-3 polyunsaturated fatty acid supplementation improves postabsorptive and prandial protein metabolism in patients with chronic obstructive pulmonary disease: a randomized clinical trial.
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BACKGROUND: Disturbances in protein metabolism and impaired muscle health have been observed in chronic obstructive pulmonary disease (COPD). The -3 (n-3) PUFAs EPA and DHA are known for their anti-inflammatory and muscle health-enhancing properties. OBJECTIVES: We examined whether daily EPA+DHA supplementation can improve daily protein homeostasis in patients with COPD by reducing postabsorptive whole-body protein breakdown (PB) and enhancing the anabolic response to feeding in a dose-dependent way. METHODS: Normal-weight participants with moderate to severe COPD (n=32) received daily for 4 wk, according to a randomized double-blind placebo controlled 3-group design, a high dose (3.5g, n=10) of EPA+DHA, a low dose (2.0g, n=10) of EPA+DHA, or placebo (olive oil, n=12) via gel capsules. At pre- and postintervention, stable isotope tracers were infused to assess postabsorptive netPB [postabsorptive PB - protein synthesis (PS)] and the anabolic response (prandial netPS=prandial PS-PB) to a protein meal. In addition, muscle mass and function were measured. RESULTS: Plasma phosphatidylcholine EPA and DHA concentrations were higher after 4 wk of supplementation in both EPA+DHA groups (P<0.004), and there was a trend toward higher values for plasma EPA after the high compared with the low dose of EPA+DHA (P=0.065). Postabsorptive PB was lower after 4 wk of the high dose of EPA+DHA, whereas netPB was lower independent of the dose of EPA+DHA (low dose, P=0.037; high dose, P=0.026). Prandial netPS was increased only after the high dose of EPA+DHA (P=0.03). Extremity lean mass but not muscle function was increased, independent of the EPA+DHA dose (P<0.05). CONCLUSIONS: Daily n-3 PUFA supplementation for 4 wk induces a shift toward a positive daily protein homeostasis in patients with COPD in part in a dose-dependent way. Daily doses up to 3.5g EPA and DHA are still well tolerated and lead to protein gain in these patients. This trial was registered at clinicaltrials.gov as NCT01624792.
