Childhood asthma and physical activity: a systematic review with meta-analysis and Graphic Appraisal Tool for Epidemiology assessment

Abstract

BackgroundChildhood asthma is a global problem affecting the respiratory health of children. Physical activity (PA) plays a role in the relationship between asthma and respiratory health. We hypothesized that a low level of PA would be associated with asthma in children and adolescents. The objectives of our study were to (1) summarize the evidence available on associations between PA and asthma prevalence in children and adolescents and (2) assess the role of PA in new-onset or incident asthma among children and adolescents.MethodsWe searched Medline, the Cochrane Library, and Embase and extracted data from original articles that met the inclusion criteria. Summary odds ratios (ORs) and confidence intervals (CIs) were used to express the results of the meta-analysis (forest plot). We explored heterogeneity using funnel plots and the Graphic Appraisal Tool for Epidemiology (GATE).ResultsWe retrieved 1,571 titles and selected 11 articles describing three cohort and eight cross-sectional studies for inclusion. A meta-analysis of the cohort studies revealed a risk of new-onset asthma in children with low PA (OR [95 % CI] 1.32 [0.95; 1.84] [random effects] and 1.35 [1.13; 1.62] [fixed effects]). Three cross-sectional studies identified significant positive associations between childhood asthma or asthma symptoms and low PA.ConclusionsChildren and adolescents with low PA levels had an increased risk of new-onset asthma, and some had a higher risk of current asthma/or wheezing; however, there was some heterogeneity among the studies. This review reveals a critical need for future longitudinal assessments of low PA, its mechanisms, and its implications for incident asthma in children. The systematic review was prospectively registered at PROSPERO (registration number: CRD42014013761; available at: http://www.crd.york.ac.uk/PROSPERO [accessed: 24 March 2016]).Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-016-0571-4) contains supplementary material, which is available to authorized users.

Physical activity and asthma: cause or consequence? A bidirectional longitudinal analysis

“…Contrary to the findings by Lochte et al ,5 our analysis found no evidence that PA influences either current or incident asthma. The inconsistency between our results and those of the systematic review5 may be due to fundamental differences in the exposure and outcome definitions and measurement techniques employed by our team as compared with those within the systematic review.…”

“…The inconsistency between our results and those of the systematic review5 may be due to fundamental differences in the exposure and outcome definitions and measurement techniques employed by our team as compared with those within the systematic review. For example, while our study looked at time spent in PA, the studies contained within the review used number of team sports played,8 sports participation frequency7 and duration of tv viewing6 as their PA exposure.…”

“…Some previous research has investigated the effect of PA on asthma in children, and this research was collated in a systematic review published in 2016 by Lochte et al 5. Their meta-analysis of three longitudinal studies concluded that lower levels of PA were associated with a 35% increased risk of new-onset asthma and wheeze in children (fixed-effect pooled OR 1.35; 95% CI 1.13 to 1.62; I 2 =60.6%) 5. However, these studies varied in their assessment and definition of the exposure; while one looked at sedentary time,6 the second and third questioned the amount of time spent in sports 7 8.…”

Designing a physical activity intervention for children with asthma: a qualitative study of the views of healthcare professionals, parents and children with asthma

“…7 Systematic reviews have suggested that children with asthma engage in less physical activity than children who do not have asthma, and these differences may be more marked for girls than boys 8–10. In addition, a recent systematic review of epidemiological studies has shown that children with low levels of physical activity are at up to 35% increased risk of new onset asthma and/or wheezing 11. The same review also reported that more than 50% of the cross-sectional studies reported positive associations between low physical activity and childhood asthma 11…”

Effect of the leukotriene receptor antagonist montelukast on orthodontic tooth movement

“…It affects about 4 to 10% of the population, and its burden has increased substantially during the last 20 years, particularly in industrialized countries (1,2). Laboratory analysis of bronchoalveolar lavage fluid from asthmatic patients shows inflammatory reactions characterized by increased numbers of mast cells, epithelial cells, eosinophils, lymphocytes, and inflammatory mediators.…”