“How to Keep Your Lungs Healthy, According to Pulmonologists”

Healthy aging is about more than your heart, brain, or joints—keeping your lungs in tip-top shape is important too. Here's what doctors recommend for easy breathing.

HOW TO KEEP YOUR LUNGS HEALTHY: Even though the heart gets a lot of attention, healthy lungs are also crucial for overall health—particularly in light of the coronavirus pandemic. “You don’t say ‘My lungs bleed for you,’” says Patricia Finn, MD, the Earl M. Bane professor and chair of the Department of Medicine at the University of Illinois at Chicago.  But “there’s a lot of interaction between the rest of your body and your lungs.” Luckily, a heart-healthy lifestyle is also great for the lungs. But if your health habits aren’t up to par, or you’re putting your lungs in harm’s way, you could be at greater risk for lung infections and disease. Here’s what to do, or avoid doing, to keep your lungs in tip-top shape:

MANAGE CHRONIC CONDITIONS: Lung infections often develop as a complication of another chronic illness, says Michael Niederman MD, clinical director and associate chief of pulmonary and critical care medicine at New York-Presbyterian/Weill Cornell Medical Center in New York City. People with congestive heart failure, a chronic condition in which the heart enlarges and struggles to pump enough blood, can have fluid accumulate in the lungs, which increases the risk of bacterial pneumonia. Or, if diabetes isn’t well controlled, the disease can interfere with immune function—and that can increase the risk of lung infection. “Controlling any chronic medical problem can potentially reduce your risk of developing a respiratory infection,” he said.

GO SMOKE AND VAPE FREE: You’ve heard it before, but pulmonologists can’t say it enough: Stop smoking. It’s the No. 1 cause of lung cancer deaths and a major risk factor for lung infections and disease, including chronic obstructive pulmonary disease (COPD). COPD, which includes emphysema and chronic bronchitis, is the 3rd leading cause of the death in the US, according to the American Lung Association. Smoking tobacco or inhaling secondhand smoke gunks up your lungs’ self-cleaning system. Toxins and cancer-causing particles lodge in your airways and in the tiny air sacs (called alveoli) that supply your blood with oxygen and get rid of carbon dioxide. “Smoking breaks down some of these lovely little barriers and restraints that we have in the lung to protect it,” Dr. Finn said. Marijuana smoke is no better. It contains many of the same chemicals and carcinogens as tobacco smoke, says the lung association. As for e-cigarettes, a 2018 government report concludes that vaping cartridges contain and emit potentially toxic substances. Acrolein, a common ingredient, causes irreversible lung damage, says the lung association.

AVOID GERMY SITUATIONS: Covering coughs and sneezes is the polite thing to do, but it’s also good hygiene. A well-placed crook of the elbow can prevent the spread of viruses that cause the flu, the common cold, and more serious respiratory illnesses. Pneumonia often develops as a complication of a respiratory infection, especially the flu. People who contract COVID-19 can develop serious lung complications. Other strategies for preventing the spread of germs that cause lung infection include handwashing and staying home when you’re sick or avoiding close contact with others who have respiratory infections. Anyone can get pneumonia, but older adults, children, and people with chronic diseases like asthma and COPD are especially vulnerable. Likewise for COVID-19. It can affect anyone, but older folks and people with an underlying medical condition may be at greater risk of developing serious illness.

GET YOUR SHOTS: “Something as simple as a flu shot can prevent the flu, which can help avoid developing influenza pneumonia”—a viral form of pneumonia, according to Dr. Niederman. And there’s a downstream benefit because that can protect you from developing very serious bacterial pneumonias, he said. The Centers of Disease Control and Prevention urges all adults to get an annual flu vaccine. You should speak with your physician about getting shots against bacterial forms of pneumonia. The CDC recommends two vaccines that can protect against certain bacteria that can cause pneumonia:

• Adults 65 and older, and anyone (2 and older) with an underlying condition that may boost their risk for pneumococcal disease, should get a pneumococcal polysaccharide vaccine (PPSV23 or Pneumovax).
• The pneumococcal conjugate vaccine (PCV13 or Prevnar 13) is recommended for adults 19 to 64 with immune-compromising conditions. Adults 65 and older who are not immune compromised and haven't previously had the PCV13 vaccine should talk to their doctor about whether to get one.

FILL YOUR PLATE WITH PRODUCE: A diet rich in fruits and veggies is heart healthy and good for the gut—and may also help to prevent chronic lung disease. In a large Swedish study of current and former smokers, people who ate lots of fruits and vegetables had a lower risk of developing COPD than those who ate less. Apples; pears; green, leafy vegetables, and peppers seemed to offer the greatest protection. The more servings, the greater the benefit. Cruciferous vegetables, like arugula, broccoli, Brussel sprouts, and kale, may have cancer-fighting benefits, although the evidence is mixed when it comes to lung cancer. Recently, a large Japanese study suggested that cruciferous vegetables may reduce lung-cancer risk in non-smokers. (But if you are a smoker or former smoker, don't try to get that benefit from vitamins; studies have linked beta-carotene supplements to a higher risk of lung cancer in smokers.)

TAKE YOUR LUNGS FOR A WALK: For overall health, most healthy adults should get 150 minutes of moderate physical activity or 75 minutes of vigorous activity per week. Any exercise that gets your heart rate up counts—be it swimming, cycling, gardening, or brisk walking. As you work out, your lungs work out too. They boost the oxygen supply to the body for energy and remove carbon dioxide. The heart, in turn, circulates more oxygen to your muscles. You may feel out of breath after exercising, but you should not feel breathless. Regular exercise makes that process more efficient, so you use less oxygen and become less winded over time. “Even for people who have underlying lung disease, they’re going to have better physical functioning if they keep themselves well conditioned,” Dr. Niederman said.

STRIKE A YOGA POSE: Dr. Finn says some studies suggest simple yoga with stretching and breathing may actually increase your lung function and exercise capacity. A pilot study randomized 43 patients with moderate-to-severe COPD to one of two interventions. One group participated in 12 weeks of "pranayama," or yoga breathing, plus education about COPD, while the control group received education alone. When researchers compared the two groups' performance on a 6-minute walking test, the pranayama group showed significant improvement in exercise tolerance. Separately, a 2019 review and meta-analysis of 11 randomized clinical trials suggests that breathing-focused yoga may be helpful for people with COPD.

BREATHE DEEPLY: Doing deep-breathing exercises can improve your lungs’ efficiency, maintain healthy lungs, and help people with respiratory diseases learn to breathe better. Try pursed-lip breathing: Breathe in through your nose and then breathe out slowly through pursed lips as if blowing out a candle, advises the American Lung Association. Your exhale should be two to three times longer than the inhale. Or try belly breathing. Lying down, place a hand on your chest, and the other below your rib cage. Pay attention to your belly as you breathe in through your nose. Tighten your stomach muscles and let them sink inward as you breathe out through pursed lips. This trains your diaphragm (a sheet of muscle between the chest and abdomen) to assume some of the work of breathing.

AVOID NOXIOUS FUMES AND POLLUTANTS: Airborne pollutants affect people in different ways, but they are almost always bad for your lungs. Tiny foreign particles (think automobile exhaust and other pollutants) can get lodged in your respiratory system and trigger an inflammatory response, while inhaling toxins can destroy lung tissue. Of course, you can’t fully control everything you breathe, although wearing a mask can help. “I don’t know if you’ve flown into Beijing, but when there’s smog … people have masks on,” Dr. Finn said. It's also smart to minimize your exposure as much as possible when working with known irritants and toxins, like oil-based paints, fiberglass, pesticides, or household chemicals. Gas stoves, scented candles, and fireplaces can also be sources of indoor air pollution. “If you’re using bleach every single day, … I guarantee you’re breathing that stuff in,” Dr. Finn noted.

SPICE UP YOUR DIET: While there’s no hard-and-fast evidence that spices are a “panacea” for respiratory problems, there’s no harm in spicing up your meals—and there may be a potential upside, Dr. Finn said. Most studies of the benefits of spices are done in petri dishes or animals, and those findings don't always translate into benefits for humans. However, some studies suggest curcumin, the yellow pigment found in turmeric, and capsaicin, the ingredient that gives chili peppers their heat, may inhibit tumor growth in lung cancer. In other studies, curcumin has been shown to have anti-inflammatory properties that may benefit people with asthma.

KEEP IT CLEAN: Dust mites, pet dander, and mold: If they’re lurking in your home, they can trigger allergies and asthma or worsen existing respiratory symptoms. “Carpets are a reservoir of many of these indoor allergens,” Dr. Finn cautioned. Fortunately, there’s a lot you can do to reduce your exposure to irritants at home. Wash bedding in hot water once a week. Keep pets off the furniture and bed. Eliminate drapes and curtains to reduce the number of surfaces where dust mites can reside. Vacuum and damp-mop frequently. Fix leaks and run exhaust fans. Toss out moldy materials that can’t be cleaned.

GO NUTS: Eating a handful of nuts a day, including tree nuts and peanuts, may cut your risk of dying from respiratory disease by half. That’s according to a large analysis of studies on nut consumption. (It also showed significant reductions in heart disease and overall cancer risk.) Nuts are rich in vitamin E, which reduces cell oxidation and inflammation in the body. Of course, people with peanut and tree nut allergies should opt for anti-inflammatory alternatives, like olive oil and fatty fish.

BY: Karen Pallarito, Health Magazine

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