dietary intervention increasing omega-3 intake

Conditions: Chronic Obstructive Pulmonary Disease

Summary: this dietary intervention is being done to evaluate the feasibility of a food voucher program and dietary counseling to increase consumption of healthy fatty acids (omega-3) in individuals with chronic obstructive pulmonary disease (copd).

the goal of this pilot intervention is to evaluate the feasibility of a food voucher program and dietary counseling to increase dietary intake of omega-3 fatty acid in individuals with copd. this hypothesis is based on a number of recent observations. studies have investigated the impact of omega-3 fatty acids, especially eicosapentaenoic acid (epa), docosahexaenoic acid (dha), alfa-linolenic acid (ala) intake in chronic diseases and show a link with decreased systemic inflammation measured by cytokines including interleukin 1 (il-1b), interleukin 6 (il-6), interleukin 10 (il-10), tumoral necrosis factor alfa (tnf-α) and eicosanoids; and improved outcomes. in a large cross-sectional study of individuals with copd, a diet rich in the omega-3 ala was associated with lower serum tnf-α levels while a diet rich in the omega-6's la and arachidonic acid (aa) had higher systemic inflammatory markers il-6 and c-reactive protein (crp). other recent nutritional epidemiological study showed the association of greater intakes of omega-3 fatty acids with better lung function profile, but also a slower forced expiratory volume at the 1 second (fev1) decline in the same smoker cohort. preliminary cross-sectional data (n=59), from the clean air study, reported that at baseline, a higher omega 3 dietary intake was linked with reduced systemic inflammation (il-1b) and improved respiratory outcomes (a 28% decrease in the odds of copd symptoms in moderate-severe copd and conversely, higher omega-6 levels associated with worse outcomes, including increased dyspnea and lower lung function. these findings support the importance of implementing an intervention program to confirm there is a beneficial association between fatty acid dietary intake and reduced copd symptoms. to this end, the investigators propose a pilot intervention study in 20 subjects to see if the investigators can increase omega-3 dietary intake over a 4 week period. the investigators will measure self-report dietary intake of omega 3 and 6 fatty acids, as well as measure, fasting plasma fatty acid levels, before and after the intervention.

Eligibility criteria:
inclusion criteria: * age ≥ 40 years, * physician diagnosis of copd, global initiative for obstructive lung disease (gold) stage ii-iv disease with forced -expiratory volume (fev1)/ forced vital capacity (fvc) \<70% and fev1 (% predicted) \<80%, * tobacco exposure ≥ 10 pack-years * former smoker with an exhaled carbon monoxide (eco)\<=6 ppm to confirm smoking status * no home smoking ban. * subjects with low omega-3 intake (epa+dha levels \<500mg) based on data extracted from a food frequency questionnaire (ffq) completed before the randomization. exclusion criteria: * chronic systemic corticosteroids, * other chronic lung disease including asthma, * living in location other than home (e.g., long term care facility) * homeowner or occupant planning to move or change residence within study period.

Keywords: copd