The longitudinal association between physical activity, strength and fitness, and lung function: A UK Biobank cohort study

Author: Ls Katrina Li1, Rasia Cassim2, Jennifer L Perret3, Shyamali C Dharmage2, Adrian J Lowe2, Caroline J Lodge2, Melissa A Russell4
Affiliation: <sup>1</sup> UniSA Allied Health &amp; Human Performance, University of South Australia, Australia; Allergy and Lung Health Unit, Centre of Epidemiology and Biostatistics, University of Melbourne, Australia; School of Allied Health, Human Services and Sport, La Trobe University, Australia. <sup>2</sup> Allergy and Lung Health Unit, Centre of Epidemiology and Biostatistics, University of Melbourne, Australia. <sup>3</sup> Allergy and Lung Health Unit, Centre of Epidemiology and Biostatistics, University of Melbourne, Australia; Institute for Breathing and Sleep (IBAS), Victoria, Australia. <sup>4</sup> Allergy and Lung Health Unit, Centre of Epidemiology and Biostatistics, University of Melbourne, Australia. Electronic address: melissar@unimelb.edu.au.
Conference/Journal: Respir Med
Date published: 2023 Nov 19
Other: Pages: 107476 , Special Notes: doi: 10.1016/j.rmed.2023.107476. , Word Count: 261

Background:
While physical activity is hypothesized to slow lung-function decline, the evidence is limited at a population level. This study investigated the longitudinal association between physical activity and related measures (grip strength, cardiovascular fitness) and lung function decline.

Methods:
20,111 UK Biobank cohort participants with lung function measures at baseline (2006-2010) and follow-up (2012-2014) were included. Physical activity (International Physical Activity Questionnaire: low, moderate, high categories), grip strength (dynamometer) and cardiovascular fitness (subsample, submaximal stationary bicycle) data were collected. Linear regression was utilized to assess the effect on follow-up FEV1, FVC, FEV1/FVC ratio (as decline in ml/yr and as z-scores) adjusting for baseline lung function and confounders.

Results:
After 6.3 years mean follow-up, the decline in mean FEV1 and FVC was 30 ml/year and 38 ml/year respectively (n = 20,111). Consistent low physical activity (across baseline and follow-up) was associated with accelerated decline in FEV1 z-score (-0.119, 95 % Confidence Interval (CI) -0.168, -0.071, n = 16,900) and FVC z-score (-0.133, 95%CI -0.178, -0.088, n = 16,832). Accelerated decline in FEV1 z-scores was observed with decreasing baseline grip strength (-0.029, -95%CI -0.034, -0.024, n = 19,903), and with less strong evidence, decreasing fitness (-0.024, 95%CI -0.070, 0.022, n = 3048).

Conclusion:
This is the largest ever study to date to identify that lower physical activity, grip strength, and potentially cardiovascular fitness over time is associated with accelerated lung function decline. Although the effect sizes appear modest, such changes at population levels can have a substantial overall impact. This study provides evidence for adding 'lung health benefits' to the current physical activity guidelines.

Keywords: Exercise; Physical activity; Respiratory function tests.

PMID: 37989422 DOI: 10.1016/j.rmed.2023.107476