Omega-3 fatty acid intake and prevalent respiratory symptoms among U.S. adults with COPD

Chantal M Lemoine S, Emily P Brigham, Han Woo, Corrine K Hanson, Meredith C McCormack, Abigail Koch, Nirupama Putcha, Nadia N Hansel, Chantal M Lemoine S, Emily P Brigham, Han Woo, Corrine K Hanson, Meredith C McCormack, Abigail Koch, Nirupama Putcha, Nadia N Hansel

Abstract

Background: Omega-3 fatty acids, including alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and derivatives, play a key role in the resolution of inflammation. Higher intake has been linked to decreased morbidity in several diseases, though effects on respiratory diseases like COPD are understudied.

Methods: The National Health and Nutrition Examination Survey (NHANES), with a focus on dietary assessment, provides a unique opportunity to explore relationships between omega-3 intake and morbidity in respiratory diseases marked by inflammation in the United States (US) population. We investigated relationships between ALA or EPA + DHA intake and respiratory symptoms among US adults with COPD, as well as variation in relationships based on personal characteristics or exposures.

Results: Of 878 participants, mean age was 60.6 years, 48% were current smokers, and 68% completed high school. Omega-3 intake was, 1.71 ± 0.89 g (ALA), and 0.11 ± 0.21 g (EPA + DHA). Logistic regression models, adjusting for age, gender, race, body mass index, FEV1, education, smoking status, pack-years, total caloric intake, and omega-6 (linoleic acid, LA) intake demonstrated no primary associations between omega-3 intake and respiratory symptoms. Interaction terms were used to determine potential modification of relationships by personal characteristics (race, gender, education) or exposures (LA intake, smoking status), demonstrating that at lower levels of LA intake, increasing ALA intake was associated with reduced odds of chronic cough (pint = 0.015) and wheeze (pint = 0.037). EPA + DHA, but not ALA, was associated with reduced symptoms only among current smokers who did not complete high school.

Conclusions: Individual factors should be taken into consideration when studying the association of fatty acid intake on respiratory diseases, as differential responses may reveal susceptible subgroups.

Keywords: COPD; Education; Fatty acid; Omega; Smoking.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Relationship between ALA Intake and Odds of Respiratory Symptoms is Modified by LA Intake in U.S. Adults with COPD. Odds of chronic cough (Panel A) and wheeze (Panel B) per 1 g increase in ALA. ALA and LA included simultaneously in logistic regression models adjusting for age, gender, race, education, smoking status, FEV1, caloric intake, BMI, and pack-years
Fig. 2
Fig. 2
Relationship between EPA + DHA Intake and Respiratory Symptoms is Modified by Socioeconomic and Smoking Status Among U.S. Adults with COPD. 3-way interaction analyses between education, smoking status, and EPA + DHA. Symptoms with a significant interaction are shown (nocturnal wheeze excluded, pintx = 0.767). Logistic regression models adjusted for age, gender, race, FEV1, caloric intake, BMI, pack-years, and omega-6 (LA) intake. (<high school, former smoker: n = 133; <high school, current smoker: n = 149; >high school, former smoker, n = 323; >high school, current smoker, n = 273) *denotes statistical significance within stratified analyses for p < 0.05

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