Associations between physical activity and the incidence of restrictive spirometry patterns: A cohort study

Backgrounds: Restrictive spirometry patterns (RSP) are associated with adverse health outcomes, but the association between physical activity (PA) levels and RSP risk, as well as the influence of factors like age, sex, and smoking status, is not well understood. Methods: This study included 212,023 participants (mean age: 38 years, 40.7 % women). PA levels were classified into four groups, and RSP incidence was assessed. RSP was defined using Global Lung Initiative criteria as FEV1/FVC z-score ≥ −1.64 and FVC z-score < −1.64. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95 % confidence intervals (CIs) for RSP incidence. Subgroup analyses were conducted to evaluate the potential influence of age, sex, and smoking status on the association between PA and RSP risk. Results: Engaging in any level of PA was associated with a reduced risk of RSP compared with complete inactivity. Subgroup analyses revealed that older adults (≥45 years) exhibited a significantly lower risk of RSP (HR: 0.81, 95 % CI: 0.73–0.90) compared to younger adults. Men had a lower risk than women (HR: 0.87, 95 % CI: 0.83–0.92), and current smokers showed a reduced risk compared to non-smokers (HR: 0.86, 95 % CI: 0.80–0.93). These findings indicate that the protective effect of PA on RSP may vary across population subgroups. Conclusions: Even minimal PA is associated with a lower RSP risk. Subgroup differences highlight the need for tailored PA interventions in diverse populations.