OMEGA COPD Trial

欧米茄慢性阻塞性肺病试验

• 批准号: 10491204
• 负责人: Nadia N Hansel
• 金额: $ 81.07万
• 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/10491204
• 关键词: Accounting; Address; Adult; Adverse effects; Affect; Arbitration; Attenuated; Biological Markers; Cause of Death; Chronic Disease; Chronic Obstructive Pulmonary 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; 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; Modification; Morbidity - disease rate; Nutritional; Omega-3 Fatty Acids; Outcome; Participant; Particulate Matter; Pathway interactions; Patients; Personal Behavior; Persons; Population; Predisposition; Prevalence; Pulmonary Inflammation; Qualitative Methods; Quality of life; Reduce health disparities; Research; Respiratory Disease; 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; future implementation; health disparity; implementation strategy; improved; indoor concentrations; 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.

OMEGA 慢性阻塞性肺病试验摘要 慢性阻塞性肺疾病 (COPD) 是美国的一个主要原因，其中 低收入社区的患病率、发病率和死亡率较高。饮食摄入不足，特别是 omega-3 多不饱和脂肪酸摄入量低是低收入社区的一个常见问题，并且已成为 与呼吸系统疾病人群的不良后果相关。我们和其他人已经证明， 以较低 omega-3 摄入量定义的饮食与慢性阻塞性肺病 (COPD) 呼吸系统结局较差相关。因为omega-3 通过饮食获得的多不饱和脂肪酸负责仲裁肺部和全身 通过类二十烷酸途径产生炎症，摄入 omega-3 也可能是对抗炎症的关键保护剂 与慢性阻塞性肺病 (COPD) 呼吸道疾病发病相关的促炎性暴露的不利影响。我们组还有进一步 证明室内空气颗粒物 (PM) 水平与个体呼吸道疾病发病率恶化有关 患有慢性阻塞性肺病 (COPD) 的患者，事实上，低 omega-3 饮食可能会加剧污染物暴露对身体的不利影响 呼吸道疾病。不幸的是，患有慢性阻塞性肺病的低收入人群通常饮食中摄入 omega-3 除了室内 PM 暴露水平相对较高之外，其水平远低于建议水平，导致 呼吸系统不良后果的风险增加。旨在增加 omega-3 摄入量的饮食干预 食物来源，有可能对这一弱势群体产生重大影响。在本提案中，我们将测试饮食 基于富含 omega-3 食物的干预措施，旨在改善呼吸系统健康（目标 1），并保护 对抗环境暴露对患有慢性阻塞性肺病的低收入成年人的不利影响（目标 2）。这 干预措施将克服低收入社区的几个常见营养障碍：粮食不安全（a 将提供优惠券）、食品获取和新鲜食品供应（送货上门和从一系列食品中选择） 健康食品选择），并支持实现和维持饮食改变（定期接触饮食 接受过培训的健康教练支持围绕健康食品选择的个人行为，并提供文化- 有关营养和食物准备的知情教育）。通过定性方法（目标 3），我们还将 探索干预措施的障碍和促进因素，以优化未来实施的可持续性 策略。结果将全面阐述循证营养干预对健康的影响 慢性阻塞性肺病健康，并为其他慢性病的饮食干预提供框架 影响易受影响的低收入人群。积极的成果将受到现有基础设施的推动 领先的全国杂货配送服务支持扩大健康食品的获取范围，提供现成的 超越研究并具有直接政策影响的可持续性和传播平台。