Investigating associations of omega-3 fatty acids, lung function decline, and airway obstruction

Authors: PATCHEN, BONNIE - Cornell University; BALTE, PALAVI - Columbia University - New York; BARTZ, TRACI - University Of Washington; BARR, R - Columbia University - New York; FORNAGE, MYRIAM - University Of Texas Health Science Center; GRAFF, MARIAELISA - University Of North Carolina; JACOBS JR, DAVID - University Of Minnesota; KALHAN, RAVI - Northwestern University; LEMAITRE, ROZENN - University Of Washington; O'CONNOR, GEORGE - Boston University Medical School; PSATY, BRUCE - University Of Washington; SEO, JUNGKYUN - University Of North Carolina; TSAI, MICHAEL - University Of Minnesota; WOOD, ALEXIS - Children'S Nutrition Research Center (CNRC); XU, HANFEI - Boston University School Of Public Health; ZHANG, JINGWEN - Boston University School Of Public Health; GHARIB, SINA - University Of Washington; MANICHAIKUL, ANI - University Of Virginia; NORTH, KARI - University Of North Carolina; STEFFEN, LYN - University Of Minnesota; DUPUIS, JOSEE - Boston University School Of Public Health; OELSNER, ELIZABETH - Columbia University - New York; HANCOCK, DANA - Rti International, Usa; CASSANO, PATRICIA - Cornell University

Submitted to: American Journal of Respiratory and Critical Care Medicine
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/21/2023
Publication Date: 7/20/2023
Citation: Patchen, B.K., Balte, P., Bartz, T.M., Barr, R.G., Fornage, M., Graff, M., Jacobs Jr, D.R., Kalhan, R., Lemaitre, R.N., O'Connor, G., Psaty, B., Seo, J., Tsai, M.Y., Wood, A.C., Xu, H., Zhang, J., Gharib, S.A., Manichaikul, A., North, K., Steffen, L.M., Dupuis, J., Oelsner, E., Hancock, D.B., Cassano, P.A. 2023. Investigating associations of omega-3 fatty acids, lung function decline, and airway obstruction. American Journal of Respiratory and Critical Care Medicine. https://doi.org/10.1164/rccm.202301-0074OC.
DOI: https://doi.org/10.1164/rccm.202301-0074OC

Interpretive Summary: Inflammation contributes to lung function decline, which underlies the development of chronic obstructive pulmonary disease. Omega-3 fatty acids have anti-inflammatory properties and may benefit lung health, but their relationship in protecting lung health is unclear. This paper investigated whether blood levels of four omega-3 fatty acids associate with long-term lung health. Our analysis found that higher blood levels of omega-3 fatty acids were associated with less decline in lung function and lower likelihood of developing airway obstruction over time, in older US adults. These results support beneficial effects of higher blood levels of omega-3 fatty acids on long-term lung health.

Technical Abstract: Inflammation contributes to lung function decline and the development of chronic obstructive pulmonary disease. Omega-3 fatty acids have anti-inflammatory properties and may benefit lung health. Our objective was to investigate associations of omega-3 fatty acids with lung function decline and incident airway obstruction in diverse adults from general population cohorts. Complementary study designs were employed: (1) longitudinal study of plasma phospholipid omega-3 fatty acids and repeated FEV1 and FVC measures in the National Heart, Lung, and Blood Institute Pooled Cohorts Study, and (2) two-sample Mendelian Randomization (MR) study of genetically predicted omega-3 fatty acids and lung function parameters. The longitudinal study found that higher omega-3 fatty acid levels were associated with attenuated lung function decline in 15,063 participants, with the largest effect sizes for the most metabolically downstream omega-3 fatty acid, docosahexaenoic acid (DHA). An increase in DHA of 1% of total fatty acids was associated with an attenuation of 1.4 mL/year for FEV1 (95% confidence interval [CI] 1.1–1.8) and 2.0 mL/year for FVC (95% CI 1.6–2.4) and a 7% lower incidence of spirometry-defined airway obstruction (95% CI 0.89–0.97). DHA associations persisted across sexes, smoking histories, and Black, White and Hispanic participants, with the largest magnitude associations in former smokers and Hispanics. The MR study showed similar trends towards positive associations of genetically predicted downstream omega-3 fatty acids with FEV1 and FVC. The longitudinal and MR studies provide evidence supporting beneficial effects of higher levels of downstream omega-3 fatty acids, especially DHA, on lung health.