Research suggests physical activity and weight affect children’s lung health over time

A summary of research published in Thorax

A new paper suggests that physical activity and weight are two factors that have an impact on how well children’s lungs work as they grow.

Measuring lung function allows us to understand the risk for long-term lung disease. We know that lung function usually increases in childhood, remains level for a while, and then begins to decline with age. Understanding what shapes this growth and decline is important to prevent long-term lung conditions.

The new research has looked at how lung health changes over time, known as lung health pathways, or trajectories, as well as looking at the factors that affect these pathways over time.


Previous research has found a range of standard pathways from childhood to adulthood, that could be used in a similar way to height and growth charts that have been used around the world for many years to map children’s growth. You can read more about this research here.

The lung trajectories help us to spot children who are on a lower pathway and are therefore likely to experience poorer lung health and have a higher risk of developing a chronic lung condition.

What did the new study look at?

Researchers around the world are using lung function measurements from various populations to check for patterns. This new paper uses lung function measurements from 1,151 children in Spain. They were assessed as they aged at around 4, 7, 9, 10, 11, 14 and 18 years using spirometry tests. They also collected information on individual characteristics and lifestyle factors for the children to spot patterns in things that could affect lung function.

What do the results show?

The new paper describes four different lung heath pathways.

  • A lower-than-normal lung health pathway.
  • A normal lung health pathway.
  • A higher-than-normal lung health pathway.
  • A catch-up lung health pathway. This pathway describes a child who has below average lung function at 4 years of age, but normal lung function from 10 years of age and onwards.

When the researchers compared the catch-up pathway to the lower-than-normal pathway, children with higher levels of physical activity at the age of 4 were more likely to belong to the catch-up pathway. This was also true for children who had a higher weight measurement at the age of 4.

This suggests that some children’s lung health can improve over time, even if they started on a lower pathway.

Why is this important?

The findings add to our understanding of lung health pathways. The discovery of lung health pathways can help us to protect and improve lung health, while also promoting healthier growth and ageing globally.

The authors suggest that to support lung function growth in children, we need research and public health to encourage increases in physical activity levels and for children to maintain a healthy body weight.

ELF are committed to raising awareness of keeping lungs healthy. The ELF and ERS Healthy Lungs for Life campaign, puts a spotlight on 5 key areas: breathing clean air, being smoke free, being active, keeping up to date with vaccinations and fighting climate change. There is currently an open call for Healthy Lungs for Life grants for organisations to hold events promoting these themes. Find out more.

If you are a teacher, we also have resources available to share these important topics with children in school. Read more about our Healthy Lungs for Life for Schools campaign and access the free resources.

Read the original research paper:

Physical activity and body mass related to catch-up lung function growth in childhood: a population-based accelerated cohort study