Asthma and physical activity in childhood

This thesis investigates the association between asthma and physical activity in children. Asthma is one of the most common chronic diseases in childhood and is caused by multiple factors, both genetic and environmental. Previous research has shown that obesity is a risk factor for developing asthma. This thesis focuses on the role of physical activity. The thesis describes several studies investigating asthma and physical activity in different directions and at different ages. Questionnaires, motion sensors (accelerometry) and lung function tests were used for this purpose. In conclusion, it can be stated that asthma and physical activity are not clearly associated

Comparison of parent reported physician diagnosed asthma and general practitioner registration

OBJECTIVE: To compare parent reported physician diagnosed asthma from questionnaires for epidemiological purposes, to general practitioner (GP) recorded childhood asthma. METHODS: This study was embedded in the KOALA Birth Cohort Study with regular follow-up by ISAAC core questions on asthma in 2834 children in two different recruitment groups, with 'conventional' lifestyles or 'alternative' lifestyles. At age 11-13 years these data were linked to data extracted from GP records. We compared parent reported physician diagnosed asthma, asthma medication use, and current asthma with GP recorded asthma diagnosis and medication. Two different combinations of questions were used to define current asthma (i.e. ISAAC and MeDALL based definition). RESULTS: Among 958 children with information provided both by the parents and GPs, 98 children (10.2%) had parent reported physician diagnosed asthma, 115 children (12.0%) had a GP recorded asthma diagnosis (Cohen's kappa 0.49; 95% CI 0.40 to 0.57). Discrepant cases showed that asthma symptoms at an early age led to different labeling between parents and GP. The agreement between ISAAC based definition and MeDALL based definition was excellent (Cohen's kappa 0.82; 95% CI 0.74 to 0.88). CONCLUSION: Parent reported physician diagnosed asthma and GP recorded childhood asthma had only moderate agreement, and is possibly influenced by labeling early transient wheeze as asthma diagnosis. It is important that parent reported physician diagnosed asthma is combined with additional questions such as current asthma symptoms and asthma medication use, as used in ISAAC or MeDALL based current asthma, in order to obtain reliable information for epidemiological research

Physical Activity and Asthma: A Systematic Review and Meta-Analysis

INTRODUCTION: This review aims to give an overview of available published evidence concerning the association between physical activity and asthma in children, adolescents and adults. METHODS: We included all original articles in which both physical activity and asthma were assessed in case-control, cross-sectional or longitudinal (cohort) studies. Excluded were studies concerning physical fitness, studies in athletes, therapeutic or rehabilitation intervention studies such as physical training or exercise in asthma patients. Methodological quality of the included articles was assessed according to the Newcastle-Ottawa Scale (NOS). RESULTS: A literature search was performed until June 2011 and resulted in 6,951 publications derived from PubMed and 1,978 publications from EMBASE. In total, 39 studies met the inclusion criteria: 5 longitudinal studies (total number of subjects n = 85,117) with physical activity at baseline as exposure, and asthma incidence as outcome. Thirty-four cross-sectional studies (n = 661,222) were included. Pooling of the longitudinal studies showed that subjects with higher physical activity levels had lower incidence of asthma (odds ratio 0.88 (95% CI: 0.77-1.01)). When restricting pooling to the 4 prospective studies with moderate to good study quality (defined as NOS≥5) the pooled odds ratio only changed slightly (0.87 (95% CI: 0.77-0.99)). In the cross-sectional studies, due to large clinical variability and heterogeneity, further statistical analysis was not possible. CONCLUSIONS: The available evidence indicates that physical activity is a possible protective factor against asthma development. The heterogeneity suggests that possible relevant effects remain hidden in critical age periods, sex differences, or extremes of levels of physical activity (e.g. sedentary). Future longitudinal studies should address these issues

Physical activity and asthma development in childhood:Prospective birth cohort study

Contains fulltext : 219883.pdf (Publisher’s version ) (Open Access)BACKGROUND: Sedentary behavior and decreased physical activity are possible risk factors for developing asthma. This longitudinal study investigates the association between physical activity and subsequent asthma. We hypothesize that children with decreased physical activity at early school age, have higher risk of developing asthma. METHODS: One thousand eight hundred thirty-eight children from the KOALA Birth Cohort Study were analyzed. Children who were born prematurely or with congenital defects/diseases with possible influence on either physical activity or respiratory symptoms were excluded. Physical activity, sedentary behavior, and screen time were measured at age 4 to 5 years by questionnaire and accelerometry in a subgroup (n = 301). Primary outcome was asthma, assessed by repeated ISAAC questionnaires between age 6 and 10. Secondary outcome was lung function measured by spirometry in a subgroup (n = 485, accelerometry subgroup n = 62) (forced expiratory volume in 1 second [FEV1], forced vital capacity [FVC] and FEV1/FVC ratio) at age 6 to 7 years. RESULTS: Reported physical activity was not associated with reported asthma nor lung function. Accelerometry data showed that daily being 1 hour less physically active was associated with a lower FEV1/FVC (z score beta, -0.65; 95% confidence interval, -1.06 to -0.24). CONCLUSIONS: Physical activity at early school age was not associated with reported asthma development later in life. However, lung function results showed that sedentary activity time was associated with lower FEV1/FVC later in childhood. As this is the first longitudinal study with objectively measured physical activity and lung function, and because the subgroup sample size was small, this result needs replication.01 januari 202

pooling of cross-sectional data using motion sensors: physical activity measured by motion sensors and asthma prevalence.

<p>Random effects, CI; confidence interval. Not adjusted for potential confounders. Low physical activity used as reference category.</p

Overview of cross-sectional studies on physical activity and asthma prevalence.

<p>Overview of study characteristics, study quality based on the Newcastle-Ottawa Scale (NOS), odds ratios and author's conclusions of cross-sectional studies on physical activity and asthma prevalence. Odds ratios are noted here only if odds ratios or equivalents with 95% confidence intervals are specified in the article. Author's conclusions are noted only if the author mentions a conclusion on the relation between physical activity and asthma prevalence. If not, a conclusion was drawn based on the data in the article. In this case the conclusion is noted between [ ].</p><p>CI; confidence interval, PA; physical activity, aOR; adjusted odds ratio, aHR; adjusted hazard ratio, OR; odds ratio, aGMR; adjusted geometric mean ratio, MVPA; moderate to vigorous physical activity, VPA; vigorous physical activity.</p>*<p>P<0.05.</p>**<p>P<0.01.</p>***<p>P<0.001.</p>#a<p>frequency of physical activity (PA).</p>#b<p>participation of enough PA to meet the recommendations for PA.</p>#c<p>Energy Expenditure (EE).</p>#d<p>Metabolic Equivalent of Task (MET).</p>#e<p>physical inactivity (e.g. TV watching, computer play).</p>#f<p>physically active vs. physically not active group.</p

pooling of longitudinal data: physical activity at baseline and risk of asthma incidence.

<p>M-H; Mantel-Haenszel method, Random effects, CI; confidence interval. Not adjusted for potential confounders. Low physical activity used as reference category. Note that odds ratios are different of those in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0050775#pone-0050775-t001" target="_blank">table 1</a> because reference categories were reversed and/or the number of categories was converted into two categories per study. For example Beckett et al. and Lucke et al. use high physical activity as reference category; in our meta-analysis we standardized low physical activity as reference category. In studies were more than two categories of physical activity were used (such as Beckett et al. who used 5 levels of physical activity), these were converted into two categories (in case of Becket et al. we converted the highest two levels into high physical activity, and the lowest three levels into low physical activity).</p

flow diagram of study inclusion.

<p>flow diagram of study inclusion.</p

4,4'-(2, 3-Dimethyltetramethylene)dipyrocatechol

Contains fulltext : 80097.pdf (publisher's version ) (Open Access)CONTEXT: Ovarian dysfunction is classically categorized on the basis of cycle history, FSH, and estradiol levels. Novel ovarian markers may provide a more direct insight into follicular quantity in hypergonadotropic women. OBJECTIVE: The objective of the study was to investigate the distribution of novel ovarian markers in young hypergonadotropic women as compared with normogonadotropic regularly menstruating women. DESIGN: This was a nationwide prospective cohort study. SETTING: The study was conducted at 10 hospitals in The Netherlands. PATIENTS: Women below age 40 yr with regular menses and normal FSH (controls; n = 83), regular menstrual cycles and elevated FSH [incipient ovarian failure (IOF); n = 68]; oligomenorrhea and elevated FSH [referred to as transitional ovarian failure (TOF); n = 79]; or at least 4 months amenorrhea together with FSH levels exceeding 40 IU/liter [premature ovarian failure (POF); n = 112]. MAIN OUTCOME Measures: Serum levels of anti-Mullerian hormone (AMH), inhibin B, and antral follicle count (AFC) was measured. RESULTS: All POF patients showed AMH levels below the fifth percentile (p(5)) of normoovulatory women. Normal AMH levels (>p(5)) could be identified in 75% of IOF, 33% of TOF patients, and 98% of controls. AFC and AMH levels changed with increasing age (P < 0.0001), whereas inhibin B did not (P = 0.26). AMH levels were significantly different between TOF and IOF over the entire age range, whereas AFC became similar for TOF and IOF at higher ages. CONCLUSIONS: Compared with inhibin B and AFC, AMH was more consistently correlated with the clinical degree of follicle pool depletion in young women presenting with elevated FSH levels. AMH may provide a more accurate assessment of the follicle pool in young hypergonadotropic patients, especially in the clinically challenging subgroups of patients with elevated FSH and regular menses (i.e. IOF) and in hypergonadotropic women with cycle disturbances not fulfilling the POF diagnostic criteria (i.e. TOF)