Cured meat consumption, lung function, and chronic obstructive pulmonary disease among United States adults

Rationale: Cured meats are high in nitrites. Nitrites generate reactive nitrogen species that may cause nitrative and nitrosative damage to the lung resulting in emphysema. Objective: To test the hypothesis that frequent consumption of cured meats is associated with lower lung function and increased odds of chronic obstructive pulmonary disease (COPD). Methods: Cross-sectional study of 7,352 participants in the Third National Health and Nutrition Examination Survey, 45 years of age or more, who had adequate measures of cured meat, fish, fruit, and vegetable intake, and spirometry. Results: After adjustment for age, smoking, and multiple other potential confounders, frequency of cured meat consumption was inversely associated with FEV1 and FEV1/FVC but not FVC. The adjusted differences in FEV, between individuals who did not consume cured meats and those who consumed cured meats 1 to 2, 3 to 4, 5 to 13, and 14 or more times per month were -37.6 -11.5, -42.0, and -110 ml, respectively (p for trend < 0.001). Corresponding differences for FEV1/FVC were -0.91, -0.54, -1.13, and -2.13% (p for trend = 0.001). These associations were not modified by smoking status. The multivariate odds ratio for COPD (FEV1/FVC <= 0.7 and FEV, < 80% predicted) was 1.78 (95% confidence interval, 1.29-2.47) comparing the highest with the lowest category of cured meat consumption. The corresponding odds ratios for mild, moderate, and severe COPD were 1.11, 1.46, and 2.41, respectively. Conclusions: Frequent cured meat consumption was associated independently with an obstructive pattern of lung function and increased odds of COPD. Additional studies are required to determine if cured meat consumption is a causal risk factor for COPD.