Increased Physical Activity Improves Asthma Control in Pediatric Patients


Though previous studies have measured different levels of physical activity, few before this have considered the interrelationship involving body mass index and childhood asthma control.

New data from China indicated an association between increased physical activity and improved childhood asthma control, with body mass index (BMI) status exhibiting a negative effect on the association.

In previous studies, BMI and physical activity had been linked to several asthma symptoms and disease control, with increasing data suggesting that physical activity positively impacting asthma prevalence.

In asthmatic adults, weight loss and improved asthma control were reported when participants engaged in more physical activity.

In pediatric and young adults, various studies had been conducted regarding different levels of physical activity, though few had considered the interrelationship among physical activity, BMI, and childhood asthma control.

As such, Zeyi Zhang, MD, School of Nursing and Rehabilitation, Cheeloo College of Medicine at Shadong University, and fellow investigators evaluated the association between physical activity and childhood asthma control, and estimated the potential mediating or modifying role of BMI status.

The Study

Zhang and colleagues enrolled 303 children aged 5-14 years with asthma who attended the pediatric respiratory outpatient of 4 individual hospitals in Jinan, China.

Each participant was given a 6-item questionnaire that measured frequency and participation of physical activity over the course of a week’s time.

Questions included “How often a week do you participate in vigorous PA such as running, swimming, soccer, basketball, badminton, rope skipping, etc.”, “How often a week do you participate in moderate PA such as jogging, cycling, ping‐pong, Tai Chi, dancing, etc.”, “How often a week do you participate in brisk walking training”, and the duration of each activity.

The BMI of each participants were measured using the children’s height and weight.

The Chinese version of the Childhood Asthma Control Test (C-ACT) was applied to children and parents to adequately measure asthma control.

Multiple linear regression was used to determine the association of physical activity and childhood asthma control. To assess the effect modification by BMI status, physical activity‐by‐BMI interaction was fitted in the multiple linear regression model. Stratified analyses were also performed for each BMI status.

The Results

The team reported that a positive association between continuous physical activity level and childhood asthma control assessed by C‐ACT after adjustment for covariates (B = 0.144, p = .012, Table 2), and a similar result was observed when physical activity was fitted with categorized variable, which indicated that children with higher physical activity levels had better asthma control than their inactive participants.

There was no physical activity level by BMI status interaction effect on children asthma control with adjustment for covariates.

Surprisingly, observation of the regression coefficient in the study found a positive association between physical activity level and BMI.

Though the team said this finding contradicted their hypothesis, they believed it was possibly due to a reverse causation where children who are overweight are already engaged in a physically active lifestyle due to body image recognition and health education.

Overall, Zhang and colleagues observed that physical activity should be encouraged to improve asthma control in children.

“Moreover, PA as a modifiable factor may have a role in the treatment for asthma‐obesity children,” the team wrote. “Additionally, our findings underscore mechanisms other than weight loss, by which increased PA and improved childhood asthma control are correlated.”

The study, “Physical activity and childhood asthma control: Mediation and moderation role of body mass index,” was published online in Pediatric Pulmonology.

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