Physical activity and lung function—Cause or consequence?
Concerns exist that the positive association of physical activity with better lung function, which has been suggested in previous longitudinal studies in smokers, is due to reverse causation. To investigate this, we applied structural equation modeling (SEM), an exploratory approach, and marginal st...
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| Veröffentlicht in: | PloS one Jg. 15; H. 8; S. e0237769 |
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20.08.2020
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| Abstract | Concerns exist that the positive association of physical activity with better lung function, which has been suggested in previous longitudinal studies in smokers, is due to reverse causation. To investigate this, we applied structural equation modeling (SEM), an exploratory approach, and marginal structural modeling (MSM), an approach from the causal inference framework that corrects for reverse causation and time-dependent confounding and estimates causal effects, on data from participants in the European Community Respiratory Health Survey (ECRHS, a multicentre European cohort study initiated in 1991-1993 with ECRHS I, and with two follow-ups: ECRHS II in 1999-2003, and ECRHS III in 2010-2014). 753 subjects who reported current smoking at ECRHS II, with repeated data on lung function at ECRHS I, II and III, physical activity at ECRHS II and III, and potential confounders at ECRHS I and II, were included in the analyses. SEM showed positive associations between physical activity and lung function in both directions. MSM suggested a protective causal effect of physical activity on lung function (overall difference in mean β (95% CI), comparing active versus non-active individuals: 58 mL (21-95) for forced expiratory volume in one second and 83 mL (36-130) for forced vital capacity). Our results suggest bi-directional causation and support a true protective effect of physical activity on lung function in smokers, after accounting for reverse causation and time-dependent confounding. |
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| AbstractList | Concerns exist that the positive association of physical activity with better lung function, which has been suggested in previous longitudinal studies in smokers, is due to reverse causation. To investigate this, we applied structural equation modeling (SEM), an exploratory approach, and marginal structural modeling (MSM), an approach from the causal inference framework that corrects for reverse causation and time-dependent confounding and estimates causal effects, on data from participants in the European Community Respiratory Health Survey (ECRHS, a multicentre European cohort study initiated in 1991–1993 with ECRHS I, and with two follow-ups: ECRHS II in 1999–2003, and ECRHS III in 2010–2014). 753 subjects who reported current smoking at ECRHS II, with repeated data on lung function at ECRHS I, II and III, physical activity at ECRHS II and III, and potential confounders at ECRHS I and II, were included in the analyses. SEM showed positive associations between physical activity and lung function in both directions. MSM suggested a protective causal effect of physical activity on lung function (overall difference in mean β (95% CI), comparing active versus non-active individuals: 58 mL (21–95) for forced expiratory volume in one second and 83 mL (36–130) for forced vital capacity). Our results suggest bi-directional causation and support a true protective effect of physical activity on lung function in smokers, after accounting for reverse causation and time-dependent confounding. Concerns exist that the positive association of physical activity with better lung function, which has been suggested in previous longitudinal studies in smokers, is due to reverse causation. To investigate this, we applied structural equation modeling (SEM), an exploratory approach, and marginal structural modeling (MSM), an approach from the causal inference framework that corrects for reverse causation and time-dependent confounding and estimates causal effects, on data from participants in the European Community Respiratory Health Survey (ECRHS, a multicentre European cohort study initiated in 1991-1993 with ECRHS I, and with two follow-ups: ECRHS II in 1999-2003, and ECRHS III in 2010-2014). 753 subjects who reported current smoking at ECRHS II, with repeated data on lung function at ECRHS I, II and III, physical activity at ECRHS II and III, and potential confounders at ECRHS I and II, were included in the analyses. SEM showed positive associations between physical activity and lung function in both directions. MSM suggested a protective causal effect of physical activity on lung function (overall difference in mean [beta] (95% CI), comparing active versus non-active individuals: 58 mL (21-95) for forced expiratory volume in one second and 83 mL (36-130) for forced vital capacity). Our results suggest bi-directional causation and support a true protective effect of physical activity on lung function in smokers, after accounting for reverse causation and time-dependent confounding. Concerns exist that the positive association of physical activity with better lung function, which has been suggested in previous longitudinal studies in smokers, is due to reverse causation. To investigate this, we applied structural equation modeling (SEM), an exploratory approach, and marginal structural modeling (MSM), an approach from the causal inference framework that corrects for reverse causation and time-dependent confounding and estimates causal effects, on data from participants in the European Community Respiratory Health Survey (ECRHS, a multicentre European cohort study initiated in 1991-1993 with ECRHS I, and with two follow-ups: ECRHS II in 1999-2003, and ECRHS III in 2010-2014). 753 subjects who reported current smoking at ECRHS II, with repeated data on lung function at ECRHS I, II and III, physical activity at ECRHS II and III, and potential confounders at ECRHS I and II, were included in the analyses. SEM showed positive associations between physical activity and lung function in both directions. MSM suggested a protective causal effect of physical activity on lung function (overall difference in mean β (95% CI), comparing active versus non-active individuals: 58 mL (21-95) for forced expiratory volume in one second and 83 mL (36-130) for forced vital capacity). Our results suggest bi-directional causation and support a true protective effect of physical activity on lung function in smokers, after accounting for reverse causation and time-dependent confounding.Concerns exist that the positive association of physical activity with better lung function, which has been suggested in previous longitudinal studies in smokers, is due to reverse causation. To investigate this, we applied structural equation modeling (SEM), an exploratory approach, and marginal structural modeling (MSM), an approach from the causal inference framework that corrects for reverse causation and time-dependent confounding and estimates causal effects, on data from participants in the European Community Respiratory Health Survey (ECRHS, a multicentre European cohort study initiated in 1991-1993 with ECRHS I, and with two follow-ups: ECRHS II in 1999-2003, and ECRHS III in 2010-2014). 753 subjects who reported current smoking at ECRHS II, with repeated data on lung function at ECRHS I, II and III, physical activity at ECRHS II and III, and potential confounders at ECRHS I and II, were included in the analyses. SEM showed positive associations between physical activity and lung function in both directions. MSM suggested a protective causal effect of physical activity on lung function (overall difference in mean β (95% CI), comparing active versus non-active individuals: 58 mL (21-95) for forced expiratory volume in one second and 83 mL (36-130) for forced vital capacity). Our results suggest bi-directional causation and support a true protective effect of physical activity on lung function in smokers, after accounting for reverse causation and time-dependent confounding. Concerns exist that the positive association of physical activity with better lung function, which has been suggested in previous longitudinal studies in smokers, is due to reverse causation. To investigate this, we applied structural equation modeling (SEM), an exploratory approach, and marginal structural modeling (MSM), an approach from the causal inference framework that corrects for reverse causation and time-dependent confounding and estimates causal effects, on data from participants in the European Community Respiratory Health Survey (ECRHS, a multicentre European cohort study initiated in 1991-1993 with ECRHS I, and with two follow-ups: ECRHS II in 1999-2003, and ECRHS III in 2010-2014). 753 subjects who reported current smoking at ECRHS II, with repeated data on lung function at ECRHS I, II and III, physical activity at ECRHS II and III, and potential confounders at ECRHS I and II, were included in the analyses. SEM showed positive associations between physical activity and lung function in both directions. MSM suggested a protectivecausaleffect of physical activity on lung function (overall difference in mean beta (95% CI), comparing active versus non-active individuals: 58 mL (21-95) for forced expiratory volume in one second and 83 mL (36-130) for forced vital capacity). Our results suggest bi-directional causation and support a true protective effect of physical activity on lung function in smokers, after accounting for reverse causation and time-dependent confounding. |
| Audience | Academic |
| Author | Peralta, Gabriela P. Squillacioti, Giulia Weyler, Joost Leynaert, Bénédicte Bédard, Annabelle Pin, Isabelle Garcia-Aymerich, Judith Jarvis, Deborah Carsin, Anne-Elie Janson, Christer Heinrich, Joachim Dharmage, Shyamali C. Accordini, Simone Sánchez-Ramos, José Luis Garcia-Larsen, Vanessa Fuertes, Elaine Johannessen, Ane |
| AuthorAffiliation | 16 INSERM, Institut for Advanced Biosciences, Grenoble, France 13 UMR 1152, University Paris Diderot, Paris, France 20 MRC-PHE Centre for Environment and Health, Imperial College London, London, United Kingdom 2 Universitat Pompeu Fabra (UPF), Barcelona, Spain 15 CHU Grenoble Alpes, Department of Pediatrics, Grenoble, France 14 Pneumology Service, Juan Ramón Jiménez Hospital, Huelva, Spain 1 ISGlobal, Barcelona, Spain 7 Program in Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America 5 Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy 10 Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway 12 Inserm, UMR 1152, Pathophysiology and Epidemiology of Respiratory Diseases, Paris, France 8 Institute and Outpatient Clinic for Occupational, Social and Environmental Medi |
| AuthorAffiliation_xml | – name: 14 Pneumology Service, Juan Ramón Jiménez Hospital, Huelva, Spain – name: 2 Universitat Pompeu Fabra (UPF), Barcelona, Spain – name: 4 National Heart and Lung Institute, Imperial College London, London, United Kingdom – name: 20 MRC-PHE Centre for Environment and Health, Imperial College London, London, United Kingdom – name: 12 Inserm, UMR 1152, Pathophysiology and Epidemiology of Respiratory Diseases, Paris, France – name: 9 Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden – name: 17 University Grenoble Alpes, Grenoble, France – name: Cincinnati Children's Hospital Medical Center, UNITED STATES – name: 3 CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain – name: 8 Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich, Ludwig Maximilians University Munich, Munich, Germany – name: 5 Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy – name: 1 ISGlobal, Barcelona, Spain – name: 16 INSERM, Institut for Advanced Biosciences, Grenoble, France – name: 7 Program in Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America – name: 15 CHU Grenoble Alpes, Department of Pediatrics, Grenoble, France – name: 19 Department of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium – name: 11 Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway – name: 10 Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway – name: 13 UMR 1152, University Paris Diderot, Paris, France – name: 18 Department of Public Health and Pediatrics, University of Turin, Turin, Italy – name: 6 Allergy and Lung Health Unit, School of Population and Global Health, University of Melbourne, Melbourne, Australia |
| Author_xml | – sequence: 1 givenname: Annabelle orcidid: 0000-0002-7842-8889 surname: Bédard fullname: Bédard, Annabelle – sequence: 2 givenname: Anne-Elie surname: Carsin fullname: Carsin, Anne-Elie – sequence: 3 givenname: Elaine surname: Fuertes fullname: Fuertes, Elaine – sequence: 4 givenname: Simone surname: Accordini fullname: Accordini, Simone – sequence: 5 givenname: Shyamali C. surname: Dharmage fullname: Dharmage, Shyamali C. – sequence: 6 givenname: Vanessa surname: Garcia-Larsen fullname: Garcia-Larsen, Vanessa – sequence: 7 givenname: Joachim surname: Heinrich fullname: Heinrich, Joachim – sequence: 8 givenname: Christer surname: Janson fullname: Janson, Christer – sequence: 9 givenname: Ane surname: Johannessen fullname: Johannessen, Ane – sequence: 10 givenname: Bénédicte surname: Leynaert fullname: Leynaert, Bénédicte – sequence: 11 givenname: José Luis surname: Sánchez-Ramos fullname: Sánchez-Ramos, José Luis – sequence: 12 givenname: Gabriela P. surname: Peralta fullname: Peralta, Gabriela P. – sequence: 13 givenname: Isabelle surname: Pin fullname: Pin, Isabelle – sequence: 14 givenname: Giulia surname: Squillacioti fullname: Squillacioti, Giulia – sequence: 15 givenname: Joost surname: Weyler fullname: Weyler, Joost – sequence: 16 givenname: Deborah surname: Jarvis fullname: Jarvis, Deborah – sequence: 17 givenname: Judith surname: Garcia-Aymerich fullname: Garcia-Aymerich, Judith |
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| Copyright | COPYRIGHT 2020 Public Library of Science 2020 Bédard et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2020 Bédard et al 2020 Bédard et al |
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publication-title: Clin Sci doi: 10.1042/CS20090458 – volume: 73 start-page: 376 year: 2018 ident: pone.0237769.ref002 article-title: Leisure-time vigorous physical activity is associated with better lung function: the prospective ECRHS study publication-title: Thorax doi: 10.1136/thoraxjnl-2017-210947 – volume: 176 start-page: 608 year: 2012 ident: pone.0237769.ref008 article-title: Invited commentary: structural equation models and epidemiologic analysis publication-title: Am J Epidemiol doi: 10.1093/aje/kws213 – volume: 22 start-page: 278 year: 2017 ident: pone.0237769.ref019 article-title: Physical activity and lung function decline in adults with asthma: The HUNT Study publication-title: Respirology doi: 10.1111/resp.12884 – volume: 156 start-page: 139 year: 2002 ident: pone.0237769.ref014 article-title: Physical inactivity is associated with lower forced expiratory volume in 1 second: European prospective investigation into cancer-norfolk prospective population study publication-title: Am J Epidemiol doi: 10.1093/aje/kwf021 – volume: 17 year: 2017 ident: pone.0237769.ref016 article-title: Association of physical activity with lung function in lung-healthy German adults: Results from the KORA FF4 study publication-title: BMC Pulm Med doi: 10.1186/s12890-017-0562-8 – volume: 58 start-page: 265 year: 2004 ident: pone.0237769.ref010 article-title: A definition of causal effect for epidemiological research publication-title: J Epidemiol Community Heal doi: 10.1136/jech.2002.006361 – volume: 142 start-page: 1009 year: 2012 ident: pone.0237769.ref007 article-title: Alternative Dietary Indices Both Strongly Predict Risk of Chronic Disease publication-title: J Nutr doi: 10.3945/jn.111.157222 – volume: 168 start-page: 494 year: 2003 ident: pone.0237769.ref013 article-title: Delaying decline in pulmonary function with physical activity: A 25-year follow-up publication-title: Am J Respir Crit Care Med doi: 10.1164/rccm.200208-954OC |
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| Title | Physical activity and lung function—Cause or consequence? |
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