The Association between Leisure-Time Physical Activities and Asthma Symptoms among 10- to 12-Year-Old Children: The Effect of Living Environment in the PANACEA Study

Abstract

Objective. This study evaluated the interrelationships of living environment, physical activity, lifestyle/dietary habits, and nutritional status on the prevalence of childhood asthma. Methods. In a cross-sectional survey 1125 children (529 boys), 10 to 12 years old, were selected from 18 schools located in an urban environment (Athens, n = 700) and from 10 schools located in rural areas (n = 425) in Greece. Results. Children living in Athens had higher likelihood of “ever had” asthma compared with children living in rural areas (odds ratio (OR) = 1.78, 95% confidence interval (CI) = 1.25–2.54), after adjusting for age and sex. After adjusting for age, sex, body mass index, and adherence to the Mediterranean diet (KIDMED score), leisure-time physical activity was inversely associated with “ever had” asthma. When stratifying by county of residence, a trend toward reduced asthma symptoms among children engaged in outdoor physical activities during their leisure time who reside in rural (but not urban) environment was observed (OR = 0.88, 95% CI = 0.77–1.01). Conclusions. The inverse relationship between asthma symptoms and leisure-time physical activity in the rural environment and the lack of an association between asthma symptoms and organized sports-related activities should draw the attention of public healthcare authorities. Their efforts should focus on the planning of a sustainable natural environment, which will promote the physical health of children and reduce the burden of childhood asthma.

• asthma
• children
• environment
• lifestyle
• physical activity

Acknowledgements

The authors thank the field investigators of the “PANACEA” study: Adina Tsoutsou, Marios Papadopoulos, and Martha Harisi (pediatricians); Maria Konstantinidou (dietician); Dionysia Kounadi (visiting nurse); Nika Priftis (sports science specialist); and George Antonogiorgos (physician/biostatistician). The authors also thank the schoolteachers, the children, and their parents who participated in the study for their support.

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.