J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://www.jocmr.org

Original Article

Volume 14, Number 11, November 2022, pages 466-473

Effect of Omega-3 Polyunsaturated Fatty Acids Intake on Eosinophil Airway Inflammation in University Athletes

Figure 1. Comparison of FeNO levels at baseline and after 1, 2, and 3 weeks of PUFA supplementation between the three groups. Error bars represent standard deviations. *P < 0.05 vs. baseline and 1 week. ^†P<0.05 vs. N_PUFA and control. ^‡P < 0.05 vs. control. PUFA: polyunsaturated fatty acids; I: airway inflammation; N: non-airway inflammation; I_PUFA: intake of PUFA and FeNO ≥ 25 ppb; N_PUFA: intake of PUFA and FENO < 25 ppb and eCO ≥ 3.6 ppm; FeNO: fractional exhaled nitric oxide.

**Table 1.** Respiratory Function at Baseline and After 3 Weeks
	I_PUFA (n = 10)	N_PUFA (n = 5)	Control (n = 8)
Data are presented as mean ± SD. PUFA: polyunsaturated fatty acid; I_PUFA: intake of PUFA and FeNO ≥ 25 ppb; N_PUFA: intake of PUFA and FENO < 25 ppb and eCO ≥ 3.6 ppm; FeNO: fractional exhaled nitric oxide; eCO: exhaled carbon dioxide; FVC: forced vital capacity; FEV1: forced expiratory volume in the first second; PEF: peak expiratory flow; SD: standard deviation.
Age (years)	21.0 ± 1.4		20.0 ± 2.1		20.0 ± 1.7
Weight (kg)	82.5 ± 15.2		79.9 ± 13.8		74.4 ± 13.0
FVC (L)	4.4 ± 0.7	4.6 ± 0.6	4.4 ± 0.8	4.7 ± 0.7	4.0 ± 0.7	4.6 ± 0.4
FVC (% predicted)	98.7 ± 16.0	104.5 ± 11.2	101.1 ± 15.4	106.7 ± 13.1	92.7 ± 16.5	105.7 ± 8.9
FEV₁ (L)	3.9 ± 0.8	4.0 ± 0.7	3.9 ± 0.6	4.1 ± 0.5	3.4 ± 0.6	3.9 ± 0.4
FEV₁ (% predicted)	89.8 ± 17.2	93.9 ± 14.6	90.8 ± 11.3	95.1 ± 8.2	81.1 ± 14.1	92.3 ± 6.9
FEV₁/FVC (%)	89.0 ± 8.6	86.1 ± 7.5	88.0 ± 6.0	87.5 ± 5.8	85.1 ± 6.3	84.7 ± 2.6
PEF (L/s)	9.4 ± 2.1	9.9 ± 1.6	8.5 ± 2.1	9.0 ± 1.6	7.2 ± 2.0	8.6 ± 1.0

Table 1. Respiratory Function at Baseline and After 3 Weeks

I_PUFA (n = 10)

N_PUFA (n = 5)

Control (n = 8)

Baseline

3 weeks

Baseline

3 weeks

Baseline

3 weeks

Data are presented as mean ± SD. PUFA: polyunsaturated fatty acid; I_PUFA: intake of PUFA and FeNO ≥ 25 ppb; N_PUFA: intake of PUFA and FENO < 25 ppb and eCO ≥ 3.6 ppm; FeNO: fractional exhaled nitric oxide; eCO: exhaled carbon dioxide; FVC: forced vital capacity; FEV1: forced expiratory volume in the first second; PEF: peak expiratory flow; SD: standard deviation.

Age (years)

21.0 ± 1.4

20.0 ± 2.1

20.0 ± 1.7

Weight (kg)

82.5 ± 15.2

79.9 ± 13.8

74.4 ± 13.0

FVC (L)

4.4 ± 0.7

4.6 ± 0.6

4.4 ± 0.8

4.7 ± 0.7

4.0 ± 0.7

4.6 ± 0.4

FVC (% predicted)

98.7 ± 16.0

104.5 ± 11.2

101.1 ± 15.4

106.7 ± 13.1

92.7 ± 16.5

105.7 ± 8.9

FEV₁ (L)

3.9 ± 0.8

4.0 ± 0.7

3.9 ± 0.6

4.1 ± 0.5

3.4 ± 0.6

3.9 ± 0.4

FEV₁ (% predicted)

89.8 ± 17.2

93.9 ± 14.6

90.8 ± 11.3

95.1 ± 8.2

81.1 ± 14.1

92.3 ± 6.9

FEV₁/FVC (%)

89.0 ± 8.6

86.1 ± 7.5

88.0 ± 6.0

87.5 ± 5.8

85.1 ± 6.3

84.7 ± 2.6

PEF (L/s)

9.4 ± 2.1

9.9 ± 1.6

8.5 ± 2.1

9.0 ± 1.6

7.2 ± 2.0

8.6 ± 1.0

**Table 2.** Changes in eCO and Blood Eosinophils Levels Over 3 Weeks
	Baseline	1 week	2 weeks	3 weeks
Data are presented as mean ± SD. ^aP < 0.05: compared to baseline. ^bP < 0.05 compared to I_PUFA and PUFA. PUFA: polyunsaturated fatty acid; I_PUFA: intake of PUFA and FeNO ≥ 25 ppb; N_PUFA: intake of PUFA and FENO < 25 ppb and eCO ≥ 3.6 ppm; eCO: exhaled carbon monoxide; SD: standard deviation.
CO (ppm)
I_PUFA	3.7 ± 0.7	3.5 ± 1.4	2.8 ± 0.5^a	2.4 ± 0.5^a
N_PUFA	4.7 ± 0.9	3.7 ± 0.9	2.9 ± 0.4^a	2.4 ± 0.6^a
Control	2.9 ± 0.4^b	2.7 ± 0.5	2.3 ± 0.3	2.5 ± 0.6
Eosinophilic (%)
I_PUFA	5.7 ± 1.7	5.9 ± 1.9	4.8 ± 1.0	5.4 ± 2.0
N_PUFA	2.9 ± 1.5	2.8 ± 1.1	2.7 ± 1.8	3.1 ± 1.3
Control	1.8 ± 0.5	2.2 ± 0.5	2.3 ± 1.0	2.0 ± 0.6

Table 2. Changes in eCO and Blood Eosinophils Levels Over 3 Weeks

Baseline

1 week

2 weeks

3 weeks

Data are presented as mean ± SD. ^aP < 0.05: compared to baseline. ^bP < 0.05 compared to I_PUFA and PUFA. PUFA: polyunsaturated fatty acid; I_PUFA: intake of PUFA and FeNO ≥ 25 ppb; N_PUFA: intake of PUFA and FENO < 25 ppb and eCO ≥ 3.6 ppm; eCO: exhaled carbon monoxide; SD: standard deviation.

CO (ppm)

I_PUFA

3.7 ± 0.7

3.5 ± 1.4

2.8 ± 0.5^a

2.4 ± 0.5^a

N_PUFA

4.7 ± 0.9

3.7 ± 0.9

2.9 ± 0.4^a

2.4 ± 0.6^a

Control

2.9 ± 0.4^b

2.7 ± 0.5

2.3 ± 0.3

2.5 ± 0.6

Eosinophilic (%)

I_PUFA

5.7 ± 1.7

5.9 ± 1.9

4.8 ± 1.0

5.4 ± 2.0

N_PUFA

2.9 ± 1.5

2.8 ± 1.1

2.7 ± 1.8

3.1 ± 1.3

Control

1.8 ± 0.5

2.2 ± 0.5

2.3 ± 1.0

2.0 ± 0.6

**Table 3.** Changes in Respiratory Impedance Markers Over 3 Weeks
	I_PUFA group (n = 10)	Control group (n = 8)
Data are presented as mean ± SD. PUFA: polyunsaturated fatty acid; I_PUFA: intake of PUFA and FeNO ≥ 25 ppb; R5: 5 Hz; R20: 20 Hz; X5: reactance at 5 Hz; Fres: resonant frequency; SD: standard deviation.
R5 (cm H₂O/L/s)	2.29 ± 1.1	2.26 ± 1.0	1.92 ± 0.7	1.75 ± 0.6	2.13 ± 0.6	2.25 ± 0.7	1.92 ± 0.4	1.84 ± 0.3
R20 (cm H₂O/L/s)	2.14 ± 0.8	2.03 ± 0.6	2.03 ± 0.6	1.84 ± 0.3	2.14 ± 0.6	2.00 ± 0.2	2.00 ± 0.2	1.83 ± 0.2
R5 - R20 (cm H₂O/L/s)	0.12 ± 0.5	-0.10 ± 0.5	-0.10 ± 0.5	-0.09 ± 0.5	0.11 ± 0.5	-0.08 ± 0.3	-0.08 ± 0.3	0.01 ± 0.3
X5 (cm H₂O/L/s)	-0.14 ± 0.4	-0.21 ± 0.2	-0.28 ± 0.3	-0.08 ± 0.3	-0.10 ± 0.1	-0.25 ± 0.3	-0.11 ± 0.1	-0.19 ± 0.2
Fres (Hz)	6.47 ± 3.0	5.99 ± 1.5	7.85 ± 3.2	7.50 ± 4.9	5.84 ± 1.1	7.39 ± 3.8	6.10 ± 1.2	7.21 ± 2.0

Table 3. Changes in Respiratory Impedance Markers Over 3 Weeks

I_PUFA group (n = 10)

Control group (n = 8)

Baseline

1 week

2 weeks

3 weeks

Baseline

1 week

2 weeks

3 weeks

Data are presented as mean ± SD. PUFA: polyunsaturated fatty acid; I_PUFA: intake of PUFA and FeNO ≥ 25 ppb; R5: 5 Hz; R20: 20 Hz; X5: reactance at 5 Hz; Fres: resonant frequency; SD: standard deviation.

R5 (cm H₂O/L/s)

2.29 ± 1.1

2.26 ± 1.0

1.92 ± 0.7

1.75 ± 0.6

2.13 ± 0.6

2.25 ± 0.7

1.92 ± 0.4

1.84 ± 0.3

R20 (cm H₂O/L/s)

2.14 ± 0.8

2.03 ± 0.6

1.84 ± 0.3

2.14 ± 0.6

2.00 ± 0.2

1.83 ± 0.2

R5 - R20 (cm H₂O/L/s)

0.12 ± 0.5

-0.10 ± 0.5

-0.09 ± 0.5

0.11 ± 0.5

-0.08 ± 0.3

0.01 ± 0.3

X5 (cm H₂O/L/s)

-0.14 ± 0.4

-0.21 ± 0.2

-0.28 ± 0.3

-0.08 ± 0.3

-0.10 ± 0.1

-0.25 ± 0.3

-0.11 ± 0.1

-0.19 ± 0.2

Fres (Hz)

6.47 ± 3.0

5.99 ± 1.5

7.85 ± 3.2

7.50 ± 4.9

5.84 ± 1.1

7.39 ± 3.8

6.10 ± 1.2

7.21 ± 2.0

**Table 4.** Dietary Intake as Assessed by the Food Frequency Questionnaire at Baseline and 3 Weeks
	I_PUFA group (n = 10)	N_PUFA group (n = 5)	Control group (n = 8)
Data are presented as mean ± SD. PUFA: polyunsaturated fatty acid; I_PUFA: intake of PUFA and FeNO ≥ 25 ppb; N_PUFA: intake of PUFA and FENO < 25 ppb and eCO ≥ 3.6 ppm; eCO: exhaled carbon monoxide; SD: standard deviation.
Energy (kcal)	2,517 ± 332.5	2,305 ± 344.5	2,607.2 ± 316.8	2,312.0 ± 152.2	2,408.3 ± 162.0	2,290.4 ± 133.0
Lipid (g)	68.0 ± 6.4	66.7 ± 8.0	69.8 ± 5.2	64.8 ± 2.2	66.05 ± 2.1	65.1 ± 2.4
Protein (g)	92.31 ± 7.4	88.56 ± 7.7	95.3 ± 7.3	89.2 ± 4.4	90.3 ± 3.1	88.2 ± 2.9
Carbohydrate (g)	376.8 ± 65.0	312.7 ± 61.5	388.3 ± 63.3	330.8 ± 36.2	355.0 ± 49.5	322.4 ± 34.2

Table 4. Dietary Intake as Assessed by the Food Frequency Questionnaire at Baseline and 3 Weeks

I_PUFA group (n = 10)

N_PUFA group (n = 5)

Control group (n = 8)

Baseline

3 weeks

Baseline

3 weeks

Baseline

3 weeks

Data are presented as mean ± SD. PUFA: polyunsaturated fatty acid; I_PUFA: intake of PUFA and FeNO ≥ 25 ppb; N_PUFA: intake of PUFA and FENO < 25 ppb and eCO ≥ 3.6 ppm; eCO: exhaled carbon monoxide; SD: standard deviation.

Energy (kcal)

2,517 ± 332.5

2,305 ± 344.5

2,607.2 ± 316.8

2,312.0 ± 152.2

2,408.3 ± 162.0

2,290.4 ± 133.0

Lipid (g)

68.0 ± 6.4

66.7 ± 8.0

69.8 ± 5.2

64.8 ± 2.2

66.05 ± 2.1

65.1 ± 2.4

Protein (g)

92.31 ± 7.4

88.56 ± 7.7

95.3 ± 7.3

89.2 ± 4.4

90.3 ± 3.1

88.2 ± 2.9

Carbohydrate (g)

376.8 ± 65.0

312.7 ± 61.5

388.3 ± 63.3

330.8 ± 36.2

355.0 ± 49.5

322.4 ± 34.2

**Table 5.** Changes in Blood n-3 PUFA Over 3 Weeks
	I_PUFA group (n = 10)	N_PUFA group (n = 5)	Control group (n = 8)
Data are presented as mean ± SD. *P < 0.05, compared to baseline. n-3: omega-3; PUFA: polyunsaturated fatty acid; I_PUFA: intake of PUFA and FeNO ≥ 25 ppb; N_PUFA: intake of PUFA and FENO < 25 ppb and eCO ≥ 3.6 ppm; SD: standard deviation EPA: eicosatetraenoic acid; DHA: docosahexaenoic acid; AA: arachidonic acid.
EPA (μg/mL)	27.7 ± 16.9	52.1 ± 12.3*	20.8 ± 8.7	70.4 ± 36.1*	31.6 ± 19.7	26.9 ± 17.7
DHA (µg/mL)	73.8 ± 23.9	76.6 ± 17.3	70.8 ± 24.1	86.8 ± 27.5	80.5 ± 28.5	79.0 ± 16.7
AA (µg/mL)	198.4 ± 46.9	183.5 ± 28.9	212.1 ± 34.3	198.0 ± 36.7	208.7 ± 33.8	221.2 ± 36.8
EPA/AA	0.14 ± 0.1	0.29 ± 0.1*	0.10 ± 0.0	0.36 ± 0.2*	0.15 ± 0.1	0.12 ± 0.1

Table 5. Changes in Blood n-3 PUFA Over 3 Weeks

I_PUFA group (n = 10)

N_PUFA group (n = 5)

Control group (n = 8)

Baseline

3 weeks

Baseline

3 weeks

Baseline

3 weeks

Data are presented as mean ± SD. *P < 0.05, compared to baseline. n-3: omega-3; PUFA: polyunsaturated fatty acid; I_PUFA: intake of PUFA and FeNO ≥ 25 ppb; N_PUFA: intake of PUFA and FENO < 25 ppb and eCO ≥ 3.6 ppm; SD: standard deviation EPA: eicosatetraenoic acid; DHA: docosahexaenoic acid; AA: arachidonic acid.

EPA (μg/mL)

27.7 ± 16.9

52.1 ± 12.3*

20.8 ± 8.7

70.4 ± 36.1*

31.6 ± 19.7

26.9 ± 17.7

DHA (µg/mL)

73.8 ± 23.9

76.6 ± 17.3

70.8 ± 24.1

86.8 ± 27.5

80.5 ± 28.5

79.0 ± 16.7

AA (µg/mL)

198.4 ± 46.9

183.5 ± 28.9

212.1 ± 34.3

198.0 ± 36.7

208.7 ± 33.8

221.2 ± 36.8

EPA/AA

0.14 ± 0.1

0.29 ± 0.1*

0.10 ± 0.0

0.36 ± 0.2*

0.15 ± 0.1

0.12 ± 0.1