Physical activity and body weight are key to developing lung function in childhood

A team led by researchers from the Barcelona Institute of Global Health (ISGlobal), a center supported by the La Caixa Foundation, sheds light on the development of lung function in childhood. The results suggest that high levels of physical activity and a higher body mass index (BMI) play a key role in recovery from initial deficits.

These findings, published in the journal Thorax, have important implications for clinical practice, research and public health policy as they provide new insights into how to improve respiratory health from childhood to adulthood.

The study analyzed data from a Spanish age group ((LINK:EXTERNO|||https://www.isglobal.org/-/proyecto-inma-infancia-y-medio-ambiente|||proyecto INMA – Infancia y Environment) ), which included a total of 1151 children and adolescents aged 4 to 18 years. The authors measured lung function using spirometry, a method that evaluates lung function based on the amount of air exhaled.

More specifically, they measured forced tidal volume in one second (FEV1), which is the volume of air exhaled in the first second during a forced expiration after a deep inspiration, and forced vital capacity (FVC), which is the maximum amount of air that a person can exhale after a deep breath without any time limit. If FEV1 is an indicator of the degree of openness of the airways, then FVC gives an idea of ​​​​the size of the lungs.

Based on spirometry data, four trajectories of lung function growth were identified: low (19% of the sample for both FEV1 and FVC), normal (62% and 63%), high (16% and 13%), and the final trajectory, which was called recovery or catching up (2% and 5% of the sample). The catch-up group started with lung function values ​​below the low trajectory and demonstrated accelerated growth between the ages of 4 and 10 years, reaching normal lung function values.

“The key finding of our study is that poor lung function in early childhood does not automatically lead to poor lung function in early adulthood, but rather, accelerated growth can restore lung function deficits in childhood and lead to normal lung function in adolescence,” – says Sarah. Koch, ISGlobal researcher and first author of the study.

Predictors of lung function growth

Using medical records, questionnaires, and in-person visits with participants and their families, the team collected information on potential predictors of lung function growth. They were grouped into four categories: demographic and congenital characteristics, allergic diseases, smoking and other environmental exposures, and physical activity and body weight.

The study results indicate that accelerated growth in lung function is primarily associated with higher levels of physical activity in early childhood (ages 4 to 7 years) and higher body mass index at age 4 years.

“Our study confirms and goes beyond previous studies of known predictors of lung function. Boys and girls with fewer allergic diseases were more likely to have normal or high FEV1 trajectories, according to the study. This confirms previous findings about how allergic conditions in children affect the growth of lung function,” said Judith Garcia-Aymerich, ISGlobal researcher and senior author of the study.

Prevention

Early onset or accelerated decline in lung function beyond the normal aging process is a clear risk factor for chronic respiratory disease. Therefore, understanding the determinants that predict growth in lung function during childhood and adolescence is as important for the prevention of these diseases as understanding the determinants of decline in lung function in late adulthood.

The results of this study have important implications for clinical practice and public health policy. “Both clinical management and public health policy should support and encourage healthy eating and high levels of physical activity in boys and girls with low baseline lung function, suboptimal environmental conditions or allergies. This may help overcome growth limitations in lung function. and improve respiratory health in childhood and adulthood,” says Sarah Koch.

Reference Koch, S et al. “Physical activity and body weight are associated with catch-up growth in lung function in childhood: a population-based accelerated cohort study.” Breast.