A "J"-shaped model has been proposed to describe the relationship between physical
activity and risk of upper-respiratory tract infection (URTI). However, little epidemiologic
evidence is available to support the contention that moderately active individuals
are at lowest risk of URTI. This investigation examined differences in URTI risk between
physically inactive and moderately active adults.
Observational study of 547 healthy adults (49% women) aged 20-70 yr reported URTI
events at 90-d intervals over 12-month of follow-up (5 evaluations). Three 24-h physical
activity recalls per evaluation were obtained and averaged to quantify total moderate-vigorous
activity (> or =3.0 metabolic equivalents [MET]). Associations between URTI and physical
activity levels were estimated using incidence rate ratios (IRR) derived using Poisson
regression while adjusting for a number of potential confounders including age, education,
anxiety, cynicism, and selected dietary factors.
Men and women reported 1.2 (1.4) and 1.2 (1.2) URTI events per year, respectively
(mean [(SD]). Adjusting for gender and potential confounders, the IRR for less than
3.93, 3.94-7.15, 7.16-11.95, and > or = 11.96 MET-h.d(-1) among men, and less than
2.38, 2.39-4.09, 4.10-6.24, and > or = 6.25 MET-h.d(-1) among women, were 1.00 (referent),
0.87 (95% confidence interval [CI], 0.70-1.07), 0.88 (95% CI, 0.71-1.09), and 0.77
(95% CI, 0.62-0.95), respectively (P(trend) = 0.03). This effect was stronger in men
(P(trend) = 0.03) than women (P(trend) = 0.17), although at similar expenditure levels
(6-7 MET-h.d-1), risk was reduced by about 20% in men and women. Risk reduction was
most pronounced in the fall of the year (P(trend) = 0.02).
These data support the hypothesis that moderate levels of physical activity are associated
with a reduced risk for URTI.