Aerobic Physical Activity Associated with Reduced Risk of Influenza and Pneumonia Mortality

by | Feb 14, 2024 | 2023, Fitness and Exercise, Immune Health

Written by Taylor Woosley, Science Writer. Participants reporting 75-150 min/week of vigorous-intensity aerobic physical activity had a 56% lower adjusted mortality risk compared to those who reported no vigorous-intensity aerobic physical activity. 

fInfluenza and pneumonia account for substantial mortality in the United States and are consistently within the top ten leading causes of death1. Physical inactivity is a risk factor for chronic diseases and acute respiratory infections such as the common cold, influenza, and pneumonia2. Furthermore, national guidelines state that physical activity is one of the most important measures for individuals of all ages to improve health3.

The 2008 Physical Activity Guidelines for Americans recommend a target range of 150 to 300 minutes per week of moderate-intensity physical activity, 75 to 150 minutes of vigorous physical activity, or an equivalent volume from a combination of activities4. Physical activity aids in prevention of infectious diseases because physically active people are more likely to be resilient to infection through better immunosurveillance against pathogens5. Additionally, research has shown that subjects who were active (20 minutes vigorous exercise three or more times per week) had higher influenza antibody levels and influenza-specific lymphocyte proliferation compared to the inactive group6.

Webber et al. conducted a longitudinal study using data from the National Health Interview Survey (NHIS) from 1998-2018. The NHIS is an ongoing, cross-sectional household interview survey focused on collecting health data on a representative sample of the civilian United States population. Participants provided information regarding how frequently they partook in ≥10 minutes of moderate to vigorous-intensity activities (MVPA) or muscle strengthening activities (MSA). Subjects were classified into four groups based on physical activity guideline adherence: meeting neither guideline (<150 min/week of MVPA and <2 episodes/week of MSA); meeting only the aerobic guideline (≥150 min/week of MVPA and <2 episodes/week of MSA); meeting only the muscle-strengthening guideline (<150 min/week of MVPA and ≥2 episodes/week of MSA) and meeting both guidelines (≥150 min/week of MVPA and ≥2 episodes/week of MSA).

Covariates included in the analysis were available NHIS data on sex, age, race/ethnicity, education, marital status, smoking, alcohol consumption, body mass index (BMI), disease history, and influenza and pneumococcal vaccination status. Mortality outcomes were collected from the 2019 NHIS-National Death Index. A total of 577,909 subjects were included in the final analysis. 52.2% of participants were women, 69.2% were non-Hispanic white, and 50.5% did not meet the aerobic or muscle-strengthening guidelines. A median of 9.23 years of follow-up resulted in 81,431 recorded deaths, with 1,516 deaths being attributed to influenza and pneumonia. Significant findings of the study are as follows:

  • Subjects who met both guidelines had a 48% lower adjusted risk of influenza and pneumonia mortality compared to participants who did not meet either physical activity guidelines. Those who met the aerobic guideline had a 36% lower adjusted risk.
  • Participants who reported MVPA at any intensity level had a lower risk of influenza and pneumonia mortality compared to those who did not partake in any MVPA, with a 21% lower risk for those reporting 10-149 min/week to 50% for subjects reporting 301-600 min/week.
  • After adjusting for the aerobic category, participants reporting 2 MSA episodes/week had a 47% lower risk of influenza and pneumonia mortality.

Results of this large US cohort study show that subjects participating in aerobic and muscle strengthening physical activities had a significantly reduced risk of influenza and pneumonia mortality. Study limitations include the self-reported nature of exposure data at a single time point and the lack of measuring shorter periods of physical activity, along with not distinguishing between light-intensity and moderate-intensity activity.

Source: Webber, Bryant J., Anne G. Wheaton, Peng-jun Lu, and Geoffrey P. Whitfield. “Joint Prevalence of Influenza Preventive Behaviors Among Adults—United States, 2020.” Journal of Primary Care & Community Health 14 (2023): 21501319231191681.

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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Posted February 14, 2024.

Taylor Woosley studied biology at Purdue University before becoming a 2016 graduate of Columbia College Chicago with a major in Writing. She currently resides in Glen Ellyn, IL.

References:

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  2. Nieman DC, Sakaguchi CA. Physical activity lowers the risk for acute respiratory infections: Time for recognition. J Sport Health Sci. Nov 2022;11(6):648-655. doi:10.1016/j.jshs.2022.08.002
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  6. You M. Role of Physical Activity in the Prevention and Treatment of Influenza: A Review. Sports Med Open. Dec 2 2023;9(1):115. doi:10.1186/s40798-023-00660-x