Today’s edition of Medical Myths centers on misconceptions about chronic obstructive pulmonary disease (COPD). We cover myths about exercise, body weight, treatments, and more.
Written by Tim Newman on — Fact checked by Catherine Carver, BA, MPH, MBChB
In our Medical Myths series, we approach medical misinformation head on. Using expert insight and peer reviewed research to wrestle fact from fiction, MNT brings clarity to the myth riddled world of health journalism.
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COPD is an umbrella term for a collection of progressive respiratory conditions, all of which cause breathing difficulties.
Two of the most common forms of COPD are chronic bronchitis and emphysema.
The most prevalent symptoms of COPD are shortness of breath and a cough. Over time, even everyday activities, such as getting dressed, can become challenging.
In this article, we cover some of the most common myths associated with COPD. To ensure we provide accurate information, we have recruited two experts.
Dr. Neil Schachter is a professor of medicine — pulmonary, critical care, environmental medicine, and public health — at the Icahn School of Medicine at Mount Sinai in New York. He is also medical director of pulmonary rehabilitation at the Mount Sinai Health System.
Dr. Shahryar Yadegar is a critical care medicine specialist, pulmonologist, and medical director of the ICU at Providence Cedars-Sinai Tarzana Medical Center, CA.
1. COPD is rare
According to the World Health Organization (WHO), COPD caused 3.23 millionTrusted Source deaths in 2019, making it the third leading cause of death worldwide.
Dr. Schachter explained that in the United States, COPD “is the fourth leading causeTrusted Source of death. More than 16 million Americans are diagnosed.”
Additionally, as Dr. Yadegar told Medical News Today, “millionsTrusted Source more people may be undiagnosed.”
The American Lung Association (ALA) recommends that anyone who is “experiencing COPD symptoms — chronic cough, shortness of breath, frequent respiratory infections, significant mucus production (also called phlegm or sputum), and/or wheezing — speak with [a] doctor about obtaining a breathing test called ‘spirometry,’ which can help diagnose COPD.”
2. Only smokers develop COPD
It is true that smoking tobacco is the leading cause of COPD, but as Dr. Schachter told MNT, “There are many other risk factors that contribute to the development of the disease, including air pollution, work-related pollution, infection, and some forms of asthma.”
Extending this further, Dr. Yadegar told us:
“Approximately 10–20% of COPD patients never smoked. Some of these never-smokers include significant secondhand smoke exposure; genetic predisposition, primarily through alpha-1 antitrypsin deficiency; or substantial exposure to air pollution.”
Alpha-1 antitrypsin is an enzyme that protects the body from an immune attack. Some people have a mutation in the gene that codes for this enzyme; this causes alpha-1 antitrypsin deficiency.
Deficiency of alpha-1 antitrypsin increases the risk of developing COPD and other conditions that affect a range of bodily systems.
3. Only older adults develop COPD
COPD is certainly more common in older adults than in younger people, but younger people are not immune to the condition.
For instance, in the U.S., between 2007 and 2009, COPD affected 2%Trusted Source of males and 4.1% of females aged 24–44 years. Similarly, the condition affected 2% of males and 3% of females aged 18–24 years.
Dr. Schachter told us that a “significant proportion of those individuals diagnosed before the age of 50” have a hereditary form of the disease that causes a deficiency of alpha-1 antitrypsin.
4. COPD only affects the lungs
“False,” said Dr. Schachter. “COPD coexists with many comorbidities, including heart disease, lung cancer, hypertension, osteoporosis, and diabetes. The association may be due to common causative factors, as well as ‘systemic inflammation.’”
In other words, some of these conditions share risk factors, which makes them more likely to occur with COPD. For instance, smoking is a risk factor for both COPD and heart disease.
At the same time, health experts associate COPD with systemic inflammation, which can also independently increase the risk of other conditions.
5. People with COPD cannot exercise
According to Dr. Yadegar, “Without proper guidance, patients with COPD may have difficulty completing physical exercises.”
However, he also explained that doctors recommend people with COPD do exercise, as it can help “increase their breathing capacity and improve their daily symptoms.”
“Pulmonary rehabilitation programs typically offer guided breathing techniques in conjunction with physical exercise in order to maximize better patient outcomes,” he continued.
In a nutshell, Dr. Schachter told us that “exercise is therapeutic for COPD, reducing the number of exacerbations
This, thankfully, is a myth. “There are numerous therapies and strategies that improve the course of the disease,” Dr. Schachter told MNT, “including medications, rehabilitation, diet, and vaccines that protect against respiratory infections that accelerate the course of the disease.”
Dr. Yadegar said, “With a spectrum of presentations, patients may benefit from inhaled bronchodilators, anticholinergics, corticosteroids, and supplemental oxygen.” These, he said, can be tailored uniquely to each person.
“Certain patients may also benefit from alpha-1 antitrypsin augmentation or even lung transplants,” he added.
“While both diseases are considered obstructive lung diseases, there are several differences between COPD and asthma,” Dr. Yadegar explained.
“Asthma most commonly begins in childhood, where it is frequently associated with allergies and problems of inflammation. COPD usually begins in the 60s and is associated with smoking. There is, however, an overlap syndrome, which has features of both.”
– Dr. Neil Schachter
Dr. Yadegar dove into the details: “COPD is a disease of the alveoli, mostly […] a result of elasticity loss induced primarily by smoking. Asthma is a disease of the airways, primarily […] a result of chronic airway inflammation.”
“While clinical symptoms may overlap between the two diseases,” he continued, “treatments vary in order to best help patients in the short and long term.”
This is not true. Dr. Schachter told us that carrying excess body weight can increase the disability associated with COPD.
Conversely, if people have a body weight that is below moderate, it can be “a sign of emphysema and also indicates a poor prognosis.”
This is another myth. As Dr. Schachter told MNT, “It is never too late to quit.”
He explained that “smoking accelerates the loss of lung function that accompanies COPD.” He also said that smoking tobacco can promote exacerbations of the symptoms.
“Shortness of breath is a major presenting symptom but hardly the only one,” according to Dr. Schachter.
“Cough, excess phlegm production, respiratory infections, and all the symptoms of the comorbidities are often signs of progressing COPD.”
Other symptoms can include sleep problems, anxiety, depression, pain, and cognitive decline.
As a matter of fact, a healthy diet can make a difference for people living with COPD. Dr. Schachter told MNT that a healthy diet promotes “general health and can protect against exacerbations of COPD itself and its comorbidities.”
For example, a 2020 meta-analysis of eight observational studies investigated the role of diet in COPD. The authors conclude that “healthy dietary patterns are associated with a lower prevalence of COPD, while unhealthy dietary patterns are not.”
Similarly, the data generated in another reviewTrusted Source suggest that “a higher intake of fruits, probably dietary fiber, and fish reduce the risk of COPD.”
In summary, although there is no cure for COPD, treatments are available, and lifestyle changes can reduce symptom severity. For more information on the causes, diagnosis, symptoms, and treatment of COPD.
Chronic obstructive pulmonary disease (COPD)
Chronic obstructive pulmonary disease (COPD) is an umbrella term for two chronic lung conditions: bronchitis and emphysema. Smoking is the most common cause. Bronchodilators and lifestyle measures can help manage it, but it will usually worsen over time.
A person with COPD may have chronic bronchitis, emphysema, or both. These issues limit the functioning of the airways and cause trouble breathing.
COPD is primarily an umbrella term for two conditions: emphysema and chronic bronchitis. Someone with COPD may have one or both of these issues, and the severity of each varies from person to person.
Emphysema damages the air sacs of the lungs. The lungs lose their elasticity and are no longer able to exchange oxygen and carbon dioxide efficiently, as a result.
Chronic bronchitis involves inflammation of the lining of the airways. This results in increased production and thickening of mucus. Bronchitis becomes chronic when it persists and resists treatment.
Asthma symptoms may be part of COPD, and a history of asthma can increaseTrusted Source the risk of developing the condition. Asthma causes inflammation of the airways, which spasm and overreact to inhaled substances.
COPD is a lifelong issue involving irreversible damage to the lungs and worsening difficulty breathing and airway obstruction. A person with advanced COPD may be unable to climb the stairs or cook. They may need medications and supplementary oxygen.
In 2014, COPD was the third Trusted Source leading cause of death in the United States.
COPD causes some or all of the following:
- breathlessness, especially after exertion
- a persistent cough
- excess production of sputum
- fatigue
- wheezing
- difficulty breathing that worsens over time
A person with severe symptoms may also have:
- a bluish tint to the lips or fingernail beds
- shortness of breath while talking
- reduced mental alertness
- a rapid heartbeat
Anyone with any severe symptoms should receive immediate medical care.
If symptoms are mild, a person may not realize that they have COPD. Almost 6.4%Trusted Source of the U.S. population have diagnosed COPD, but its actual prevalence may be far more extensive.
Here, find tips to stop wheezing.
Visual model of COPD
Below is an interactive 3D model of COPD. Explore it with the mouse pad or touchscreen.
In the U.S., as many as 75%Trusted Source of people with COPD smoke or once did. Beyond smoking, COPD risk factors include:
- exposure to secondhand smoke
- exposure to other air pollutants and toxins, at home or in the workplace, for example
- asthma
- rarely, genetic factors, which may lead to a deficiency of the protective protein alpha-1 antitrypsin
- a family historyTrusted Source of COPD
If COPD develops before the age of 40, there is usually an underlying health issue, such as an alpha-1 antitrypsin deficiency.
Asthma can increase the risk of COPD because it inflames and narrows the airways. However, treatment can usually reverse any damage resulting from asthma.
Various measures can help reduce the impact and progression of COPD.
Breathing exercises
These can counter breathlessness, and some examples include pursed-lip breathing and diaphragmatic breathing, or “belly breathing.”
Here, learn other techniques to relieve shortness of breath.
Pulmonary rehabilitation
Pulmonary rehabilitationTrusted Source aims to help people maximize their activity levels and quality of life.
A healthcare professional draws up a plan, which may involve:
- boosting exercise tolerance
- doing breathing exercises
- making dietary changes
- learning about the lungs
- learning to use medication most effectively
- learning ways to conserve energy and reduce breathlessness
- attending counseling to help manage any depression or anxiety
Here, find other natural ways to manage COPD symptoms.
People with COPD are more likelyTrusted Source to experience:
- mobility problems, due to shortness of breath
- mental health conditions, such as depression
- fair or poor overall health
- other chronic diseases, such as heart disease, diabetes, or asthma
- confusion and memory loss
- a loss of work and income
- social isolation
Following up with the healthcare team and attending all medical appointments can help prevent or manage complications.
COPD can be life-threatening, and a person’s life expectancy largely depends on whether they smoke and the severity of existing lung damage.
People who smoke and have advanced COPD may lose around 6 yearsTrusted Source of their life expectancies, apart from the 4 years that smoking itself takes away, according to a study published in 2009.
COPD is irreversible, and people who smoke can reduce their risk by quitting as soon as possible.
COPD is an irreversible lung condition that causes difficulty breathing. Someone with COPD may have chronic bronchitis, emphysema or both.
There is no cure, but treatment can help manage the symptoms and enhance the quality of life.
Anyone who receives a COPD diagnosis should take action to protect their lungs. For those who smoke, quitting is essential.
