Relationship between physical activity and chronic obstructive pulmonary disease: a cross-sectional study

Background: This study explores the association between physical activity (PA) levels and patterns during adulthood and chronic obstructive pulmonary disease (COPD). Methods: Data from the National Health and Nutrition Examination Survey (NHANES) 2007–2018 was analyzed. A total of 34,392 participants were included. Three physical activity levels groups were categorized: insufficiently active (individuals not meeting the criteria for “Sufficiently active” or “HEPA active”), sufficiently active ((≥3 days of vigorous activities (≥480 MET-min/week), or ≥5 days of moderate activities /walking (≥600 MET-min/week), or ≥5 days of combined activities (≥600 MET-min/week)), HEPA active ((≥3 days of vigorous activities (≥1,500 MET-minutes/week), or ≥7 days of combined activities (≥3,000 MET-min/week)). Five PA patterns groups were categorized: vigorous work activity, moderate work activity, walk/bicycle for transportation, vigorous recreational activity, moderate recreational activity. The relationship between PA and COPD was explored using a multivariable logistic regression model, restricted cubic spline (RCS) analysis, and stratified analysis. Results: Compared to insufficiently active individuals, being sufficiently active (OR: 0.86, 95% CI = 0.75–0.98, p = 0.025) and HEPA active (OR: 0.84, 95% CI = 0.73–0.96, p = 0.010) were associated with lower COPD prevalence. Compared to those lacking corresponding PA patterns, low-level (OR: 1.35, 95% CI = 1.12–1.62, p = 0.002) and sufficient (OR: 1.19, 95% CI = 1.05–1.35, p = 0.006) moderate work activities (OPA) were linked to higher COPD prevalence. Sufficient transportation-related physical activities (TPA) (OR: 0.72, 95% CI = 0.59–0.89, p = 0.003), sufficient vigorous recreational activities (RPA) (OR: 0.68, 95% CI = 0.55–0.85, p < 0.001), low-level moderate RPA (OR: 0.77, 95% CI = 0.66–0.90, p = 0.001), and sufficient moderate RPA (OR: 0.71, 95% CI = 0.61–0.84, p < 0.001) were all significantly associated with lower COPD prevalence. Conclusion: In adulthood, TPA and RPA were associated with a lower COPD prevalence, while OPA were associated with a higher COPD prevalence. However, COPD patients might become less active because of their symptoms, which may influence study results. Increasing TPA/RPA proportion in total PA could be a potential COPD prevention strategy, but causal evidence requires further validation.