B30-05 Higher Dietary Antioxidant Intake Is Associated With Decreased Biomarkers of Oxidative Stress and Respiratory Symptom Burden in United States Veterans With Chronic Obstructive Pulmonary Disease (COPD)

Abstract Rationale Although oxidative stress is a major driving mechanism of chronic obstructive pulmonary disease (COPD), the association of dietary antioxidant intake with systemic measures of oxidative stress and respiratory symptoms remains uncertain. Methods As part of a study of indoor air pollution, we recruited 140 participants (137 Veterans and three non-veterans) with COPD (FEV1/FVC 0.70) who had formerly smoked (≥10 pack years) at Veterans Affairs Boston Healthcare System between 2012 and 2017. At study entry, participants completed the Harvard semi-quantitative food frequency questionnaire based on recall of average dietary intake over the past year. Estimates of daily intake of antioxidants included Vitamin A (retinol activity equivalents in uq), Vitamin E (mg), Vitamin C (mg), and total flavonoids (sum ug of five sub-categories). Indoor black carbon (BC) and particulate matter ≤2.5um (PM2.5) concentrations were measured using in-home samplers over one week, up to 4 times. After each monitoring period, University of California San Diego (UCSD) dyspnea and St. George Respiratory Symptom questionnaires (SGRQ) were completed and urine samples were collected for malondialdehyde (MDA), a biomarker of lipid peroxidation, and 8-hydroxy-2’ -deoxyguanosine (8-OHdG), a bio marker of oxidative DNA damage were measured. Nutrient intake was adjusted by total caloric intake (median=1650) using the log residual method and stratified by quartile. Mixed effects linear regression models with a participant-specific random intercept were used to assess associations, adjusting for BMI, age, diabetes and recent cold symptoms, with and without indoor BC and PM2.5. MDA and 8-OHdG were log-transformed, and urine creatinine adjusted. Linear trend p-values for mean MDA, 8-OHdG, and UCSD and SGRQ scores across quartiles were calculated using the median of each log nutrient quartile. Results Median daily antioxidant consumption was similar to or above the available recommended dietary intakes (Vitamin A, Vitamin C, Vitamin E) and had a interquartile range that varied by 3 to 23 fold for each nutrient. There were significant (p 0.001) inverse linear trends between increasing quartile of Vitamin A, Vitamin C, and Vitamin E intake and mean MDA and 8-OHDG concentrations, and between quartile of flavones and MDA. Associations were similar adjusting for either indoor BC or PM2.5. There were also significant (p 0.001) inverse linear trends between quartile of Vitamin A, Vitamin C, and Vitamin E and mean UCSD and SGRQ symptom scores. Conclusions Dietary antioxidant intake in patients with COPD is inversely associated with systemic biomarkers of oxidative damage, dyspnea, and respiratory symptom score. This abstract is funded by: National Institute of Environmental Health Sciences NIH Grants R01 ES019853, R21 ES029637, and P30 ES000002, and by resources and the use of facilities at the VA Boston Healthcare System. This work was also made possible by USEPA grant RD-83479801 and RD-83587201. The contents do not represent the views of the U.S. Department of Veterans Affairs, US EPA, or the United States Government.