Obesity and Worse Outcomes in COPD: More Shortness of Breath

In COPD, A Link between Obesity and Worse Outcomes (more shortness of breath, poor Quality of Life, and reduced walking distance)

Background: Although obesity is common in the United States (see post on January 1, 2017 under COPD News), the association between obesity and worse outcomes in those with COPD  is unclear.

Study: Dr. Allison Lambert, Assistant Professor of Medicine at Johns Hopkins University, and colleagues analyzed information on 3,631 participants in the COPDGene study. A body mass index of 30 or higher was used to define obesity. The findings were published in the January 2017 issue of the journal CHEST (volume 151; pages 68-77).

Obesity and worse outcomes regardless of shape

Two common types of obesity – apple and pear shapes

Findings: Overall, 35% of participants in the study were obese – which is identical to the general population in the United States.  Increasing obesity was associated with worse quality of life, reduced distance walked in six minutes, more shortness of breath, and greater odds of a severe exacerbation (sudden worsening) of COPD. 

Conclusions: The authors concluded that obesity is common among individuals with COPD and is associated with worse outcomes. These include more shortness of breath with activities, poor quality of life, shorter distance walked in six minutes, and more frequent severe exacerbations.

Obese adults walking

My Comments: If you have COPD and are obese, I strongly encourage you to lose weight. Certainly, losing weight is hard work especially with food being a focus of celebrations including birthdays, holidays, anniversaries, etc. Studies show that the most effective way to lose weight is a combination of

Seniors participating in physical activity such as walking, biking, and swimming

Seniors Exercising

eating fewer calories and an exercise program. Regular exercise can burn some calories, but its major effect with weight loss is to increase the metabolic rate (which burns more calories throughout the day). Participation in a pulmonary rehabilitation program is a great way to start an exercise routine. Talking to a nutritionist may help you select healthy and low calorie foods.

Sitting Time and Obesity in Men Living in the United States

More Sitting Time for Men – More Likely to Be Obese

Background: The Center of Disease Control and Prevention (CDC) reported in November 2016 that over one-third (35%) of adults in the United States are obese. Obesity is typically defined by Body Mass Index (abbreviated BMI). BMI is calculated by weight in kilograms divided by the square of height in meters. You can ask your health care provider to calculate your BMI at your next appointment. A value between 25 and 30 means someone is overweight. A BMI value of 30 or higher indicates obesity.

Study: Dr. Carolyn Barlow and colleagues at the Cooper Institute in Dallas, Texas,  reported the results of a study which analyzed sitting time and body weight.  The study was published in December 29, 2016, issue of the journal Prevention of Chronic Diseases.  doi: 10.5888/pcd13.160263.

Results: Estimates of sitting time, measures of obesity, blood lipids, blood glucose, blood pressure, and exercise testing were collected in 4,486 men and 1,845 women. Nearly one-half of the men reported sitting three-fourths of the day, while only 13% of women said the same.

Men who sat almost all of the time were more likely to be obese as measured by waist size (circumference) or body fat compared with men who sat almost none of the time. Sitting time was NOT associated with other cardiac risk factors. For women, there was no significant association between sitting time and cardiac risk factors.

Conclusions: The researchers could not pinpoint a cause for the higher rates of obesity in sedentary men. Dr. Barlow said that one limitation of the study was that subjects were mainly white, generally healthy, and well educated. The authors suggested that reducing sitting time can be a first step in a plan for men to be more active.

Woman working at desk reduces sitting time

Woman working at stand up desk

My Comments:  In a previous study from the Cooper Institute (Mayo Clinic Proceeding, September 29, 2015), researchers showed that standing for at least one-quarter of the day was linked to a lower risk of obesity. For example, standing a quarter of the time was linked to a reduced chance of obesity (by 32% in men and by 35% in women) . If you sit at desk for work or for using a computer, consider getting a stand up desk with adjustable height that allows you to stand.

Pneumonia Risk Factors in COPD: An Analysis

Pneumonia Vaccine Associated with Lower Rate of Pneumonia 

Background: Pneumonia is a seriously chest infection that can affect healthy individuals and those with COPD. If severe, it can lead to a serious illness that requires hospitalization.

Study: Dr. Kurashima and colleagues from the Saitama Cardiovascular and Respiratory Center in Japan reviewed the risk factors for pneumonia in 509 patients with COPD. The study results were published on line in the Journal of COPD.

Chronic Obstr Pulm Dis (Miami). 2016; 3(3): In press. doi: http://dx.doi.org/10.15326/jcopdf.3.3.2015.0167 – See more at: http://journal.copdfoundation.org/jcopdf/id/1114/Risk-Factors-for-Pneumonia-and-the-Effect-of-the-Pneumococcal-Vaccine-in-Patients-With-Chronic-Airflow-Obstruction#sthash.R8878z4p.dpuf

Results: Using multivariate analsyis (which means consideration of all possible factors), the authors found that a low body mass index (a measure of weight related to height), a low forced expiratory volume in one second (how much air can be exhaled in one second), history of vaccination with the 23-valent pneumococcal polysaccharide vaccine (PPV-23), and the presence of emphysema were associated with the overall frequency of pneumonia. 

Conclusions: The pneumococcal vaccine-23 was associated with a signficantly lower rate of pneumonia in those with COPD.

My Comments: Of the four factors reported in this study, you can possibly affect or change two of these: your body mass index (or body weight) and whether or not you have received the pneumococcal vaccine containing 23 strains of the bacteria called Streptococcus pneumoniae. 

A body mass index (BMI) of less than 22 means someone who is very thin. It is possible albeit challenging for some thin individuals to gain weight. However, a healthy diet of frequent small meals is the best strategy.

Finally, make sure that you have received the vaccine called PPV-23. If you are not sure, ask your health care provider.

There is a newer vaccine called PCV-13 that contains 13 different strains of the bacteria called Streptococcus pneumoniae. Please view a Real FAQs post on May 1, 2015, , on this website for more information on the PCV-13.