Restrictive Spirometry Pattern Risk Lower in Adults With Regular Physical Activity

Asturias, Spain, young woman training in gym on a treadmill, legs section
Adults who are physically active have been shown to have a decreased risk of developing a restrictive spirometry pattern after 10 years.

Adults who are physically active have been shown to have a decreased risk of developing a restrictive spirometry pattern after 10 years, according to the results of a large longitudinal analysis conducted across Europe in 2 population-based cohorts: the European Community Respiratory Health Survey (ECRHS) and the Swiss Study on Air Pollution and Lung Disease in Adults (SAPALDIA). The analysis was published in the American Journal of Epidemiology.

Recognizing that being physically active has been consistently linked to higher levels of pulmonary function, investigators sought to establish whether regular physical activity on the part of adults is associated with reduced rates of developing a restrictive spirometry pattern, which has been related to high morbidity and mortality. Of the 2 population-based cohort studies included in the analysis, ECRHS involved 46 centers in 24 countries, whereas SAPALDIA involved 8 centers located in Switzerland. The present analysis used data compiled during ECRHS II and SAPALDIA 2 (from 2000 to 2002; known as baseline) and approximately 10 years later during ECRHS III and SAPALDIA 3 (from 2010 to 2013; known as follow-up examinations).

A total of 5293 individuals (ECRHS: n=2714; SAPALDIA: n=2579) were available for evaluation after participants with a restrictive spirometry pattern at baseline (ECRHS: n=166; SAPALDIA: n=121) and those with an obstructive spirometry pattern at baseline or follow-up (ECRHS: n=422; SAPALDIA: n=612) were excluded. Further, at follow-up, a total of 173 participants had developed a restrictive spirometry pattern.

In baseline analyses, forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and physical activity were evaluated in all participants, with these assessments repeated 10 years later in the follow-up examinations. A restrictive spirometry pattern was defined as having a postbronchodilator FEV1/FVC ratio ≥ the lower limit of normal and an FVC <80% predicted, whereas an obstructive spirometry pattern was defined as having an FEV1/FVC ratio < the lower limit of normal. Individuals who had neither an obstructive spirometry pattern nor a restrictive spirometry pattern were considered to have a normal spirometry pattern.

Compared with those participants who had a normal spirometry pattern, those with a new-onset restrictive spirometry pattern were significantly more overweight or obese at baseline (P <.001), had a significantly higher prevalence of respiratory symptoms (P <.001), and had significantly lower levels of FEV and FVC (P <.001).

Being physically active at baseline was associated with a significantly lower risk of exhibiting a restrictive spirometry pattern at 10-year follow-up (relative risk [RR], 0.60;  95% CI, 0.46-0.79 and adjusted RR, 0.76; 95% CI, 0.59-0.98), with this relationship being strongest in individuals who were overweight or obese compared with those with normal body weight (P interaction =.06),

The investigators concluded that the findings from this study highlight the importance of encouraging the regular practice of physical activity in the overall population, in order to improve general health and help to prevent the development of certain conditions later in life.


Carsin A-E, Keidel D, Fuertes E, et al. Regular physical activity levels and incidence of restrictive spirometry pattern: a longitudinal analysis of two population-based cohorts [published online June 8, 2020]. Am J Epidemiol. doi:10.1093/aje/kwaa087