Melissa A Russell1,2, Christer Janson3, Francisco Gómez Real4,5, Ane Johannessen6, Marie Waatevik7, Bryndis Benediktsdóttir8,9, Mathias Holm10, Eva Lindberg3, Vivi Schlünssen11,12, Wasif Raza13, Shyamali C Dharmage1,2, Cecilie Svanes6,14. 1. a Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health , University of Melbourne , Melbourne , Australia. 2. b Gastro & Food Allergy Group , Murdoch Children's Research Institute , Melbourne , Australia. 3. c Department of Medical Sciences: Respiratory , Allergy and Sleep Research, Uppsala University , Uppsala , Sweden. 4. d Department of Clinical Science , University of Bergen , Bergen , Norway. 5. e Department of Gynaecology and Obstetrics , Haukeland University Hospital , Bergen , Norway. 6. f Center for International Health , University of Bergen , Bergen , Norway. 7. g Center for Clinical Research , Haukeland University Hospital , Bergen , Norway. 8. h Faculty of Medicine , University of Iceland , Reykjavik , Iceland. 9. i Department of Respiratory Medicine and Sleep , The National University Hospital of Iceland , Reykjavik , Iceland. 10. j Department of Occupational and Environmental Medicine , Sahlgrenska University Hospital , Göteborg , Sweden. 11. k Department of Public Health , Aarhus University , Aarhus , Denmark. 12. l The National Research Centre for the Working Environment , Copenhagen , Denmark. 13. m Division of Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine , Umeå University , Umeå , Sweden. 14. n Department of Occupational Medicine , Haukeland University Hospital , Bergen , Norway.
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.
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.
Authors: Melissa Anne Russell; Shyamali Dharmage; Elaine Fuertes; Alessandro Marcon; Anne-Elie Carsin; Silvia Pascual Erquicia; Joachim Heinrich; Ane Johannessen; Michael J Abramson; Andre F S Amaral; Isa Cerveri; Pascal Demoly; Vanessa Garcia-Larsen; Deborah Jarvis; Jesus Martinez-Moratalla; Dennis Nowak; Leopoldo Palacios-Gomez; Giulia Squillacioti; Wasif Raza; Margareta Emtner; Judith Garcia-Aymerich Journal: ERJ Open Res Date: 2021-03-01