Effects of nutritional support with Omega-3 rich diets on inflammation, respiratory functions and quality of life in patients with COPD

This study was conducted to determine the nutritional status of the stable stage Chronic Obstructive Pulmonary Disease (COPD) patients with various anthropometric and biochemical parameters and to define the relationship between these parameters and respiratory functions, exercise capacity, health status. In addition to this purposes, objective of this study was to determine the effects of nutritional support with omega-3 rich diets on inflammation, respiratory functions and quality of life. The study was planned on 21 stable stage 1, 2 and 3 COPD patients ages between 40-65 years old without any systemic disease at Ataturk Chest Diseases and Thoracic Surgery Education and Research Hospital between December 2009 and November 2010. A questionnaire was applied to patients including demographic and disease information. The nutritional status of the patients was determined by food-frequency questionnaire, a three-d 24-h dietary record and Subjective Global Assessment. Patients? quality of life was assessed by SF-36 questionnaire, exercise performance was assessed by 6 Minute Walking Test, dyspnea was specified by BORG scale and respiratory functions was assessed by spirometry. Some biochemical parameters, anthropometric measurements and physical activity levels of the patients were also determined. Before the personal diets were planned, patients? personal needs were determined and an omega-3 rich diet was administered with an omega-3 dietary supplementation (180 mg EPA and 120 mg DHA). The mean age of the patients was 58.8±4.75 years and mean duration of COPD was 4.7±4.46 years. COPD stages of the patients were; 9.5% stage 1, 61.9% stage 2 and 28.6% stage 3. Before and after dietary management, anthropometric measurements were similar. Biochemical parameters of patients were similar before and after intervention and they were all between the references. After the diet therapy, mean plasma hs-CRP level was decreased (p>0.05). Although before and after treatment, mean PaO2 levels were lower than references after diet therapy mean PaO2 levels was increased (p>0.05). According to SGA results, before and after dietary treatment, the percentage of well-nourished patients was 90.5%, moderately-malnourished patients was 9.5%. After dietary intervention, patients? mean BORG scale result was decreased (p<0.05). Patients? life quality levels were determined. After dietary intervention physical component score and mental component score were increased and these differences between before and after intervention were statistically significant (p<0.05). The mean walking distance of the patients was 395.9±53.65 m before intervention and 420.8±48.07 m after intervention (p<0.05). Before dietary intervention, FEV1/FVC was 64.1±11.61% and after the intervention this ratio increased to 67.8±9.37% (p>0.05). Patients? daily energy intake was lower before the intervention. Daily mean dietary carbohydrate intake was 263.1±58.18 g (52.8% total energy) before intervention and 230.8±70.26 g (48.6% total energy) after intervention (p<0.05). The percentage of dietary energy from fat was 32.9±5.30% before the intervention, this ratio increased to 36.7±6.79% after the intervention (p<0.05). Omega-3 and omega-6 consumption of the patients were increased after the dietary intervention (p<0.05). Dietary EPA and DHA consumptions were increased after the intervention (p<0.05), ?-linolenic acid consumption of patients was similar before and after the intervention. Daily dietary intakes of vitamins B6, B12, thiamine and calcium, magnesium, potassium were lower than DRI recommendations. After intervention, patients? fish and vegetable consumption were increased. Increase in vegetable consumption was found to be statistically significant (p<0.05). After dietary intervention, there was a significant negative correlation between dietary omega-3 and BORG scale(r=-0.623, p=0.003), a significant positive correlation between dietary omega-3 and SF-36 Physical Health component (r=0.456, p=9.038). As a conclusion, COPD patients should be considered to be at high risk for reduced quality of life, exercise capacity and respiratory functions because of systemic inflammation. For these reasons, while planning the COPD patients? diet it should be so important to provide adequate energy, low carbohydrate and high omega-3 content within diets for the quality of life and survival.