Table 2. Overview of cross-sectional studies on physical activity and asthma prevalence.
| Study basics | Physical activity | Asthma | Confounders | NOS | Odds ratio (95% CI) | Reference | Author's conclusions | |||
| Reference | Country | n | Age | Measurement | Diagnosis | |||||
| Adults Questionnaire | ||||||||||
| Chen 2001 | Canada | 16,813 | >12 | Questionnaire #c | Doctor's diagnosis (self reported) | Weight, smoking, other | 6 | It was concluded that asthmatics were not consistently inactive compared with non-asthmatics. | ||
| Dogra 2008 | Canada | 21,636 | 65–79 | Questionnaire #f | Doctor's diagnosis (self reported) | Gender, weight, other | 5 | Older asthmatics were less active than their non-asthmatic peers. | ||
| Ford 2003 | U.S. | 165,123 | >18 | Questionnaire #b d f | Doctor's diagnosis (self reported) | Gender, weight, smoking, other | 8 | Participants with current asthma were significantly more often considered to be inactive and had significantly lower estimated energy expenditure compared with respondents who never had asthma. | ||
| Kilpeläinen 2006 | Finland | 10,667 | 18–25 | Questionnaire #a | Doctor's diagnosis (self reported) | Gender, weight, smoking, other | 7 | Men:Moderate PA: aOR 0.62 (0.42–0.92)*Vigorous PA: aOR 0.77 (0.56–1.07)Women:Moderate PA: aOR 0.77 (0.56–1.07)Vigorous PA: aOR 1.19 (0.88–1.60) | low PA | Moderate leisure time physical activity was associated with lower risk of asthma in men, but not among women |
| Mälkiä 1998 | Finland | 7,193 | >30 | Questionnaire #d | Doctor's diagnosis (self reported) and spirometry | Gender | 7 | The intensity of physical activity was lower in theasthmatic subjects than in those who were not asthmatic. | ||
| Ritz 2010 | U.S. | 40 | 21–38 | Questionnaire #a | Doctor's diagnosis | Other | 2 | No differences were found between asthma and controls in physical activity. | ||
| Strine 2007 | U.S. | 354,025 | >18 | Questionnaire #f | Doctor's diagnosis (self reported) | Gender, weight, smoking, other | 7 | No leisure time PA in past 30 days: aOR 1.2 (1.1–1.2)* | Leisure time PA in past 30 days | Moreover, persons who (…) were physically inactive were slightly more likely to have asthma than those without (…) these behaviors. |
| Teramoto 2011 | U.S. | 3,840 | >18 | Questionnaire #b f | Doctor's diagnosis (self reported) | Gender, weight | 6 | No regular PA: aOR 3.01 (1.63–5.55)***No leisure time PA in past 30 days: aOR 2.17 (1.40–3.37)*** | Regular PA in past 30 days | It was found that asthmatic people spent significantly less time on moderate and vigorous physical activity than their nonasthmatic counterparts. |
| Vogt 2008 | U.S. | 4,925 | > 18 | Questionnaire #b | Doctor's diagnosis (self reported) | Gender, weight, smoking, other | 7 | [No significant relation between physical activity and asthma diagnosis.] | ||
| Children Questionnaire | ||||||||||
| Bener 1996 | United Arab Emirates | 729 | 6–14 | Questionnaire #f | Asthma symptoms (self reported) | None stated | 3 | Environmental risk factors associated with asthma were (…) physical exercise. (…) | ||
| Cheng 2010 | China | 232 | 7–14 | Questionnaire #a | Doctor's diagnosis and spirometry | Gender | 4 | Asthmatic children took part in less exercise than their healthy peers. | ||
| Chiang 2006 | China | 429 | 9–11 | Questionnaire #a b | Doctor's diagnosis | Gender, weight, other | 5 | MVPA>90 min/week:Healthy controls: OR 1.24 (0.57–2.71)VPA>60 min/week:Healthy controls: OR 2.03 (1.31–3.15)** | Diagnosed asthma | Asthma interferes with children's ability to participate in vigorous physical activity but not in moderate-to-vigorous physical activity. |
| Corbo 2008 | Italy | 20,016 | 6–7 | Questionnaire #a e | Asthma symptoms (self reported) | Gender, weight, smoking, other | 7 | Rarely PA: aOR 1.05 (0.85–1.29)1–2 times/week: aOR 1.13 (0.93–1.38)>3 times/week: aOR 1.33 (0.99–1.77) | No PA | Our data support the hypothesis that (…) spending a lot of time watching television (…) increases the risk of asthma symptoms in children. Wheeze or asthma was not associated with regular sports activity. |
| Gannotti 2007 | U.S. | 15,300 | 9 | Questionnaire #a e | Doctor's diagnosis (self reported) | None stated | 5 | For children with asthma (…), the most frequent perception of parents was that their children were as active as their peers. Days per week of aerobic activity, number of structured activities per week, and playing sports with parents three times a week or more did not vary significantly between children with and without disabilities [including asthma]. | ||
| Glazebrook 2006 | U.K. | 117 | 7–14 | Questionnaire #a | Doctor's diagnosis and Peak Flow variability | Gender, weight, other | 2 | We found that children attending a hospital clinic for asthma (…) were significantly less active than a comparison group with other medical conditions. | ||
| Jones 2006 | U.S. | 13,222 | high school (grades 9–12) | Questionnaire #b e f | Doctor's diagnosis (self reported) | Gender, other | 6 | Sufficient VPA:Current asthma: OR 1.1 (1.0–1.3)Sufficient MPA:Current asthma: OR 1.1 (0.9–1.3) | No asthma | No significant differences were found for participation in sufficient vigorous or moderate physical activity or strengthening exercises among students with and without current asthma. |
| Kitsantas 2000 | U.S. | 135 | 14–18 | Questionnaire #a | Doctor's diagnosis | Gender (only girls included) | 6 | It was found that asthmatic girls (…) participated less often in vigorous activities than nonasthmatic girls. | ||
| Lang 2004 | U.S. | 243 | 6–12 | Questionnaire #a f | Doctor's diagnosis (self reported) | None stated | 4 | Children with asthma were less active than their peers. | ||
| Nystad 1997 | Norway | 4,585 | 7–16 | Questionnaire #a | Doctor's diagnosis (self reported) | Gender, other | 5 | PA 1–3 times/week: aOR 0.9 (0.5–1.4)PA>3 times/week: aOR 1.1 (0.6–1.9) | PA<3 times/month | The data suggest that asthmatic children are as physically active as their peers. |
| Ownby 2007 | U.S. | 636 | 8–10 | Questionnaire #d | Doctor's diagnosis (self reported) | Gender, other | 7 | Higher levels of physical activity were related to more diagnosed asthma. | ||
| Priftis 2007 | Greece | 700 | 10–12 | Questionnaire #a d e | Asthma symptoms (self reported) | Gender, weight, other | 7 | Not participating in any PA: Asthmatic boys: aOR 2.17 (1.34–3.54)* Asthmatic girls: aOR 1.63 (0.86–3.11) | No asthma | Multiple logistic regression analysis revealed that (…) sedentary lifestyle is associated with asthma symptoms only in boys. |
| Romieu 2004 | U.S. | 7,851 | 2–16 | Questionnaire #e | Doctor's diagnosis (self reported) | Gender, weight, smoking, other | 7 | Television watching >4 hours/day: aOR 2.67 (0.97–7.31) | Television watching <3 hours/day | [No significant relation between physical activity and and asthma diagnosis.] |
| Tsai 2007 | China | 2,218 | 11–12 | Questionnaire #a e | Doctor's diagnosis (self reported) | Gender, weight, other | 6 | Boys:PA 1–2 times/week: aOR 0.74 (0.42–1.32)PA>3 times/week: aOR 0.55 (0.30–1.03)PA every day: aOR 0.76 (0.43–1.35)Girls:PA 1–2 times/week: aOR 1.63 (0.69–3.84)PA>3 times/week: aOR 2.27 (0.92–5.59)PA every day: aOR 1.74 (0.67–4.47) | PA low (<1 time/week) | Results of the present study suggest that sedentary life is associated with increased risk of respiratory symptoms. [No significant relation between physical activity and asthma diagnosis.] |
| Tsai 2009 | China | 1,287 | 11–12 | Questionnaire #a e | Doctor's diagnosis (self reported) | Gender, weight, smoking, other | 7 | PA>30 min, times/week: aOR 1.02 (0.96–1.09) | PA <30 min times/week | The number of respiratory symptoms was positively correlated with (…) self-reported sedentary time per weekend-day in girls. [No significant relation between physical activity and asthma diagnosis.] |
| Vlaski 2008 | Macedonia | 3,026 | 13–14 | Questionnaire #a e | Doctor's diagnosis (self reported) | Gender, weight, smoking, other | 7 | VPA 1–2 times/week: aOR 1.84 (0.94–3.60)VPA>3 times/week: aOR 1.13 (0.40–3.23) | VPA occasionally/never | The findings support the aggravating role of sedentary regimen and poor physical fitness on asthma symptoms. [No significant relation between physical activity and asthma diagnosis.] |
| Vogelberg 2007 | Germany | 2,910 | 16–18 | Questionnaire #a e | Asthma symptoms (self reported) | Gender, weight, smoking, other | 6 | Sport>3 times/week: aOR 0.8 (0.5–1.3) | Sport <1 time/month | In the bivariate analyses, exercising more than once per week (…) was inversely related to new onset of wheeze. The association between physical activity and new onset of wheeze disappeared when active smoking was taken into account. |
| Weston 1989 | New Zealand | 408 | 11–13 | Questionnaire #a | Doctor's diagnosis (self reported) | None stated | 4 | Asthmatic children were significantly more active than nonasthmatic children for all activities and for school activities. | ||
| Children Motion sensor | ||||||||||
| Berntsen 2009 | Norway | 174 | 13–14 | Accelero-meter SenseWear #a c | Doctor's diagnosis (self reported) | Gender, other | 7 | Neither aerobic fitness, total energy expenditure nor hours in moderate to very vigorous intensity physical activity during week and weekend differed between adolescents with and without asthma. | ||
| Eijkemans 2008 | The Netherlands | 305 | 4–5 | Accelero-meter Actigraph and Questionnaire #a | Asthma symptoms (self reported) | Smoking, other | 6 | Total activity (counts/minute)Boys:Recent wheeze: aGMR 1.06 (0.94–1.20) Girls:Recent wheeze: aGMR 0.99 (0.85–1.14) | Never wheeze | Our data provide no evidence that asthmatic symptoms induce a lower physical activity level. |
| Firrincieli 2005 | U.S. | 54 | 3–5 | Accelero-meter Actiwatch #a | Asthma symptoms (self reported) | None stated | 5 | Physical activity measured with the motion sensor was decreased among children with a history of wheezing. | ||
| Rundle 2009 | U.S. | 437 | 4 | Accelero-meter Actiwatch #a e | Doctor's diagnosis or wheeze (both self reported) | Weight, other | 5 | Quartile of mean activity counts/minuteQuartile 2: aOR 0.85 (0.45–1.63)Quartile 3: aOR 1.03 (0.54–1.96)Quartile 4: aOR 0.91 (0.46–1.80) | Quartile 1 (lowest PA) | In cross-sectional analyses (…) asthma symptoms were not associated with physical activity in this age group. |
| Vahlkvist 2009 | Denmark | 214 | 6–14 | Accelero-meter RT3 #a d | Asthma symptoms (self reported) and FEV variability | None stated | 4 | No statistically significant differences were found between the two groups [asthma vs no asthma] in overall daily activity, time spent in high or vigorous activity (…) | ||
| Van Gent 2007 | The Netherlands | 1,614 | 7–10 | Accelero-meter PAM and Questionnaire #a | Doctor's diagnosis (self reported) and FEV variability | None stated | 6 | Childhood asthma does not appear to be associated with a decreased level of daily physical activity in our study population. | ||
| Walders-Abramson 2009 | U.S. | 118 | 10–16 | Pedometer Omron #a | Doctor's diagnosis (self reported) and asthma medication | None stated | 7 | We found similar rates of objectively measured physical activity among youth with well controlled asthma and controls. |
Overview of study characteristics, study quality based on the Newcastle-Ottawa Scale (NOS), odds ratios and author's conclusions of cross-sectional studies on physical activity and asthma prevalence. Odds ratios are noted here only if odds ratios or equivalents with 95% confidence intervals are specified in the article. Author's conclusions are noted only if the author mentions a conclusion on the relation between physical activity and asthma prevalence. If not, a conclusion was drawn based on the data in the article. In this case the conclusion is noted between [ ].
CI; confidence interval, PA; physical activity, aOR; adjusted odds ratio, aHR; adjusted hazard ratio, OR; odds ratio, aGMR; adjusted geometric mean ratio, MVPA; moderate to vigorous physical activity, VPA; vigorous physical activity.
*
P<0.05.
**
P<0.01.
***
P<0.001.
#a
frequency of physical activity (PA).
#b
participation of enough PA to meet the recommendations for PA.
#c
Energy Expenditure (EE).
#d
Metabolic Equivalent of Task (MET).
#e
physical inactivity (e.g. TV watching, computer play).
#f
physically active vs. physically not active group.