Abstract Rationale Omega-3 polyunsaturated fatty acids (PUFAs), including eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and alpha-linolenic acid (ALA), have systemic anti-inflammatory effects. Higher dietary intake of PUFAs has been linked to reduced morbidity across several diseases, including respiratory outcomes in airways disease. We examined whether food frequency questionnaire (FFQ) based intake of EPA+DHA+ALA was associated with improved respiratory symptoms and reduced exacerbation frequency among current smokers with COPD enrolled in a 6-month motivational interviewing and in-home portable air cleaner intervention study in the Baltimore/Washington area. Methods Participants (N = 119) were 40 years with physician-diagnosed COPD, post-bronchodilator forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) 70%, FEV180% predicted, and current smoking history 10 pack-years. At baseline, 3-month, and 6-month visit, EPA+DHA+ALA dietary intake was assessed using the validated Harvard FFQ and respiratory health outcomes using questionnaires. Respiratory outcomes included the COPD Assessment Test (CAT), the Clinical COPD Questionnaire (CCQ), the Ease of Cough and Sputum Clearance Scale (ECSC), St. George’s Respiratory Questionnaire (SGRQ), and the University of California, San Diego Shortness of Breath Questionnaire (UCSD SOBQ). Cough and sputum symptoms were measured by the Cough and Sputum Assessment Questionnaire (CASA-Q), and exacerbations were captured monthly. Associations between total omega-3 intake and COPD outcomes were analyzed using generalized estimating equation (GEE) regression for continuous outcomes and negative binomial regression for exacerbation frequency, adjusting for treatment group, calorie intake, BMI, age, gender, race, education, income, pack-years, baseline FEV₁% predicted, and baseline smoking. Results Participants were 63% female, 34% White, mean age 63 years (SD = 7). Mean (SD) and Median (IQR) EPA+DHA+ALA intake was 2.8 (1.9) grams and 2.4 (1.5, 3.4) grams, respectively. After covariate adjustment, each SD increment in person-average total omega-3 intake was associated with significant improved COPD symptoms scores: CAT (β = −4.1, p0.001), CCQ (β = −0.35; p=0.03), ECSC (β = −1.1; p=0.02), and CASA-Q cough (β = 9.8; p0.01) and sputum symptoms (β = 11.0; p0.01). Similarly, higher total omega-3 intake was also associated with fewer severe (IRR=0.21, p=0.047), moderate (IRR=0.15, p=0.03), moderate-to-severe exacerbations (IRR=0.30, p=0.03) and total exacerbations (IRR=0.34, p0.01). SGRQ trended positively though did not reach statistical significance (Table 1). Conclusions Higher dietary intake of total omega-3 fatty acids, EPA+DHA+ALA, was associated with improved respiratory symptoms scores and lower odds of exacerbation frequency in current smokers with moderate-to-severe COPD. These findings suggest that increased omega-3 fatty acid consumption may confer protective effects on respiratory health and COPD symptoms progression. This abstract is funded by: The MOVE study was supported by the National Institute of Health (NIH)/National Institute of Environmental Health Sciences (NIEHS) R01 ES029512.
Lorizio et al. (Fri,) studied this question.