public Health and Clinical Practice
These findings emphasize the need to promote respiratory health and implement early lung function monitoring using spirometry. Identifying low lung function early in life could make it possible to intervene and prevent chronic respiratory diseases in adulthood, concludes Rosa Faner, senior researcher at the University of Barcelona and Clínic-IDIBAPS, and the study’s last author.
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