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.

Disclosures

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

In This Article

Results

The characteristics of the cohort, according to the consumption of cured meats, are presented in Table 1 . Compared with men eating the most cured meats (≥1 serving/day), men with the lowest intake of cured meats (never/almost never) were more physically active, were less likely to be current smokers, and had a lower body mass index. Men with the highest consumption of cured meats were more likely to eat processed meats than to eat bacon or hot dogs. At baseline, 27 percent of men reported that they never ate processed meat, while 51 percent ate less than one serving per week, and 22 percent ate at least one serving per week. The comparable analysis for bacon yielded 38 percent never, 50 percent less than one serving per week, and 12 percent at least one serving per week. Likewise, the results for hot dogs were 44 percent never, 51 percent less than once per week, and 5 percent at least once per week. The consumption of cured meats was positively associated with the risk of newly diagnosed COPD in age-adjusted analysis (for highest vs. lowest consumption of cured meats: relative risk (RR) = 4.09, 95 percent confidence interval (CI): 2.32, 7.22; p trend < 0.001) and even after adjustment for age and energy intake ( Table 2 ). After controlling for smoking status, pack-years, and pack-years squared, the positive association between cured meats and the risk of newly diagnosed COPD remained. Further adjustments for race/ethnicity, US region, body mass index, and physical activity revealed the same significant positive association ( Table 2 ). Further adjustment for the prudent diet led to similar results (for highest vs. lowest consumption of cured meats: RR = 2.43, 95 percent CI: 1.26, 4.68; p trend = 0.006). Adjustment for the "modified Western pattern" led to a borderline significant association (for highest vs. lowest consumption of cured meats: RR = 1.88, 95 percent CI: 0.96, 3.69; p trend = 0.06). The "modified Western pattern" remained highly related to the risk of newly diagnosed COPD after adjustment for cured meats (for highest vs. lowest quintile of the "modified Western pattern": RR = 4.49, 95 percent CI: 1.67, 12.07; p trend = 0.001).

When the population was restricted to men without cancer or cardiovascular disease at baseline (n = 35,284), similar associations were found. The consumption of cured meats was positively associated with the risk of newly diagnosed COPD after adjustment for age and energy intake (for highest vs. lowest consumption of cured meats: RR = 3.56, 95 percent CI: 1.46, 8.66; p trend < 0.001). Further adjustment for smoking status, pack-years, pack-years squared, race/ethnicity, US region, body mass index, and physical activity led to similar results (highest vs. lowest consumption of cured meats: RR = 1.81, 95 percent CI: 0.88, 4.76; p trend = 0.01).

Of the three individual cured meats (processed meats, bacon, hot dogs), only the consumption of processed meats was significantly associated with the risk of newly diagnosed COPD (for highest vs. lowest consumption of processed meats: RR = 1.93, 95 percent CI: 1.13, 3.28; p trend = 0.02). A significant association was found for the consumption of bacon (for highest vs. lowest consumption of bacon: RR = 1.79, 95 percent CI: 0.99, 3.22; p trend = 0.03), and no relation was found for hot dog consumption (p trend = 0.43).

On average over the study period, among the 111 cases of COPD, about 86 percent reported a history of cigarette smoking. Considering different time periods, the cases occurring between 1990 and 1992 (n = 12) had the highest proportion of smokers: 67 percent were smokers and 12 percent were former smokers. Considering "ever smoker" (n = 96 cases), the age-adjusted relative risk for ever smokers versus never smokers was 3.90 (95 percent CI: 2.26, 6.72) (p < 0.001). Because smoking is the main risk factor for COPD, we conducted additional analyses excluding never smokers. This analysis was performed among 27,755 men with a history of cigarette smoking (96 cases), and we found that the consumption of cured meats was strongly and positively associated with the risk of newly diagnosed COPD ( Table 3 ).

To examine whether smoking status modifies the relation between cured meat consumption and COPD risk, we conducted multivariate analyses stratified according to smoking status ( Table 4 ). We combined the two highest categories of cured meats consumption because of the small number of cases. After adjustment for age, energy intake, smoking status, pack-years, and pack-years squared, the relative risk comparing the highest vs. the lowest categories of cured meats consumption was 2.39 (95 percent CI: 0.91, 6.27) (p trend = 0.07) in past smokers and 2.69 (95 percent CI: 1.11, 6.56) (p trend = 0.03) in current smokers.

Although the primary outcome of this study was newly diagnosed COPD, we also examined the relation between cured meats and adult-onset asthma, because of the potential overlap between the diagnoses of COPD and asthma ( Table 5 ). In contrast with the risk of newly diagnosed COPD, no association was found between the consumption of cured meats and the risk of adult-onset asthma.

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