title: High levels of physical activity are associated with poorer asthma control in young females but not in males.
abstract: OBJECTIVE
  Earlier studies on the levels of physical activity in asthma patients compared with controls have yielded varying results. We have previously reported that high versus moderate levels of physical activity were associated with higher prevalence of wheezing, especially in females. Here we studied the levels of physical activity in young patients with asthma and healthy subjects and their effect on asthma control.
  
  
  METHODS
  Four hundred eight physician-diagnosed patients with asthma and 118 controls (10-34 years) answered questions concerning frequency and/or duration of physical activity and undertook the Asthma Control Test (ACT), spirometry, methacholine challenges and exhaled nitric oxide measurements.
  
  
  RESULTS
  Asthma patients were more frequently physically active (P = 0.01) and for longer durations (P = 0.002) than controls. Highly versus moderately physically active patients with asthma had a higher prevalence of not well-controlled asthma (ACT < 20) when physical activity was assessed by frequency (40.6% vs 24.1%, P = 0.001) or duration (39.0% vs 21.7%, P < 0.001). This was only seen in females who had reduced ACT items (P < 0.05). Frequently versus moderately active females had an odds ratio of 4.81 (2.43, 9.51) to have ACT < 20, while no such effect was found in males (OR 1.18 (0.61, 2.30)) and this interaction was statistically significantly associated with gender (P = 0.003). No differences in fraction of exhaled nitric oxide or methacholine reactivity were found between moderately and highly physically active females with asthma.
  
  
  CONCLUSIONS
  Young asthma patients were more active than controls. High levels of physical activity were associated with poor asthma control as judged by the ACT in females, but not in males, and this appears unrelated to airway inflammation or responsiveness.
authors.affiliation: Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden.
authors.forename: Ludvig
authors.initials: L
authors.lastname: Lövström
authors.affiliation: Department of Neuroscience, Physiotherapy, Uppsala University, Uppsala, Sweden.|Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden.
authors.forename: Margareta
authors.initials: M
authors.lastname: Emtner
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Kjell
authors.initials: K
authors.lastname: Alving
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Lennart
authors.initials: L
authors.lastname: Nordvall
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Magnus P
authors.initials: MP
authors.lastname: Borres
authors.affiliation: Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden.
authors.forename: Christer
authors.initials: C
authors.lastname: Janson
authors.affiliation: Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden.
authors.forename: Andrei
authors.initials: A
authors.lastname: Malinovschi
mesh_terms: D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000503:physiopathology*; D001944:Breath Tests; D001985:Bronchial Provocation Tests; D016085:Bronchoconstrictor Agents; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D016210:Methacholine Chloride; D009043:Motor Activity / Q000502:physiology*; D009569:Nitric Oxide / Q000032:analysis; D012737:Sex Factors; D013147:Spirometry; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D016085:Bronchoconstrictor Agents; D016210:Methacholine Chloride; D009569:Nitric Oxide
keywords: airway responsiveness; asthma control; exhaled nitric oxide; gender difference; physical activity