Physical activity and asthma: A longitudinal and multi-country study

ABSTRACT

Objective: To investigate the impact of physical activity on asthma in middle-aged adults, in one longitudinal analysis, and one multi-centre cross-sectional analysis. Methods: The Respiratory Health in Northern Europe (RHINE) is a population-based postal questionnaire cohort study. Physical activity, height and weight were self-reported in Bergen, Norway, at RHINE II (1999–2001) and all centres at RHINE III (2010–2012). A longitudinal analysis of Bergen data investigated the association of baseline physical activity with follow-up asthma, incident asthma and symptoms, using logistic and zero-inflated Poisson regression (n = 1782). A cross-sectional analysis of all RHINE III centres investigated the association of physical activity with concurrent asthma and symptoms (n = 13,542) using mixed-effects models. Body mass index (BMI) was categorised (<20, 20–24.99, 25–29.99, 30+ kg/m²) and physical activity grouped by amount and frequency of lighter (no sweating/heavy breathing) and vigorous (sweating/heavy breathing) activity. Results: In the Bergen longitudinal analysis, undertaking light activity 3+ times/week at baseline was associated with less follow-up asthma (odds ratio [OR] 0.44, 95% confidence interval [CI] 0.22, 0.89), whilst an effect from undertaking vigorous activity 3+ times/week was not detected (OR 1.22, 95% CI 0.44, 2.76). The associations were attenuated with BMI adjustment. In the all-centre cross-sectional analysis an interaction was found, with the association between physical activity and asthma varying across BMI categories. Conclusion: These findings suggest potential longer-term benefit from lighter physical activity, whilst improvement in asthma outcomes from increasing activity intensity was not evident. Additionally, it appears the benefit from physical activity may differ according to BMI.

KEYWORDS:

• Adult
• asthma
• physical exercise
• RHINE

Acknowledgements

The authors thank the RHINE staff and study participants.

Declaration of interest

The authors declare that there are no conflicts of interest. The authors alone are responsible for the writing and content of the paper.

Funding

RHINE was supported financially by the Norwegian Research Council (Grant Nos. 214123, 912011), the Bergen Medical Research Foundation, the Western Norwegian Regional Health Authorities (Grant No. 911 892 and 911 631), the Norwegian Labour Inspection, the Norwegian Asthma and Allergy Association, the Faculty of Health of Aarhus University (Project No. 240008), the Wood Dust Foundation (Project No. 444508795), the Danish Lung Association, the Swedish Heart and Lung Foundation, the Vårdal Foundation for Health Care Science and Allergy Research, the Swedish Council for Working Life and Social Research, the Bror Hjerpstedt Foundation, the Swedish Asthma and Allergy Association, the Icelandic Research Council, and the Estonian Science Foundation (Grant No. 4350). S Dharmage is supported by an NHMRC.