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Original Article
Leisure-time vigorous physical activity is associated with better lung function: the prospective ECRHS study
  1. Elaine Fuertes1,2,3,
  2. Anne-Elie Carsin1,2,3,
  3. Josep M Antó1,2,3,
  4. Roberto Bono4,
  5. Angelo Guido Corsico5,6,
  6. Pascal Demoly7,8,
  7. Thorarinn Gislason9,
  8. José-Antonio Gullón10,
  9. Christer Janson11,
  10. Deborah Jarvis12,13,
  11. Joachim Heinrich14,15,
  12. Mathias Holm16,
  13. Bénédicte Leynaert17,18,
  14. Alessandro Marcon19,
  15. Jesús Martinez-Moratalla20,21,
  16. Dennis Nowak22,23,
  17. Silvia Pascual Erquicia24,
  18. Nicole M Probst-Hensch25,26,
  19. Chantal Raherison27,
  20. Wasif Raza28,
  21. Francisco Gómez Real29,30,
  22. Melissa Russell31,
  23. José Luis Sánchez-Ramos32,
  24. Joost Weyler33,
  25. Judith Garcia Aymerich1,2,3
  1. 1 Centre for Research in Environmental Epidemiology (CREAL), ISGlobal, Barcelona, Spain
  2. 2 Universitat Pompeu Fabra (UPF), Barcelona, Spain
  3. 3 CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
  4. 4 Department of Public Health and Pediatrics, University of Turin, Turin, Italy
  5. 5 Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
  6. 6 Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
  7. 7 Département de Pneumologie et Addictologie, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France
  8. 8 UMR-S 1136 INSERM, IPLESP, UPMC, Sorbonne Universités, Paris, France
  9. 9 Department of Respiratory Medicine and Sleep, Landspitali University Hospital Reykjavik, Reykjavik, Iceland
  10. 10 Department of Pneumology, Hospital San Agustín, Avilés, Asturias, Spain
  11. 11 Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
  12. 12 MRC-PHE Centre for Environment and Health, Imperial College London, London, UK
  13. 13 Department of Population Health and Occupational Diseases, National Heart and Lung Institute, Imperial College London, London, UK
  14. 14 Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
  15. 15 Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich, Ludwig Maximilian University, Munich, Germany
  16. 16 Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
  17. 17 Inserm, UMR 1152, Pathophysiology and Epidemiology of Respiratory Diseases, Paris, France
  18. 18 UMR 1152, University Paris Diderot Paris, Paris, France
  19. 19 Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
  20. 20 Servicio de Neumología del Complejo, Servicio de Salud de Castilla – La Mancha (SESCAM), Hospitalario Universitario de Albacete, Albacete, Spain
  21. 21 Facultad de Medicina de Albacete, Universidad de Castilla - La Mancha, Albacete, Spain
  22. 22 Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich (LMU), Munich, Germany
  23. 23 Comprehensive Pneumology Center Munich (CPC-M), Munich, Germany
  24. 24 Respiratory Department, Galdakao Hospital, OSI Barrualde-Galdakao, Biscay, Spain
  25. 25 Swiss Tropical and Public Health Institute, Basel, Switzerland
  26. 26 Department of Public Health, University of Basel, Basel, Switzerland
  27. 27 U1219, Bordeaux University, Bordeaux, France
  28. 28 Department of Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
  29. 29 Department of Clinical Science, University of Bergen, Bergen, Norway
  30. 30 Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway
  31. 31 Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
  32. 32 Department of Nursing, University of Huelva, Huelva, Spain
  33. 33 Department of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium
  1. Correspondence to Dr Elaine Fuertes, ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona 08003, Spain; elaine.fuertes{at}


Objective We assessed associations between physical activity and lung function, and its decline, in the prospective population-based European Community Respiratory Health Survey cohort.

Methods FEV1 and FVC were measured in 3912 participants at 27–57 years and 39–67 years (mean time between examinations=11.1 years). Physical activity frequency and duration were assessed using questionnaires and used to identify active individuals (physical activity ≥2 times and ≥1 hour per week) at each examination. Adjusted mixed linear regression models assessed associations of regular physical activity with FEV1 and FVC.

Results Physical activity frequency and duration increased over the study period. In adjusted models, active individuals at the first examination had higher FEV1 (43.6 mL (95% CI 12.0 to 75.1)) and FVC (53.9 mL (95% CI 17.8 to 89.9)) at both examinations than their non-active counterparts. These associations appeared restricted to current smokers. In the whole population, FEV1 and FVC were higher among those who changed from inactive to active during the follow-up (38.0 mL (95% CI 15.8 to 60.3) and 54.2 mL (95% CI 25.1 to 83.3), respectively) and who were consistently active, compared with those consistently non-active. No associations were found for lung function decline.

Conclusion Leisure-time vigorous physical activity was associated with higher FEV1 and FVC over a 10-year period among current smokers, but not with FEV1 and FVC decline.

  • adults
  • cohort
  • forced expiratory volume in one second
  • forced vital capacity
  • physical activity
  • smoking

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  • Contributors EF, A-EC and JGA designed the study. EF wrote the initial draft, conducted the statistical analyses and had final responsibility for the decision to submit for publication. All authors provided substantial contributions to the conception or design of the work, or the acquisition, analysis or interpretation of data for the work, revised the manuscript for important intellectual content, approved the final version, and agreed to be accountable for all aspects of the work.

  • Funding This project has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie Individual Fellowship scheme (Elaine Fuertes, H2020- MSCA-IF-2015; proposal number 704268). The present analyses are part of the Ageing Lungs in European Cohorts (ALEC) Study (, which has also received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement no 633212. The local investigators and funding agencies for the European Community Respiratory Health Survey (ECRHS II and ECRHS III) are reported in the online supplementary file. These funders did not have any role in the study design, in the collection, analysis and interpretation of the data, in the writing of the report, and in the decision to submit the paper for publication.

  • Competing interests PD reports consulting fees from ALK, Stallergènes Greer, Circassia, Chiesi, Thermofisher Scientific and Ménarini, and AGC reports grants from Chiesi Farmaceutici and from GlaxoSmithKline Italy, during the conduct of the study. Other authors declare no competing interests related to this work.

  • Ethics approval Each participating center obtained ethical approval from their local ethics committees and followed the rules for ethics and data protection from their country, which were in accordance with the Declaration of Helsinki.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Author note ISGlobal is a member of CERCA Programme/Generalitat de Catalunya.

  • Presented at Some of the results were presented in the form of an oral presentation at the 2016 European Respiratory Society International Congress.

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