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Physical Activity and the Risk of Community-acquired Pneumonia in US Women

  • Mark I. Neuman
    Correspondence
    Reprint requests should be addressed to Mark I. Neuman, MD, MPH, Division of Emergency Medicine, Children's Hospital Boston, 300 Longwood Ave, Boston, MA 02115
    Affiliations
    Division of Emergency Medicine, Children's Hospital, Boston, Mass

    Channing Laboratory, Boston, Mass
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  • Walter C. Willett
    Affiliations
    Channing Laboratory, Boston, Mass

    Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass

    Department of Epidemiology, Harvard School of Public Health, Boston, Mass

    Department of Nutrition, Harvard School of Public Health, Boston, Mass
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  • Gary C. Curhan
    Affiliations
    Channing Laboratory, Boston, Mass

    Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass

    Department of Epidemiology, Harvard School of Public Health, Boston, Mass
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      Abstract

      Background

      Exercise bolsters the immune system and can prevent various infections in certain populations. However, limited data exist regarding the role of physical activity and the risk of community-acquired pneumonia.

      Methods

      During a 12-year period, we prospectively examined the association between physical activity and the risk of community-acquired pneumonia among 83,165 women in the Nurses' Health Study II who were between the ages of 27 and 44 years in 1991. We excluded women who had pneumonia before 1991 and those with a history of cancer, cardiovascular disease, or asthma. Biennial self-administered mailed questionnaires were used to determine activity level. Cases of pneumonia required a diagnosis by a physician and confirmation with a chest radiograph.

      Results

      We identified 1265 new cases of community-acquired pneumonia during 965,168 person-years of follow up. After adjusting for age, women in the highest quintile of physical activity were less likely to develop pneumonia than women in the lowest quintile (relative risk [RR] = 0.72; 95% confidence interval [CI], 0.60-0.86; P for trend<.001). However, the association was attenuated and only marginally significant after further adjusting for body mass index, smoking, and alcohol use (RR=0.84; 95% CI, 0.70-1.01; P for trend=.06). Women in the highest quintile of walking were less likely to develop pneumonia compared with women who walked the least (multivariate adjusted RR=0.82; 95% CI, 0.69-0.98); however, the trend across quintiles was not significant (P for trend=.25).

      Conclusion

      Higher physical activity does not substantially reduce pneumonia risk in well-nourished women.
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      References

        • Mokdad A.H.
        • Marks J.S.
        • Stroup D.F.
        • Gerberding J.L.
        Actual causes of death in the United States, 2000.
        JAMA. 2004; 291: 1238-1245
        • Fry A.M.
        • Shay D.K.
        • Holman R.C.
        • et al.
        Trends in hospitalizations for pneumonia among persons aged 65 years or older in the United States, 1988-2002.
        JAMA. 2005; 294: 2712-2719
        • Jackson M.L.
        • Neuzil K.M.
        • Thompson W.W.
        • et al.
        The burden of community-acquired pneumonia in seniors: results of a population-based study.
        Clin Infect Dis. 2004; 39: 1642-1650
        • Kohut M.L.
        • Senchina D.S.
        Reversing age-associated immunosenescence via exercise.
        Exerc Immunol Rev. 2004; 10: 6-41
        • Salive M.E.
        • Satterfield S.
        • Ostfeld A.M.
        • et al.
        Disability and cognitive impairment are risk factors for pneumonia-related mortality in older adults.
        Public Health Rep. 1993; 108: 314-322
        • Baik I.
        • Curhan G.C.
        • Rimm E.B.
        • et al.
        A prospective study of age and lifestyle factors in relation to community-acquired pneumonia in US men and women.
        Arch Intern Med. 2000; 160: 3082-3088
        • Curhan G.C.
        • Chertow G.M.
        • Willett W.C.
        • et al.
        Birth weight and adult hypertension and obesity in women.
        Circulation. 1996; 94: 1310-1315
        • Ainsworth B.E.
        • Haskell W.L.
        • Leon A.S.
        • et al.
        Compendium of physical activities: classification of energy costs of human physical activities.
        Med Sci Sports Exerc. 1993; 25: 71-80
        • Wolf A.M.
        • Hunter D.J.
        • Colditz G.A.
        • et al.
        Reproducibility and validity of a self-administered physical activity questionnaire.
        Int J Epidemiol. 1994; 23: 991-999
        • Maruti S.S.
        • Willett W.C.
        • Feskanich D.
        • et al.
        A prospective study of age-specific physical activity and premenopausal breast cancer.
        J Natl Cancer Inst. 2008; 100: 728-737
        • Giovannucci E.L.
        • Liu Y.
        • Leitzmann M.F.
        • et al.
        A prospective study of physical activity and incident and fatal prostate cancer.
        Arch Intern Med. 2005; 165: 1005-1010
        • Colditz G.A.
        • Feskanich D.
        • Chen W.Y.
        • et al.
        Physical activity and risk of breast cancer in premenopausal women.
        Br J Cancer. 2003; 89: 847-851
        • Mantel N.
        Chi-square tests with one degree of freedom: extensions of the Mantel-Haenszel procedure.
        J Am Stat Assoc. 1963; 58: 690-700
        • Gleeson M.
        Immune function in sport and exercise.
        J Appl Physiol. 2007; 103: 693-699
        • Mazzeo R.S.
        Altitude, exercise and immune function.
        Exerc Immunol Rev. 2005; 11: 6-16
        • Woods J.A.
        • Lowder T.W.
        • Keylock K.T.
        Can exercise training improve immune function in the aged?.
        Ann N Y Acad Sci. 2002; 959: 117-127
        • McFarlin B.K.
        • Flynn M.G.
        • Phillips M.D.
        • et al.
        Chronic resistance exercise training improves natural killer cell activity in older women.
        J Gerontol A Biol Sci Med Sci. 2005; 60: 1315-1318
        • Yan H.
        • Kuroiwa A.
        • Tanaka H.
        • et al.
        Effect of moderate exercise on immune senescence in men.
        Eur J Appl Physiol. 2001; 86: 105-111
        • Kohut M.L.
        • Cooper M.M.
        • Nickolaus M.S.
        • et al.
        Exercise and psychosocial factors modulate immunity to influenza vaccine in elderly individuals.
        J Gerontol A Biol Sci Med Sci. 2002; 57: M557-M562
        • He J.
        • Gu D.
        • Wu X.
        • et al.
        Major causes of death among men and women in China.
        N Engl J Med. 2005; 35: 1124-1134
        • Paffenbarger Jr, R.S.
        • Brand R.J.
        • Sholtz R.I.
        • Jung D.L.
        Energy expenditure, cigarette smoking, and blood pressure level as related to death from specific diseases.
        Am J Epidemiol. 1978; 108: 12-18
        • Hemila H.
        • Kaprio J.
        • Albanes D.
        • Virtamo J.
        Physical activity and the risk of pneumonia in male smokers administered vitamin E and beta-carotene.
        Int J Sports Med. 2006; 27: 336-341
        • Korppi M.
        Non-specific host response markers in the differentiation between pneumococcal and viral pneumonia: what is the most accurate combination?.
        Pediatr Int. 2004; 46: 545-550
        • Swingler G.H.
        Radiologic differentiation between bacterial and viral lower respiratory infection in children: a systematic literature review.
        Clin Pediatr (Phila). 2000; 39: 627-633
        • Bettenay F.A.
        • de Campo J.F.
        • McCrossin D.B.
        Differentiating bacterial from viral pneumonias in children.
        Pediatr Radiol. 1988; 18: 453-454