Physical Activity and Asthma: A Systematic Review and Meta-Analysis

Abstract

IntroductionThis review aims to give an overview of available published evidence concerning the association between physical activity and asthma in children, adolescents and adults.MethodsWe included all original articles in which both physical activity and asthma were assessed in case-control, cross-sectional or longitudinal (cohort) studies. Excluded were studies concerning physical fitness, studies in athletes, therapeutic or rehabilitation intervention studies such as physical training or exercise in asthma patients. Methodological quality of the included articles was assessed according to the Newcastle-Ottawa Scale (NOS).ResultsA literature search was performed until June 2011 and resulted in 6,951 publications derived from PubMed and 1,978 publications from EMBASE. In total, 39 studies met the inclusion criteria: 5 longitudinal studies (total number of subjects n = 85,117) with physical activity at baseline as exposure, and asthma incidence as outcome. Thirty-four cross-sectional studies (n = 661,222) were included. Pooling of the longitudinal studies showed that subjects with higher physical activity levels had lower incidence of asthma (odds ratio 0.88 (95% CI: 0.77–1.01)). When restricting pooling to the 4 prospective studies with moderate to good study quality (defined as NOS≥5) the pooled odds ratio only changed slightly (0.87 (95% CI: 0.77–0.99)). In the cross-sectional studies, due to large clinical variability and heterogeneity, further statistical analysis was not possible.ConclusionsThe available evidence indicates that physical activity is a possible protective factor against asthma development. The heterogeneity suggests that possible relevant effects remain hidden in critical age periods, sex differences, or extremes of levels of physical activity (e.g. sedentary). Future longitudinal studies should address these issues.

Asthma prevalence in Olympic summer athletes and the general population: An analysis of three European countries

“…A similar relationship, albeit strictly negative, was found in another study based on the ECHRS II survey [21], which examined the influence of frequency and duration of physical activity on bronchial hyper-responsiveness, an asthmatic precursor [22,23]. Thus, evidence suggests that physical activity, and to a certain degree also moderate endurance exercise, might induce a protective effect against asthma and its precursors [24].…”

The Priority Group Index

“…These subpopulations were chosen as independent variables, because age, sex, race, immigrant status, marital status, education, social economic status, access to health care service (having a regular doctor, language barrier), self-perceived health, employment status, smoking, drinking, physical inactivity, obesity and overweight, unhealthy diets, and geographic location have been found to be associated with heart disease, [31][32][33][34][35][36][37][38] stroke, 37,[39][40][41][42][43][44] and chronic lower respiratory diseases. [45][46][47][48][49][50][51][52][53][54] These factors are also related to health disparities.…”

Validating the physical activity and leisure motivation scale (PALMS)

“…The link between regular physical activity (PA) and physical and psychological health has been well documented in the literature [1][2][3]. The most important benefits of regular PA include reduced prevalence of many diseases as well as decreased mortality [4][5][6][7].…”