Exercise as it relates to Disease/How does regular physical activity play a role in the incidence of asthma in adult women?

This is a critique of the Research Article: Benet, M. The effects of regular physical activity on adult-onset asthma incidence in women. Respiratory Medicine. 2011, 105(7), p.1104-1107. The critique is written as an assignment in the unit: Health, Disease and Exercise at The University of Canberra, August-September 20

What is the background to this research?
Asthma is a chronic respiratory condition whereby the airways are more sensitive to external triggers such as dust which cause the muscles of the airways to contract, making it narrower and harder to breathe.

Adult onset asthma is an important issue regarding the health adults, and though there is more research needed to prove what specific lifestyle factors may cause the onset of asthma within adults, evidence suggests there is a strong correlation between an increasing BMI and asthma incidence. Thus, physical activity may play a role in the incidence of asthma within an adult population, due to its direct association with BMI.

The busy nature of an adult life can often cause to higher levels of sedentary activity. Thus, identifying a link between sedentary activity and the onset of chronic illnesses such as asthma is a high priority issue due to its possible burden to the individuals affected and the health care system. Hence the reason for this study being undertaken.

Research Details
The baseline research started in 1993 and consisted of a large-scale questionnaire consisting of specific questions related to physical activity and asthma for approximately 78, 000 women aged between 40-65. Definitions were provided to ensure that the information recorded in the self-reported survey was accurate. The volume of participants was decreased as approximately 22, 000 participants had data missing from their physical activity survey, meaning they had to be excluded. The research continued for 10 years before all statistics were analysed to give results in 2003.

The large volume of participant meant that the conclusions drawn may derive more reliable statistics regarding the correlation between physical activity levels and asthma. The addition of simple definitions and examples for the answers in the provided questions may have helped to ensure more accurate measures of physical activity and asthma related data was recorded. However, some participants may feel inclined to lie in questionnaires, which may have an adverse effect on epidemiological data recorded. The data also lacks measures of alternate risk factors that may cause an onset of asthma e.g. smoking, air quality and diet, thus misleading correlations may be drawn without the consideration of the true cause.

Results
The results concluded that of the 51, 080 participants:
 * 512 (1%) developed asthma during the survey period.


 * The mean age of their first asthma attack was 57, suggesting that there may be a correlation between age and the onset of asthma as it is in the upper quartile of the age range recorded.


 * Higher BMI was associated with a higher risk of Asthma incidence, however physical activity is not the only factor affecting BMI. Additionally, a higher BMI can be caused because of greater lean mass; which has a direct correlation with physical activity.

Discussion
The results drawn from the research accurately reflected what was set out in the methodology; to identify trends relating to physical activity and the onset of asthma in adult women. The exclusion of females with incomplete data sets and women who reported asthma attacks at the baseline data collection survey allowed for an accurate idea of asthma development in correlation with physical activity to be drawn. The inclusion of these data sets would have skewed the data and discredited any conclusions drawn. The long time period over which the data was recorded also helped to solidify the trends drawn from the research.

Practical Advice
The steps taken were both thorough and relevant enough to attain the desired results set out at the start of the study. However, when drawing conclusions about those who had developed asthma throughout the period the study was conducted, it would be beneficial to have an extended survey regarding alternate factors that may have played a role in developing asthma e.g. smoking, diet and family history.

Conclusions
There was insufficient data to conclude that physical activity is directly related to the development of asthma. This lines up with alternate literature regarding the fact that there is no link between physical activity levels and the development of asthma.

However, evidence suggests that physical activity may be a positive lifestyle factor used to not only manage asthma severity, but alternate chronic diseases such as cardiovascular disease and type 2 diabetes mellitus. Literature also suggests that physical activity can be detrimental to those who have asthma. But this tends to only be as a result of incorrect management of asthma attacks during exercise. Thus, care needs to be taken to reap the positive benefits whilst minimising the risk associated with exercise.

Further Information
If you would like to find out more about Asthma and/or Physical Activity, check out the following links:


 * https://www.asthmaaustralia.org.au/national/about-asthma/what-is-asthma


 * http://www.asthmahandbook.org.au/clinical-issues/exercise/physical-activity


 * https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/asthma-and-exercise


 * https://www.asthmaaustralia.org.au/ArticleDocuments/865/Staying%20Active%20With%20Asthma%202014.pdf.aspx


 * https://www.webmd.com/g00/asthma/guide/exercising-asthma?i10c.encReferrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS5hdS8%3D&i10c.ua=1&i10c.dv=14