Physical activity levels in Danish adults with and without asthma - A national recurrent cross-sectional case-control study from 2010 to 2021

BACKGROUND: A few decades ago, individuals with asthma were recommended to avoid strenuous physical activity (PA) to prevent bronchoconstriction. Today, PA and exercise are key components in asthma management, as studies have shown positive effects on asthma control and exacerbation rates.

OBJECTIVE: To investigate if PA levels (PAL) changed among individuals with and without asthma from 2010 to 2021. Secondly, to investigate the association between asthma status and PALs in 2021.

METHODS: Data were derived from the National Danish Health Surveys in 2010 (n=172,226) and 2021 (n=178,875). Individuals with self-reported asthma, no COPD and complete PA data were matched 1:1 with individuals without asthma on survey year, age, sex, and educational level. The regression analyses were adjusted for mental health, pain inference, comorbidities, demographic, and behavioral factors.

RESULTS: The analyses comprised 11,842 asthma cases and controls in 2010 and 16,152 in 2021 (60% females, mean±SD age 49±17 yrs). Individuals with asthma engaging in moderate/vigorous PA (MVPA) declined from 2010 to 2021 (27% vs 21%, respectively, p<0.001). In 2010 and 2021, a lower proportion of asthma cases engaged in MVPA compared to controls (27% vs 29%, p<0.001, and 20% vs 21%, p<0.001, respectively). In 2021, having asthma was associated with reduced odds of MVPA (OR 0.84 [95% CI 0.73; 0.97]). Pain inference, self-perceived poor mental health, and being a current smoker (all p<0.001) were negatively associated with PAL.

CONCLUSION: Physical activity level declined over the past decade for individuals with and without asthma. In 2021, asthma was associated with lower odds of engaging in MVPA.