Obesity and Adverse Dietary Patterns as Susceptibility Factors to Pollutant Exposure in Urban COPD

EPA Grant Number: R836150C001
Subproject: this is subproject number 001 , established and managed by the Center Director under grant R836150
(EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).

Center: Comparing Urban and Rural Effects of Poverty on COPD
Center Director: Hansel, Nadia
Title: Obesity and Adverse Dietary Patterns as Susceptibility Factors to Pollutant Exposure in Urban COPD
Investigators: Hansel, Nadia , Hanson, Corrine K , Putcha, Nirupama
Institution: The Johns Hopkins University , University of Nebraska Medical Center
EPA Project Officer: Breville, Maggie
Project Period: July 1, 2015 through June 30, 2020
RFA: NIH/EPA Centers of Excellence on Environmental Health Disparities Research (2015) RFA Text |  Recipients Lists
Research Category: Health

Objective:

Specific Aim 1: Determine whether elevated fat mass and body composition (ie. higher trunk to total fat ratio) increases susceptibility to indoor pollution in low-income adults with COPD.

Specific Aim 2a: Determine whether adverse dietary patterns levels lead to heightened susceptibility to indoor air pollution contributing to adverse health outcomes in COPD.

Specific Aim 2b: Determine vitamin or nutrient antioxidant levels lead to heightened susceptibility to indoor air pollution contributing to adverse health outcomes in COPD.

Approach:

Though there are several factors that coalesce in poor environments that contribute to COPD morbidity or increase susceptibility to pollution exposure this project will focus on obesity and dietary intake because: 1) the literature and preliminary data strongly support the role of obesity and poor diet in contributing to COPD outcomes and susceptibility to air pollution, 2) both factors are prevalent in low-income urban settings therefore positive results are likely to have great potential for significant public health impact, 3) at the individual level, indoor air, diet and obesity are modifiable, unlike other factors such as outdoor air or access to healthcare, and 4) the hypotheses being tested in this application are highly novel. Obesity is traditionally defined by BMI alone, however, the phenotype of obesity as a disease is complex and heterogeneous and it is increasingly recognized that BMI is an imprecise measure of body composition. Given the importance of understanding these highly prevalent susceptibility factors for adverse COPD outcomes, investigators will use skin fold thickness and DEXA scanning, considered the “gold standard” for the assessment of adiposity, in order to determine whether the ability to identify susceptible individuals, compared to the use of BMI alone, has improved. In addition, investigators will assess dietary patterns by food frequency questionnaire (FFQ) and assessment of serum vitamin and anti-oxidant levels in an observational study of 120 former smokers with moderate to severe COPD from a catchment area in Baltimore with a high proportion of low-income households. Investigators aim to determine whether elevated fat mass and body composition (ie. higher trunk to total fat ratio) increases susceptibility to indoor pollution in low-income adults with COPD (Specific Aim #1); and whether adverse dietary patterns (Specific Aim #2a) and vitamin or nutrient antioxidant levels (Specific Aim #2b) lead to heightened susceptibility to indoor air pollution contributing to adverse health outcomes in COPD. This study aims build upon a well-established infrastructure of investigators with complementary areas of expertise. Study findings may identify several potential intervention strategies to reduce the harmful effects of PM and NO2 exposure in adults with COPD in low income populations. With COPD being the third leading cause of death in the US, developing strategies to reduce morbidity is an important public health priority.

Rationale:

Chronic obstructive pulmonary disease (COPD) is a progressive disease affecting approximately fifteen million people in the US. COPD prevalence and morbidity is increased in individuals from low income households. Prior research has shown that indoor air pollutant concentrations (particulate matter (PM) and nitrogen dioxide (NO2)) are higher in lower income homes compared to higher income homes. In addition, increased pollutant concentrations in homes of former smokers with COPD are associated with respiratory morbidity, including increased respiratory symptoms, worse quality of life and increased risk of exacerbations and health care utilization. 


Main Center Abstract and Reports:

R836150    Comparing Urban and Rural Effects of Poverty on COPD

Subprojects under this Center: (EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).
R836150C001 Obesity and Adverse Dietary Patterns as Susceptibility Factors to Pollutant Exposure in Urban COPD
R836150C002 Environmental Health Disparities in Rural Appalachia: The impact of air pollution, obesity and diet on COPD morbidity