Asthma and Rhinitis Are Associated with Less Objectively-Measured Moderate and Vigorous Physical Activity, but Similar Sport Participation, in Adolescent German Boys: GINIplus and LISAplus Cohorts

PLoS One. 2016 Aug 25;11(8):e0161461. doi: 10.1371/journal.pone.0161461. eCollection 2016.

Abstract

Introduction: Physical activity (PA) protects against most noncommunicable diseases and has been associated with decreased risk of allergic phenotype, which is increasing worldwide. However, the association is not always present; furthermore it is not clear whether it is strongest for asthma, rhinitis, symptoms of these, or atopic sensitization; which sex is most affected; or whether it can be explained by either avoidance of sport or exacerbation of symptoms by exercise. Interventions are thus difficult to target.

Methods: PA was measured by one-week accelerometry in 1137 Germans (mean age 15.6 years, 47% boys) from the GINIplus and LISAplus birth cohorts, and modeled as a correlate of allergic symptoms, sensitization, or reported doctor-diagnosed asthma or rhinitis.

Results: 8.3% of children had asthma, of the remainder 7.9% had rhinitis, and of the remainder 32% were sensitized to aero-allergens (atopic). 52% were lung-healthy controls. Lung-healthy boys and girls averaged 46.4 min and 37.8 min moderate-to-vigorous PA per day, of which 14.6 and 11.4 min was vigorous. PA in allergic girls was not altered, but boys with asthma got 13% less moderate and 29% less vigorous PA, and those with rhinitis with 13% less moderate PA, than lung-healthy boys. Both sexes participated comparably in sport (70 to 84%). Adolescents with wheezing (up to 68%, in asthma) and/or nose/eye symptoms (up to 88%, in rhinitis) were no less active.

Conclusions: We found that asthma and rhinitis, but not atopy, were independently associated with low PA in boys, but not in girls. These results indicate that allergic boys remain a high-risk group for physical inactivity even if they participate comparably in sport. Research into the link between PA and allergy should consider population-specific and sex-specific effects, and clinicians, parents, and designers of PA interventions should specifically address PA in allergic boys to ensure full participation.

MeSH terms

  • Accelerometry
  • Adolescent
  • Anthropometry
  • Asthma / diagnosis*
  • Asthma / epidemiology*
  • Case-Control Studies
  • Cohort Studies
  • Exercise
  • Female
  • Germany / epidemiology
  • Humans
  • Immunoglobulin E / chemistry
  • Lung / physiopathology
  • Male
  • Phenotype
  • Rhinitis / diagnosis*
  • Rhinitis / epidemiology*
  • Sex Factors
  • Sports*

Substances

  • Immunoglobulin E

Grants and funding

This study was part of the 15-year followup of two German birth cohorts, GINIplus (German Infant Study on the influence of Nutrition Intervention PLUS environmental and genetic influences on allergy development) and LISAplus (Influence of lifestyle factors on the development of the immune system and allergies Plus the influence of traffic emissions and genetics). We thank the GINIplus and LISAplus Study Groups for all their excellent work. The GINIplus Study Group includes the following: Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg (J. Heinrich, I. Brüske, H. Schulz, C. Flexeder, C. Zeller, M. Standl, M. Schnappinger, M. Sußmann, E. Thiering, C. Tiesler); Research Institute, Department of Pediatrics, Marien-Hospital, Wesel (D. Berdel, A. von Berg, B. Filipiak-Pittroff); Ludwig-Maximilians-University of Munich, Dr von Hauner Children’s Hospital (S. Koletzko, K. Werkstetter); Department of Pediatrics, Technische Universität München and Deutsche Rentenversicherung Bayern (C.P. Bauer, U. Hoffmann); and IUF-Leibniz Institute for Environmental Research, Düsseldorf (B. Hoffmann, E. Link, C. Klümper, U. Krämer). The LISAplus Study Group includes the following: Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health (J. Heinrich, I. Brüske, H. Schulz, M. Standl, M. Schnappinger, M. Sußmann, E. Thiering, C. Tiesler, C. Flexeder, C. Zeller); Department of Pediatrics, Marien Hospital Wesel, Wesel (A. von Berg); Pediatric Practice, Bad Honnef (B. Schaaf); Technical University, Munich (C.P. Bauer, U. Hoffmann); Helmholtz Centre for Environmental Research – UFZ, Department of Environmental Immunology/Core Facility Studies, Leipzig (I. Lehmann, M. Bauer, G. Herberth, J. Müller, S. Röder and M. Schilde); Department of Pediatrics, Municipal Hospital ‘St. Georg’, Leipzig (M. Borte, U. Diez, C. Dorn, E. Braun); and ZAUM – Center for Allergy and Environment, Technical University Munich (M. Ollert, J. Grosch). The GINIplus study was mainly supported for the first 3 years of the Federal Ministry for Education, Science, Research and Technology (interventional arm) and Helmholtz Zentrum Munich (former GSF) (observational arm). The 4 year, 6 year, and 10 year follow-up examinations of the GINIplus study were covered from the respective budgets of the 4 study centres: Helmholtz Zentrum Munich, Research Institute at Marien-Hospital Wesel, Ludwig-Maximilians-University Munich, Technical University Munich, and from 6 years onwards also from IUF - Leibniz Research-Institute for Environmental Medicine at the University of Düsseldorf, and a grant from the Federal Ministry for Environment (IUF Düsseldorf, FKZ 20462296). The LISAplus study was mainly supported by grants from the Federal Ministry for Education, Science, Research and Technology and in addition from Helmholtz Zentrum Munich (former GSF), Helmholtz Centre for Environmental Research - UFZ, Leipzig, Research Institute at Marien-Hospital Wesel, Pediatric Practice, Bad Honnef for the first 2 years. The 4 year, 6 year, and 10 year follow-up examinations of the LISAplus study were covered from the respective budgets of the involved partners (Helmholtz Zentrum Munich (former GSF), Helmholtz Centre for Environmental Research - UFZ, Leipzig, Research Institute at Marien-Hospital Wesel, Pediatric Practice, Bad Honnef, IUF – Leibniz-Research Institute for Environmental Medicine at the University of Düsseldorf) and in addition by a grant from the Federal Ministry for Environment (IUF Düsseldorf, FKZ 20462296). This work was supported by the Comprehensive Pneumology Center Munich (CPC-M) as member of the German Center for Lung Research. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.