Published ahead of print on December 7, 2006, doi:10.1164/rccm.200607-896OC
Am. J. Respir. Crit. Care Med., Volume 175, Number 5, March 2007, 458-463
A more recent version of this article appeared on March 1, 2007
Submitted on July 3, 2006
Accepted on December 7, 2006
Regular Physical Activity Modifies Smoking-Related Lung Function Decline and Reduces Risk of COPD
Judith Garcia-Aymerich1*, Peter Lange2, Marta Benet1, Peter Schnohr3, and Josep M Anto4
1 Centre for Research in Environmental Epidemiology (CREAL), Institut Municipal d'Investigacio Medica (IMIM), Barcelona, Spain,
2 Copenhagen City Heart Study, Epidemiological Research Unit, Bispebjerg University Hospital, Copenhagen, Denmark; Department of Cardiology and Respiratory Diseases, Hvidovre University Hospital, Hvidovre, Denmark,
3 Copenhagen City Heart Study, Epidemiological Research Unit, Bispebjerg University Hospital, Copenhagen, Denmark,
4 Centre for Research in Environmental Epidemiology (CREAL), Institut Municipal d'Investigacio Medica (IMIM), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
* To whom correspondence should be addressed. E-mail: jgarcia{at}imim.es.
Rationale: We have previously reported that regular physical activity reduces risk of COPD exacerbation. We hypothesised that higher levels of regular physical activity could reduce the risk of COPD by modifying smoking-related lung function decline.
Objective: To estimate the longitudinal association between regular physical activity and FEV1 and FVC decline and COPD risk.
Methods: A population-based sample (n=6790) was recruited and assessed with respect to physical activity, smoking, lung function and other covariates, in Copenhagen in 1981-3, and followed until 1991-4. Mean level of physical activity between baseline and follow-up was classified into "low, moderate, and high". FEV1 and FVC decline rates were expressed as ml/year. COPD was defined as FEV1/FVC 70%. Adjusted associations between physical activity and FEV1 and FVC decline, and COPD incidence were obtained using linear and logistic regression, respectively.
Results: Active smokers with moderate and high physical activity had a reduced FEV1 and FVC decline compared to those with low physical activity (relative change of +2.6 and +4.8 ml/y of FEV1, p-for-trend=0.006, and +2.6 and +7.7 ml/y of FVC, p-for-trend<0.0001, for the moderate and high physical activity group, respectively), after adjusting for all potential confounders and risk factors of lung function decline. Active smokers with moderate to high physical activity had a reduced risk of developing COPD as compared to the low physical activity group (OR=0.77, p=0.027).
Conclusions: This prospective study shows that moderate to high levels of regular physical activity are associated with reduced lung function decline and COPD risk among smokers.
Key words: Motor activity; Exercise; Pulmonary Disease, Chronic Obstructive; Respiratory Function Tests; Epidemiology.
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Copyright © 2006 American Thoracic Society
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