Prospective Study of Cured Meats Consumption and Risk of Chronic Obstructive Pulmonary Disease in Men

Raphaëlle Varraso; Rui Jiang; R. Graham Barr; Walter C. Willett; Carlos A. Camargo, Jr.


Am J Epidemiol. 2007;166(12):1438-1445. 

In This Article

Abstract and Introduction


Cured meats are high in nitrites. Nitrites generate reactive nitrogen species that may cause damage to the lung. The objective is to assess the relation between frequent consumption of cured meats and the risk of newly diagnosed chronic obstructive pulmonary disease (COPD). Between 1986 and 1998, the authors identified 111 self-reported cases of newly diagnosed COPD among 42,915 men from the Health Professionals Follow-up Study. The cumulative average intake of cured meats consumption (processed meats, bacon, hot dogs) was calculated from food frequency questionnaires administrated in 1986, 1990, and 1994 and divided according to servings per week (never/almost never, <1 serving/week, 1-3 servings/week, 4-6 servings/week, at least once/day). After adjustment for age, smoking status, pack-years, pack-years squared, energy intake, race/ethnicity, US region, body mass index, and physical activity, the consumption of cured meats was positively associated with the risk of newly diagnosed COPD (for highest vs. lowest intake: relative risk = 2.64, 95% confidence interval: 1.39, 5.00; p trend = 0.002). In contrast to these findings, the consumption of cured meats was not associated with the risk of adult-onset asthma. These data suggest that cured meat may worsen the adverse effects of smoking on risk of COPD.


Cured meats contain various compounds added to meat products as preservatives and color fixatives,[1] among which the most important are nitrites.[2] Nitrites generate reactive nitrogen species that can amplify inflammatory processes in the airways and lung parenchyma causing DNA damage, inhibition of mitochondrial respiration, and nitrosative stress.[3] The long-term persistence of nitrosative stress may contribute to the progressive deterioration of pulmonary function and may be implicated in the pathogenesis of chronic obstructive pulmonary disease (COPD).[4]

Currently, COPD is the fourth leading cause of mortality in Europe and in the United States.[5] With the increase in cigarette smoking in developing countries, COPD is expected to become the third leading cause of death worldwide by 2020.[6] Cigarette smoking is the most important risk factor for COPD in developed nations,[7] but not all smokers develop COPD[8]—an observation that suggests that other factors also are involved. In the last decade, there has been a growing interest to identify foods related to the level of lung function or COPD symptoms.[9] Most investigations have focused on foods with antioxidant properties and not foods with a potential deleterious effect.

Two recent studies have tested the hypothesis that frequent consumption of cured meats increases the risk of COPD: a cross-sectional study of more than 7,000 men and women[10] and a longitudinal study of more than 71,000 women.[11] Both reported a positive association between the frequent consumption of cured meats and an increased risk of COPD. Gender differences in the manifestations and diagnosis of obstructive airway disease over the human life span,[12] as well as gender differences in food choices and energy intake,[13] provide a compelling rationale to study the relation between cured meat and COPD among men as well. We therefore examined the association between cured meats consumption and risk of newly diagnosed COPD in a prospective cohort of more than 40,000 men.


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