EXERCISE

RATIONALE: Clinical control is difficult to achieve in obese patients with asthma. Bariatric surgery has been recommended for weight-loss and to improve asthma control; however, the benefits of nonsurgical interventions have been poorly investigated.

OBJECTIVE: To examine the effect of exercise training in a weight-loss program on asthma control, quality of life, inflammatory biomarkers and lung function.

METHODS: Fifty-five obese patients with asthma were randomly assigned to either a weight-loss program + exercise (WL+E group, n=28) or a weight-loss program + sham (WL+S group, n=27) group, where the weight-loss program included nutrition (caloric restriction) and psychological therapies. The WL+E group incorporated aerobic and resistance muscle training, whereas the WL+S group incorporated breathing and stretching exercises.

MEASUREMENTS: The primary outcome was clinical improvement in asthma control over 3 months. Secondary outcomes included quality of life, lung function, body composition, aerobic capacity, muscle strength and inflammatory/anti-inflammatory biomarkers.

MAIN RESULTS: After 3 months, 51 patients were analyzed. Compared with the WL+S group, the WL+E group demonstrated improved clinical control scores (-0.7 [-1.3, -0.3] vs. -0.3 [-0.9, 0.4]; P=0.01) and greater weight-loss (-6.8%±3.5 vs. -3.1%±2.6; P<0.001) and aerobic capacities (3.0 [2.4, 4.0] vs. 0.9 [-0.3, 1.3] mL O2.kg.min-1; P<0.001). These improvements in the WL+E group were also accompanied by improvements in lung function, anti-inflammatory biomarkers and vitamin D levels, as well as reductions in airway and systemic inflammation.

CONCLUSIONS: Adding exercise to a short-term weight-loss program should be considered as a useful strategy to achieving clinical control of asthma in obese patients. Clinical trial registration available at www.clinicaltrials.gov, ID NCT02188940.