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Could a healthy diet attenuate COPD risk in smokers?
  1. Raphaëlle Varraso1,2,
  2. Seif O Shaheen3
  1. 1INSERM U1168, Aging and Chronic Diseases, Epidemiological and Public Health Approaches, Villejuif, France
  2. 2UVSQ, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, Versailles, France
  3. 3Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
  1. Correspondence to Dr Raphaëlle Varraso, INSERM U1168, Aging and Chronic Diseases, Epidemiological and Public Health Approaches, Villejuif 94807, France; raphaelle.varraso{at}inserm.fr

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Let food be thy medicine and medicine be thy food.Hippocrates

The predominant risk factor for COPD in high-income countries is cigarette smoking,1 but not all smokers develop COPD.2 It has been hypothesised that a diet rich in antioxidants may counteract the deleterious oxidant effects of smoking and hence prevent COPD.3 Although most studies that have linked dietary antioxidant foods and nutrients to COPD have been cross-sectional,3 a few cohort studies have also reported associations between higher intake and a slower decline of lung function or a lower incidence of COPD.4–7

In Thorax,8 using longitudinal data from 44 335 men in the Cohort of Swedish Men, Kaluza et al investigated the association between total fruit and vegetable consumption and incident COPD, according to smoking habits. COPD was ascertained through patient and death registers. Briefly, after adjustment for several potential confounders, they reported a negative and significant association between fruit and vegetable intake and the risk of COPD. This finding is consistent with a large number of cross-sectional studies, and with a few longitudinal studies investigating the role of fruit and vegetable intake in the aetiology of COPD-related outcomes. Addressing the potential modifying effect of smoking on the diet-COPD association could help to clarify the potential causal role of diet. The authors reported a significant interaction between smoking and dietary intake of antioxidant-rich fruits and vegetables on the risk of COPD, and showed that the beneficial dietary associations were restricted to ex-smokers and current smokers. These results are in agreement …

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