OMEGA COPD Trial

欧米茄慢性阻塞性肺病试验

• 批准号: 10273624
• 负责人: Nadia N Hansel
• 金额: $ 81.8万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-20 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10273624
• 关键词: Accounting; Address; Adult; Adverse effects; Affect; Arbitration; Attenuated; Biological Markers; Cause of Death; Chronic Disease; Chronic Obstructive Airway Disease; Communities; Data; Development; Diet; Diet Modification; Dietary Intervention; Dietary Practices; Dietary intake; Disease Outcome; Education; Eicosanoids; Enabling Factors; Environmental Exposure; Food; Food Access; Foundations; Funding; Future; Health; Health Food; High Prevalence; Home; Individual; Indoor Air Pollution; Indoor Air Quality; Inflammatory; Infrastructure; Intake; Intervention; Intervention Studies; Interview; Investigation; Link; Low Income Population; Low income; Lung diseases; Modification; Morbidity - disease rate; Nutritional; Omega-3 Fatty Acids; Outcome; Participant; Particulate Matter; Pathway interactions; Patients; Personal Behavior; Population; Predisposition; Prevalence; Pulmonary Inflammation; Qualitative Methods; Quality of life; Research; Respiratory Signs and Symptoms; Risk; Risk Factors; Serum; Source; Structure; Testing; Training; Underserved Population; Unhealthy Diet; United States; United States National Institutes of Health; Vulnerable Populations; adverse outcome; base; cohort; dietary; environmental health disparity; epidemiology study; evidence base; experience; food insecurity; food preparation; health disparity; implementation strategy; improved; indoor particulate matter; modifiable risk; mortality; nutrition; policy implication; pollutant; respiratory; respiratory health; respiratory morbidity; satisfaction; service delivery; systemic inflammatory response; therapy design; voucher

OMEGA COPD Trial SUMMARY Chronic obstructive pulmonary disease (COPD) is a leading cause of death in the United States, with significantly higher prevalence, morbidity, and mortality in lower income communities. Poor dietary intake, and in particular low omega-3 polyunsaturated fatty acid intake, is a common problem in low-income communities and has been associated with adverse outcomes in populations with respiratory disease. We, and others, have shown that a diet defined by lower omega-3 intake is associated with worse COPD respiratory outcomes. Because omega-3 polyunsaturated fatty acids obtained through diet are responsible for arbitration of pulmonary and systemic inflammation through the eicosanoid pathway, omega-3 intake may also be a critical protector against the adverse effects of pro-inflammatory exposures related to COPD respiratory morbidity. Our group has further demonstrated that indoor air particulate matter (PM) levels are linked to worse respiratory morbidity in individuals with COPD, and indeed a diet low in omega-3 likely augments the adverse effects of pollutant exposure on respiratory morbidity. Unfortunately, low-income individuals with COPD often have diets with omega-3 intake levels well below recommended levels in addition to relatively high levels of indoor PM exposures, leading to heightened risk of poor respiratory outcomes. A dietary intervention, designed to increase intake of omega-3 in food sources, has the potential for high-impact within this vulnerable group. In this proposal, we will test a dietary intervention based in omega-3 rich foods, with the aim of improving respiratory health (Aim 1), and protecting against the adverse effects of environmental exposures (Aim 2) in low income adults with COPD. The intervention will overcome several common nutritional barriers in low-income communities: food insecurity (a voucher will be provided), food access and fresh food availability (home delivery and choice from a range of healthy food options), and support in achieving and sustaining dietary change (regular contact with a dietary health coach trained to support personal behaviors surrounding healthy food choices and provide culturally- informed education around nutrition and food preparation). Through qualitative methods (Aim 3), we will also explore barriers and facilitators of the intervention in order to optimize sustainability of future implementation strategies. Results will comprehensively address the impact of an evidence-based nutrition intervention on COPD health, and provide a framework for dietary intervention within other chronic diseases disproportionately impacting susceptible, low-income populations. Positive results will be buoyed by existing infrastructure within a leading national grocery delivery service supportive of expanding access to healthy foods, providing a ready platform for sustainability and dissemination beyond the study and with immediate policy implications.

欧米茄COPD审判摘要 慢性阻塞性肺疾病（COPD）是美国的主要死亡原因，有显着 低收入社区的较高患病率，发病率和死亡率。饮食摄入量不佳，尤其是 低收入脂肪酸摄入量低的omega-3多不饱和脂肪酸是低收入社区的一个常见问题，并且已经是 与呼吸道疾病人群中的不良结果有关。我们和其他人都表明了 由较低的omega-3摄入量定义的饮食与COPD呼吸结果较差有关。因为Omega-3 通过饮食获得的多不饱和脂肪酸负责肺和全身仲裁 通过eicosanoid途径的炎症，omega-3的摄入量也可能是针对这种关键的保护者 与COPD呼吸道发病有关的促炎性暴露的不利影响。我们的小组进一步 证明室内空气颗粒物（PM）水平与个体的呼吸发病较差有关 使用COPD，并且确实是omega-3的饮食较低的饮食可能会增加污染物暴露对 呼吸发病率。不幸的是，患有COPD的低收入个人经常患有omega-3摄入量 除了相对较高的室内PM暴露外，远低于推荐水平的水平，导致 呼吸不良的风险增加。饮食干预措施，旨在增加omega-3的摄入量 食物来源在这个脆弱的群体中具有高影响力的潜力。在此提案中，我们将测试饮食 基于omega-3富食品的干预措施，目的是改善呼吸健康（AIM 1），并保护 与COPD的低收入成年人对环境暴露的不利影响（AIM 2）。这 干预将克服低收入社区中几个常见的营养障碍：粮食不安全（a 将提供凭证），食品获取和新鲜食品可用性（从一系列 健康食品选择），并支持和维持饮食变化（定期接触饮食 受过培训的健康教练，以支持围绕健康食品选择的个人行为并提供文化 - 围绕营养和食物准备的教育）。通过定性方法（AIM 3），我们也将 探索干预的障碍和促进者，以优化未来实施的可持续性 策略。结果将全面解决基于证据的营养干预对 COPD健康，并为其他慢性疾病中的饮食干预提供了一个框架 影响易感的低收入人群。积极的结果将由现有基础设施促进 领先的国家杂货交付服务支持扩大健康食品的访问权限，提供了准备 可持续性和传播平台超出了研究，并具有直接的政策意义。