Correlation between Level of Physical Activity, Aerobic Capacity and

Body Mass Index with Vital Lung Capacity in Adolescence

Theresia Dewi Purnama, Dian Marta Sari, Sunaryo B Sastradimadja, Arnengsih,

Ellyana Sungkar, Marrietta Shanti

Department of Physical Medicine and Rehabilitation Specialist, Medical Faculty of Universitas Padjadjaran

Dr. Hasan Sadikin General Hospital, Bandung, Indonesia

Keywords: Vital capacity, Body Mass Index, Physical Activity, Bruce Exercise

Abstract: The aim of the study is to find correlation between lung function and different health-related parameters:

Body Mass Index (BMI), physical activity (PA) and aerobic fitness, to enable us to present an alternative

method for improving their pulmonary function. Method: This is an observational analytic cross-sectional

study. Forty-three 12-15 years old (26 boys and 17 girls), had no cardiovascular, respiratory and metabolic

disease. Subjects performed Bruce exercise testing. Vital capacity was measured using spirometry and

physical activity using PAQ-A questionnaire. Correlation between level of physical activity, aerobic

capacity, BMI with vital lung capacity was analysed using Pearson trial with p value < 0.05 considered

significant. Result: Data has normal distribution. Mean age of participant is 13. Correlation coefficient

between vital capacity and BMI showed r = 0.197 p 0.206, Correlation between vital capacity and aerobic

capacity showed r = 0.426 p = 0.004. Correlation between vital capacity and physical activity showed r =

0.506 p 0.001 Conclusion: Higher vital lung capacity is correlated with higher aerobic fitness and higher

physical activity in adolescence of both genders.



1 INTRODUCTION

Pulmonary function is a long-term predictor for

overall survival rates in both genders (Amstrong

2013). There is a positive relation between

pulmonary function and mortality in general

population from prospective study of the Buffalo

Health Cohort Study (Dhuong 2019). Adolescence

represents a critical period of development, in which

during that time personal lifestyle choices and

behavior patterns establish, including the choice to

be physically active (Sutherland 2016). Many

problems occur while we are trying to improve the

quality of life and material wealth of modern

society. Among them is the reduction in physical

activity across all generations throughout the world

(Hallal, 2012). The time spent in physical activity by

children has decreased significantly compared to

before. Increased time spent using visual media and

watching TV

(Hesketh, 2017), and physical

inactivity due to excessive academic pressure and

the influence of parents, has increased obesity,

incorrect posture, and muscle weakness

(Hills,

2014). Thus, children living in modern society are

showing gradually decreasing physical fitness

(Jassen, 2014).

Previous studies have investigated obesity being

associated with altered lung function. In obese

individuals, structural changes of the thoracic-

abdominal region lead to limited diaphragm mobility

and rib movement, both essential for appropriate

ventilation mechanics

(Costa Melo 2014). But many

studies have not been adjusted to reveal relationship

between BMI, physical activity levels and aerobic

fitness with respiration function in adolescence.

Regular physical activity has a strong positive

impact on physical fitness, particularly on aerobic

capacity which is the most important health

promoting component of physical fitness.

The

students who performed supervised exercise had

higher levels of body composition and lung function.

Poor BMI and waist circumference values may lead

to limiting the practice of physical activity and

increasing the probability of respiratory pathologies

(Paunescu 2014). In relation with lung function,

Purnama, T., Sari, D., Sastradimadja, S., Arnengsih, ., Sungkar, E. and Shanti, M.

Correlation between Level of Physical Activity, Aerobic Capacity and Body Mass Index with Vital Lung Capacity in Adolescence.

DOI: 10.5220/0009064601150118

In Proceedings of the 11th National Congress and the 18th Annual Scientiﬁc Meeting of Indonesian Physical Medicine and Rehabilitation Association (KONAS XI and PIT XVIII PERDOSRI

2019), pages 115-118

ISBN: 978-989-758-409-1

115

physical activity also making important

consideration in spirometry values analysis (Paulo

2013).

Therefore, the aim of the study is to find

correlation between lung function and different

health-related parameters: BMI, physical activity

(PA) and aerobic fitness in adolescence.

2 METHODS

The study involved a group of 43 students of both

sexes (17 women and 26 men) from SMAK Baptist

aged 12–15 years. Subjects were included in

investigation according to inclusion criteria: students

of full-time program, absence of contraindications to

any of tests, the exclusion criteria: participant with

cardiovascular, metabolic and respiratory disease.

Other characteristics of subjects are listed in Table 1.

Forty-three students with various BMI underwent

measurement of anthropometric values (height,

weight), aerobic fitness (predicted VO2max), vital

capacity (VC) measurements. Forty-three participant

also filled in the Physical Activity Questionnaire for

Adolescence (PAQ-A).

Height was measured according to standardized

procedure using body measuring tape. Height was

measured to the nearest 0,01 cm. Body weight and

body mass index measures were taken to the nearest

0.01 kg and 0.01 kg/m

respectively. Upon the

recommendations of the World Health Organization,

BMI is used for the classification of nutritional state

by the following criteria: BMI <18.5 kg/m

(underweight), BMI 18.5 kg/m

– 22,9 kg/m

(normally nourished), BMI 23 kg/m

– 24.9 kg/m

(overweight), BMI >25 kg/m

(obesity), BMI 25,0 –

29.9- I degree (moderate obesity), BMI >30- II

degree (extreme, severe obesity).

Spirometry was assessed using standard

spirometer, vital capacity (VC) were measured to

nearest 0.01.

All spirometry tests were conducted by

the same technician to reduce inter-observer variability

and to prevent the failure of the measurement due to

the young age of the subjects. The participants were

given sufficient explanation about the method and

instrument use, and the tests were performed in a

sitting position while wearing a nose clip. The forced

vital capacity (FVC) and the forced expiratory volume

in one second (FEV1) were measured using a Quark

PFT (Cosmed, Italy). All of the pulmonary tests were

conducted following the standards presented by the

American Thoracic Society/European Respiratory

Society

Cardiorespiratory fitness was assessed using

cardiopulmonary testing Bruce protocol. Physical

activity was assessed with Physical Activity

Questionnaire- Adolescence (PAQ-A). Five levels of

physical activity were established according to

PAQ A Scoring Protocol guideline: very low, low,

regular, good, excellent. Statistical analysis was

performed using IBM SPSS Statistics (version 20.0).

Pearson correlation coefficient at significant level of

0.05% was estimated assessing correlations between

variables

3 RESULTS

We managed to collect 43 samples. Mean age of

participants is 13. Gender composition is 17 girls

and 26 boys. Correlation between vital capacity and

BMI showed r = 0.197, p = 0.206, Correlation

between vital capacity and aerobic capacity showed

r = 0.426, p = 0.004. Correlation between vital

capacity and physical activity showed r = 0.506, p =

0.001

Figure 1: Correlation of body mass index and vital

capacity

Vital Capacity

Group

Boys

Girls

Boys

Girls

KONAS XI and PIT XVIII PERDOSRI 2019 - The 11th National Congress and The 18th Annual Scientiﬁc Meeting of Indonesian Physical

Medicine and Rehabilitation Association

116

Figure 2: Correlation of aerobic capacity and vital

capacity.

Figure 3: Correlation of level of activity and vital capacity.

4 DISCUSSIONS

Breathing is an essential function in lung function,

which can hinder quality of life and performance in

activities of daily living. To maintain respiratory

homeostasis, the structures that compose the

respiratory system need to work in equilibrium

(Manino 2013).

The term adolescence is defined as the period

from puberty to full sexual maturation and its related

with the physical, mental and the social growth.

Growth spurt in adolescence involves every

muscular and skeletal dimensions of the body. It has

been observed that adolescence habituated to high

level of physical activity and having greater average

lung capacity than comparable age (Sable 2015).

Views have been expressed that training during

this period, as compared with training after may be

of greater importance in determining the ultimate

dimensions of the lung (Olfert 2016). However, in

the recent past, a number of studies have failed to

find effects of activity, aerobic capacity and BMI on

most aspects of lung function.

The purpose of this study was to estimate the

correlation between vital capacity and the level of

physical activity, body mass index and aerobic in

adolescence to enable us to present an alternative

method for improving their pulmonary function. The

result showed that greater lung capacity was

correlated with a higher level of physical activity

and aerobic capacity in adolescence. These results

showed that physical activity and higher aerobic

capacity during growth may help in developing a

reduced resistance to expiration and a greater

endurance in respiratory muscle. Our study findings

are consistent with the finding that concluded

regular physical activity has a strong positive impact

on physical fitness, particularly on aerobic capacity

which is the most important health promoting

component of physical fitness (Amstrong 2013).

As it was told before, we did not find an

association between BMI and vital capacity. Nine

studies were selected by selecting publications in the

science database MEDLINE. The result showed that

obese individuals presented with a reduction in lung

volume and capacity as compared to healthy

individuals, which means that the presence of a

restrictive respiratory pattern associated with

obesity. The results of these studies were different

from our results.

There may be several reasons for this

phenomenon. First, the subjects of this study are

Indonesian, different background ethnic from

previous study; second, our study group consist

participant with various BMI level and comprised of

mostly students that had normal body weight and

BMI in both genders: 80.49% in girls and 73.53% in

boys.

Vital Capacity

Group

Boys

Girls

Boys

Girls

Vital Capacity

Group

Boys

Girls

Boys

Girls

Correlation between Level of Physical Activity, Aerobic Capacity and Body Mass Index with Vital Lung Capacity in Adolescence

117

Table 1: Physical characteristic of boys and girls

Variable Age

(Mean േ SD)

Height

(Mean േ SD)

Weight

(Mean േ SD)

Aerobic capacity

(Mean േ SD)

Boys

13.63േ0.652 159.8േ7.52 49.12േ8.48 43.98േ9.54

Girls

13.35േ0.493 154.5േ5.62 48.53േ8.47 37.37േ8.51

Table 2: Pearson correlation between BMI, aerobic capacity and level of activity in adolescence

BMI Aerobic capacity Level of activity

Vital capacity

(r)

0.197 0.426 0.506

p value 0.206 0.004 0.001

5 CONCLUSIONS

Higher vital lung capacity associated with higher

aerobic capacity and level of physical activity in

adolescence of both genders.

REFERENCES

Armstrong, Neil. 2013. Aerobic Fitness and Physical

Activity in Children. Pediatr Exerc Sci. 25(2):548-60.

Dhuong L, Rangarajan et al. 2019. Mortality and

cardiovasular and respiratory morbidity in individual

with impaired FEV1 (PURE) : An International

Community-Based Cohort Study. Lancet Glob Health;

7: e613–23

Sutherland JT, Mclahan Christine et al. 2016. The

Relationship Between Body Fat and Respiratory

Function in Young Adults. Eur Respir J. 48:734-47

Hallal PC, Andersen LB, Bull FC, et al. 2012. Global

physical activity levels : surveillance progress, pitfalls,

and prospects. Lancet Physical Activity Series

Working Group. LANCET; 3(80):247–257

Ji J, Wang SQ, Liu YJ, et al. 2013. Physical activity and

lung function growth in a cohort of chinese school

children: a prospective study. PLoS ONE; 39(2): 283-

Hesketh K, Wake M, Graham M, et al. 2017. Stability of

television viewing and electronic game/computer use

in a prospective cohort study of Australian children

relationship with body mass index. Int J Behav Nutr

Phys Act.4: 60-1.

Hills AP, Andersen LB, Byrne NM. 2014. Physical

activity and obesity in children. Br J Sports Med; 45:

866–870.

Janssen I, Katzmarzyk PT, Boyce WF, et al. 2014.

Overweight and obesity in Canadian adolescents and

their associations with dietary habits and physical

activity patterns. J Adolesc Health, 2004; 35: 360–

367.

Luciana Costa Melo, Maria Alayde Mendonça da Silva,

Ana Carolina do Nascimento Calles. 2014. Obesity

and lung function: a systematic review. Einstein (Sao

Paulo); 12(1):120-5.

Paunescu, Mihaela. 2014. Physical Activity and

Pulmonary Diseases : A Systematic Review. Rev

Cercet Interv So; 45 : 23-9

R. Paulo, J. Petrica, J. Martins. 2013. Physical activity and

respiratory function: corporal composition and

spirometric values analysis. Acta Med Port; 26(3):

258–259.

Mannino DM, Buist AS, Petty TL, et al. 2013. Lung

function and mortality in the United States: data from

the First National Health and Nutrition Examination

Survey follow up. Study Thorax; 58:388-93

Sable M, Kowale R et al. 2015. Study lung function in

adolescence runners and non runners. J Med Sci; 5:2

Olfert I. M. 2016. Exercise and the lungs: nature or

nurture?: Perspectives. J Phys. 594(18), 5037–38

KONAS XI and PIT XVIII PERDOSRI 2019 - The 11th National Congress and The 18th Annual Scientiﬁc Meeting of Indonesian Physical

Medicine and Rehabilitation Association

118