@ERSpublicationsData suggest processed meat intake may adversely affect lung health and the risk of COPD http:// ow.ly/tgh81In the recent Global Burden of Disease study [1], chronic obstructive pulmonary disease (COPD) was the third most common cause of death worldwide in 2010. The predominant risk factor for COPD in the developed world is cigarette smoking, but up to one-third of COPD patients have never smoked, suggesting that other factors are involved. Relatively little attention has been paid to these other factors, such as diet, and how their modification might decrease the global burden of COPD. Nevertheless, the lungs exist in a high-oxygen environment and it is reasonable to posit that certain exposures (and local inflammation) can increase the burden of oxidants further. The balance between these potentially toxic substances and the protective actions of antioxidant defences, including those derived from diet, may play a role in the loss of lung function over time and the eventual development of COPD.Based on this prevailing hypothesis, most of the diet-lung research to date has focused on dietary factors with antioxidant or anti-inflammatory properties, including: vitamin E (present in seed oils and nuts); vitamin C (fruits and vegetables); vitamin A, provitamin A carotenoids, and lycopene (fruits and vegetables); and selenium (seeds, seafood, and fish) [2]. In addition to these nutrients with antioxidant properties, the lipid composition of the diet (e.g. omega-3 fatty acids) and vitamin D also have been studied for their potential role in lung health [2,3]. Although most of the ''promising'' results for these nutrients have been from cross-sectional studies, a few longitudinal studies exist that demonstrate favourable associations between specific dietary factors and a slower decline of lung function or lower incidence of COPD. All of this nutrient-oriented research fails, in some respects, to appreciate the complexity of dietary assessment. For example, due to the fact we eat meals instead of isolated nutrients or even foods, several authors have proposed assessing dietary patterns to gain a broader picture of diet [4]. Dietary patterns might be seen as offering a more ''agnostic'' approach (similar to genome-wide association studies), whereas nutrients/foods could be seen as more of a hypothesis-driven, pathway-based approach. Either way, recent studies of dietary patterns also have shown associations with lung health. Out of five studies looking at the association between dietary patterns with spirometry or COPD symptoms or incidence [5][6][7][8][9], three studies reported a ''protective'' association for a ''prudent'' dietary pattern characterised by a high intake of fruit, vegetables, fish and wholegrain cereals [5,8,9], consistent with the dietary antioxidant or antiinflammatory properties hypothesis. Moreover, four studies (out of the five) also reported a deleterious effect of a ''Western'' diet characterised by a high intake of chicken, pork, fish, rice and noodle dishes, and preserved food...