A healthy set of lungs allows us to laugh, dance, run, and sustain life by absorbing the oxygen our body needs to survive and eliminating up to 70% of the waste our bodies produce. Good lung health is indispensable. Yet, many take these essential organs for granted, only considering lung maintenance and support when problems arise.
Whether you are in perfect health or are one of the 34 million Americans living with a lung condition, there are several things you can do to support your lung health and breathing capability, such as breathing exercises, physical activity, and smoking cessation. Yet, food is often overlooked as an instrument for lung protection.
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However, in recent years, there has been increasing evidence that omega-3 fatty acids, abundant in fish and fish oil supplements, may benefit lung health. Let’s explore the connection between omega-3s and lung health to uncover the potential benefits they may offer.
Role of Omega-3s in Lung Health
The lungs are exposed to various potentially harmful agents through each breath, such as pathogens, allergens, toxins, and irritants. The host must respond to these invaders by mounting an acute inflammatory response to resolve any insult or harm done to the lung tissue and return to homeostasis.
However, the process does not always work perfectly, and the body may fail to resolve the inflammation. In this case, acute inflammation can become excessive or turn into chronic inflammation, which may lead to several common lung diseases, such as acute respiratory distress syndrome (ARDS), asthma, chronic obstructive pulmonary disease (COPD), and cystic fibrosis. Therefore, an established way diet and nutrition can support lung health is through the modulation of inflammation.
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Diet is increasingly becoming recognized as a modifiable contributor to chronic inflammatory conditions. In particular, the intake of omega-3 fatty acids, either through a dietary lifestyle such as the Mediterranean diet or as single nutrients, has been found to play a significant role in acute and chronic inflammatory processes.
Omega-3 polyunsaturated fatty acids (PUFAs) alpha-linoleic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) have demonstrated the ability to modulate inflammatory responses and influence respiratory health. DHA can be found in the airway mucosa, and PUFAs can be released from cell membranes and circulate in the plasma to be available at sites of inflammation and injury.
EPA and DHA act on inflammation in several ways. First, they can reduce the activation of pro-inflammatory transcription factors that regulate immunity and induce the expression of various pro-inflammatory genes – such as those encoding cytokines and chemokines.
Additionally, omega-3s can act on inflammation indirectly through their derivatives. Omega-3 PUFAs are precursors of molecules known as specialized pro-resolving mediators (SPMs) that aid in inflammation resolution. SPMs biosynthesized from omega-3 fatty acids, including resolvins, protectins, and maresins, regulate neutrophil infiltration, suppress cytokine and chemokine production, and aid in the clearance of apoptotic neutrophils by macrophages, contributing to the resolution of inflammation. Several studies have identified deficiencies in SPMs in common inflammatory lung diseases.
Could increasing anti-inflammatory compounds in the diet, such as omega-3s, better manage the ungoverned inflammation observed in these diseases and improve health outcomes?
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Recent Evidence Establishes Omega-3 Effects on Lung Health
The effects of omega-3 intake on lung health have been explored in several conditions, including COPD, asthma, interstitial lung disease (ILD), acute lung injury (ALI), and ARDS. COPD, which is a progressive disease with no known cure, includes two main conditions: emphysema and chronic bronchitis. Still, lifestyle changes can improve the quality of life and slow disease progression of COPD.
A 2020 study completed in a population of former smokers with moderate to severe COPD found that higher total omega-3 intake was associated with lower risk of severe exacerbations, better health-related quality of life, and fewer respiratory symptoms. Furthermore, several studies have suggested that dietary omega-3s may be protective, and higher intake is associated with a lower risk of COPD altogether.
ILD is a family of diseases characterized by lung inflammation and fibrosis (scarring) of the lungs. Fibrosis causes stiffness in the lungs, making it harder to breathe. And like COPD, ILDs are often irreversible and progressive. A large study (n= >6,500) published in 2020 examined the associations of circulating levels of DHA and other PUFAs with hospitalization and death due to ILD over 12 years. They found that higher DHA levels were associated with lower rates of hospitalization and death due to ILD and cross-sectionally associated with fewer lung abnormalities on CT scans.
Similar findings have been seen in those with asthma, a chronic inflammatory airway disease. A 2020 cross-sectional study found that a higher omega-3 index (O3I)(>8%) was associated with better asthma control and lower inhaled corticosteroid use compared to those with lower O3I status. Similar results have been documented in children with asthma.
ALI is a common critically ill disease caused by various intrapulmonary and external factors, such as severe trauma or infection. ALI can progress to ARDS if left untreated, with a high mortality range of 31-40%. A 2020 systematic review and meta-analysis found that omega-3s can improve the respiratory function and respiratory status of ALI patients and may be a potentially effective and safe strategy for ALI treatment. Furthermore, ample evidence demonstrating the relationship between omega-3 fatty acids and COVID-19 severity and mortality, which is also related to ARDS, has been published.
New NIH Statement Confirms Correlation Between Omega-3s and Lung Function
While past studies have suggested that omega-3s may support lung health, mainly due to their established anti-inflammatory action, robust studies linking the two have been lacking – until now.
The National Institutes of Health (NIH) released a statement in July 2023 highlighting a new study that provides the most substantial evidence to date of the association between omega-3 intake in the diet and lung health. This two-part study investigated the link between omega-3 levels in the blood and lung function over time.
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First, the researchers conducted a longitudinal observational study, which included more than 15,000 Americans who were generally healthy when the study began and were followed for 7-20 years. Part one revealed that higher blood levels of omega-3 fatty acids, particularly DHA, are associated with a reduced rate of lung function decline.
The second part of the study included an analysis of genetic data from more than 500,000 healthy participants included in the UK Biobank. After studying genetic markers as an indirect measure for dietary omega-3 fatty acid levels, results showed that higher levels of omega-3 fatty acids were associated with better lung function. According to the first author of the NIH study, the goal is to one day translate current research efforts into precision nutrition for treating lung diseases.
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Other Tips to Safeguard your Lung health
According to the American Lung Association, other tips to keep your lungs healthy and reduce your risk for lung disease include:
- Smoking cessation: Cigarette smoking is a significant cause of lung cancer, COPD, chronic bronchitis, and emphysema.
- Check indoor air quality: Indoor air can be even more polluted than the air outdoors. Follow these steps to improve your indoor air quality.
- Monitor outdoor air pollution: Air quality outside can vary from day to day, and sometimes is unhealthy to breathe. Check gov to find the daily air conditions in your area and minimize exposure to polluted air when possible.
- Exercise: Being physically active can help keep your lungs healthy regardless of age or current health status. If you have an underlying health condition, be sure to talk to your doctor before starting a new exercise routine.
- Get routine check-ups: It’s best to catch lung conditions early. Regular check-ups can help address concerns or spot deterioration of lung health early on.
- Know your Omega-3 Index: Knowing associations between omega-3 status and lung health, monitoring omega-3 status, and making dietary changes to optimize omega-3 levels could help manage inflammation and support lung health.
