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Excessive abdominal fat a risk factor for COPD

People with large waist circumference had a 72% increased risk of COPD

Obesity and especially excessive abdominal fat is a risk factor for chronic obstructive pulmonary disease (COPD), according to research 'Body size and physical activity in relation to incidence of chronic obstructive pulmonary disease', published in the Canadian Medical Association Journal. Although excessive abdominal fat and low physical activity are linked to progression of the disease in people with COPD, but it is not known whether these modifiable factors are linked to new cases. As a result, a team of researchers in Germany and the US looked at the relationship of waist and hip circumference, BMI and physical activity levels to new cases of COPD in a large group of men and women in the US.

They looked at data on 113,279 people between the ages of 50 and 70 years who did not have COPD, cancer or heart disease at the beginning of the study. During the ten-year follow-up period, COPD developed in 3,648 people. People with large waist circumference (110 m or over in women and 118cm or over in men) had a 72% increased risk of COPD.

"We observed a stronger positive relation with abdominal body fat than with total body fat and COPD," commented the authors. "In particular, overweight as measured by BMI emerged as a significant predictor of increased risk of COPD only among those with a large waist circumference."

A large waist was a robust predictor of COPD in smokers as well as in people who had never smoked.

"Increased local, abdominal and overall fat depots increase local and systemic inflammation, thus potentially stimulating COPD-related processes in the lung," they write.

People with a large hip circumference and who were physically active at least five times a week were 29% less likely to experience COPD. Exercise can reduce inflammation, oxidative stress and enhance healing.

Underweight people had a 56% increased risk of COPD. Possible reasons include malnutrition and reduced muscle mass leading to increased COPD susceptibility and progression through inflammatory processes and impaired lung repair capacity.

"Our findings suggest that next to smoking cessation and the prevention of smoking initiation, meeting guidelines for body weight, body shape and physical activity level may represent important individual and public health opportunities to decrease the risk of COPD," conclude the authors. “Physicians should encourage their patients to adhere to these guidelines as a means of preventing chronic diseases in general and possibly COPD in particular.”

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