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Senior Citizen Health & Medicine
Risk of Progressive Lung Disease (COPD) Cut in Half
by Mediterranean Diet
Risk of lung cancer from COPD reduced by high-dose
inhaled corticosteroid, finds another study
May 16, 2007 – There is no known cure for chronic
obstructive pulmonary disease (COPD), which primarily strikes older
people and becomes a chronic disease for many senior citizens, but a
large study has found the chances of developing this progressive
inflammatory lung disease can by cut in half by eating a Mediterranean
diet.
(Read more about COPD below news reports.)
COPD (chronic obstructive pulmonary disease) is an
umbrella term for chronic progressive lung disease, such as emphysema
and bronchitis. It is expected to become the third leading cause of
death worldwide by 2020, with cigarette smoking the primary factor in
its development.
According to the report published online ahead of
print in Thorax, the researchers tracked the health of almost 43,000
men, who were already part of the US Health Professionals Follow up
Study. This began in 1986 and involved more than 50,000 US health care
professionals aged between 40 and 75, who were surveyed every two years.
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They were asked questions about lifestyle,
including smoking and exercise, diet and medical history. Dietary intake
was assessed in detail every four years.
Eating patterns fell into two distinct categories:
those who ate a diet rich in fruit, vegetables, whole grains and fish
(Mediterranean diet); and those who ate a diet rich in processed foods,
refined sugars, and cured and red meats (Western diet).
Researchers say between 1986 and 1998, 111 cases of
COPD were newly diagnosed.
The Mediterranean diet was associated with a 50%
lower risk of developing COPD than the Western diet, even after
adjusting for age, smoking, and other risk factors.
And men who ate a predominantly Western diet were
more than four times as likely to develop COPD, even after taking
account of other influential factors.
The higher the compliance with a Mediterranean
diet, the lower was the risk of developing COPD over the 12 year period.
Conversely, the higher the compliance with the
Western diet, the higher was the risk of developing COPD.
High-dose inhaled corticosteroid use for COPD could
cut risk of lung cancer
Among a group of mostly older male veterans
suffering from COPD, an illness that offers a greater susceptibility to
lung cancer, researchers found that regular use of high dose inhaled
corticosteroids (ICS) lowered the risk of developing lung cancer.
The results for this study appear in the first
issue for April 2007 of the American Journal of Respiratory and Critical
Care Medicine, published by the American Thoracic Society.
David H. Au, M.D., M.S., of the Veterans
Administration Puget Sound Health Care System in Seattle, along with
five associates found that among 10,474 patients with COPD, 517 were
considered regular users of ICS.
Among users of more than 1,200 micrograms of ICS
per day, the relative risk for lung cancer was lowered to 0.39. For
users of less than 1,200 micrograms per day, the relative risk was 1.13.
(A relative risk of 1 means there is no difference in risk between two
groups.)
Over the next four years, the researchers found
that among a total of 9,957 nonusers of ICS, 402 developed lung cancer.
For 298 users of ICS at a level below 1,200 micrograms per day, 16
developed lung cancer. Among 219 patients who used over 1,200 micrograms
per day, five developed lung cancer.
"Lung cancer is the most common cause of
cancer-related death in the United States and accounts for more deaths
each year than breast, prostate and colon-rectal cancer combined," said
Dr. Au. "Studies such as the Lung Health Study have demonstrated that
the most common cause of death among subjects with COPD is lung cancer."
In 2004, more than 11 million U.S. adults were
estimated to suffer from COPD, which results from chronic bronchitis and
emphysema, two inflammatory lung diseases that frequently co-exist and
interfere with normal breathing. Smoking is the primary cause of COPD.
"Tobacco smoke is a well-recognized stimulant of
systemic and local inflammation and the role of inflammation in the
causal pathway for both lung cancer and COPD has been suggested," said
Dr. Au.
The researchers noted that ICS have been shown in
prospective studies to suppress systemic markers of inflammation such as
C-reactive protein and to reduce airway inflammation.
They hypothesized that higher doses of ICS among
the male veterans reduced such factors as local airway inflammation,
cell turnover, and the propagation of genetic errors. Consequently,
these effects could lead to a subsequent reduction in lung cancer risk.
In an editorial on the research in the same issue
of the journal, York E. Miller, M.D., of the Denver Veterans Affairs
Medical Center, and Robert L. Keith, M.D., of the University of Colorado
Cancer Center, Denver, wrote:
"Although the data at present are certainly not
definitive, inhaled corticosteroids deserve further consideration for
lung cancer chemoprevention. Adequately powered, prospective, controlled
trials with prolonged follow-up to capture effects on a carcinogenic
process that progresses over years will ultimately be needed to
determine efficacy.
"If these could be designed to capture outcomes of
interest relevant to both lung cancer and COPD, joint funding by the
National Cancer Institute and the National Heart Lung Blood Institute
would then be desirable."
"The risk reduction suggested by the studies
discussed would be a clinically significant achievement, particularly in
light of the continued lung cancer epidemic," the editorialists
continued.
"Many additional agents are undergoing evaluation
for lung cancer chemoprevention, including micronutrients, tyrosine
kinase inhibitors, and blockers or agonists of signaling pathways as
reviewed. It is hoped, within the next decade, that chemoprevention of
lung cancer in high-risk individuals (beyond smoking cessation) will be
standard in pulmonary and primary care settings as is influenza
vaccination or cardiac risk factor modification. The potential for
benefit is just as great."
More About COPD
(Chronic Obstructive Pulmonary Disease)
By National Heart, Lung, and Blood Institute
Chronic Obstructive Pulmonary Disease (COPD) makes
it hard for you to breathe. Coughing up mucus is often the first sign of
COPD. Chronic bronchitis and emphysema are common COPDs.
Your airways branch out inside your lungs like an
upside-down tree. At the end of each branch are small, balloon-like air
sacs. In healthy people, both the airways and air sacs are springy and
elastic. When you breathe in, each air sac fills with air like a small
balloon. The balloon deflates when you exhale. In COPD, your airways and
air sacs lose their shape and become floppy, like a stretched-out rubber
band.
Cigarette smoking is the most common cause of COPD.
Breathing in other kinds of irritants, like pollution, dust or
chemicals, may also cause or contribute to COPD. Quitting smoking is the
best way to avoid developing COPD.
Treatment can make you more comfortable, but there
is no cure.
People with a family history of COPD are more
likely to get the disease if they smoke. The chance of developing COPD
is also greater in people who have spent many years in contact with lung
irritants, such as:
● Air pollution
● Chemical fumes, vapors, and dusts usually linked to certain jobs
A person who has had frequent and severe lung
infections, especially during childhood, may have a greater chance of
developing lung damage that can lead to COPD. Fortunately, this is much
less common today with antibiotic treatments.
Most people with COPD are at least 40 years old or
around middle age when symptoms start. It is unusual, but possible, for
people younger than 40 years of age to have COPD.
Read more at NHLBI…
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