title: Fish intake and risk of chronic obstructive pulmonary disease in 2 large US cohorts.
abstract: BACKGROUND
  Despite mechanistic data that linked fish and omega-3 (n-3) PUFAs with lower risk of chronic obstructive pulmonary disease (COPD), epidemiologic data remain scarce. Fish and n-3 PUFAs are an important component of the prudent dietary pattern that is thought to be protective in the onset of COPD.
  
  
  OBJECTIVE
  We examined the role of fish and PUFA intakes on risk of developing COPD while taking into account the overall dietary pattern.
  
  
  METHODS
  We investigated the objective in 120,175 women and men from the Nurses' Health Study and Health Professionals Follow-Up Study. Over the study period (1984-2000), there were 889 cases of newly diagnosed COPD. Cumulative average intakes of fish, eicosapentaenoic acid, docosahexaenoic acid, n-3 PUFAs, n-6 PUFAs, and the n-3:n-6 ratio were calculated from repeated food-frequency questionnaires. Because fish is a food group included in the prudent pattern, we derived a new prudent pattern without the contribution from fish, and we termed this pattern the "modified prudent" pattern. We performed multivariable Cox proportional hazards models.
  
  
  RESULTS
  Before the dietary pattern was taken into account, and with 14 factors controlled for, we showed that more-frequent fish intake (≥4 servings/wk) was inversely associated with risk of COPD [adjusted pooled HR for the highest intake compared with the lowest intake (<1 serving/wk): 0.71; 95% CI: 0.54, 0.94]. After additional adjustment for the dietary pattern (modified prudent and Western patterns), the association was NS (0.84; 95% CI: 0.63, 1.13). No significant associations were shown between PUFA intakes and risk of COPD.
  
  
  CONCLUSIONS
  Although COPD-prevention efforts should continue to focus on smoking cessation, these prospective findings support the importance of promoting a healthy diet in multi-interventional programs to prevent COPD instead of focusing on changes in an isolated food or nutrient.
authors: From the Centre for Research in Epidemiology and Population Health, U1018, Respiratory and Environmental Epidemiology team, Villejuif, France (RV); the Université Paris-Sud 11, UMRS 1018, Villejuif, France (RV); the Division of General Medicine, Departments of Medicine and of Epidemiology, Columbia University Medical Center, New York, NY (RGB); the Departments of Nutrition (WCW) and Epidemiology (WCW and CAC), Harvard School of Public Health, Boston, MA; the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (WCW, FES, and CAC); and the Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA (CAC).
authors: Raphaëlle
authors: R
authors: Varraso
authors: From the Centre for Research in Epidemiology and Population Health, U1018, Respiratory and Environmental Epidemiology team, Villejuif, France (RV); the Université Paris-Sud 11, UMRS 1018, Villejuif, France (RV); the Division of General Medicine, Departments of Medicine and of Epidemiology, Columbia University Medical Center, New York, NY (RGB); the Departments of Nutrition (WCW) and Epidemiology (WCW and CAC), Harvard School of Public Health, Boston, MA; the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (WCW, FES, and CAC); and the Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA (CAC).
authors: R Graham
authors: RG
authors: Barr
authors: From the Centre for Research in Epidemiology and Population Health, U1018, Respiratory and Environmental Epidemiology team, Villejuif, France (RV); the Université Paris-Sud 11, UMRS 1018, Villejuif, France (RV); the Division of General Medicine, Departments of Medicine and of Epidemiology, Columbia University Medical Center, New York, NY (RGB); the Departments of Nutrition (WCW) and Epidemiology (WCW and CAC), Harvard School of Public Health, Boston, MA; the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (WCW, FES, and CAC); and the Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA (CAC).
authors: Walter C
authors: WC
authors: Willett
authors: From the Centre for Research in Epidemiology and Population Health, U1018, Respiratory and Environmental Epidemiology team, Villejuif, France (RV); the Université Paris-Sud 11, UMRS 1018, Villejuif, France (RV); the Division of General Medicine, Departments of Medicine and of Epidemiology, Columbia University Medical Center, New York, NY (RGB); the Departments of Nutrition (WCW) and Epidemiology (WCW and CAC), Harvard School of Public Health, Boston, MA; the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (WCW, FES, and CAC); and the Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA (CAC).
authors: Frank E
authors: FE
authors: Speizer
authors: From the Centre for Research in Epidemiology and Population Health, U1018, Respiratory and Environmental Epidemiology team, Villejuif, France (RV); the Université Paris-Sud 11, UMRS 1018, Villejuif, France (RV); the Division of General Medicine, Departments of Medicine and of Epidemiology, Columbia University Medical Center, New York, NY (RGB); the Departments of Nutrition (WCW) and Epidemiology (WCW and CAC), Harvard School of Public Health, Boston, MA; the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (WCW, FES, and CAC); and the Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA (CAC).
authors: Carlos A
authors: CA
authors: Camargo
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D004032:Diet; D004281:Docosahexaenoic Acids / Q000008:administration & dosage; D015118:Eicosapentaenoic Acid / Q000008:administration & dosage; D015525:Fatty Acids, Omega-3; D005247:Feeding Behavior; D005260:Female; D005399:Fishes; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D010641:Phenotype; D016016:Proportional Hazards Models; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000517:prevention & control; D012307:Risk Factors; D017747:Seafood; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D015525:Fatty Acids, Omega-3; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid
keywords: diet; dietary patterns; epidemiology; fish; respiratory diseases
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