This pilot clinical trial will evaluate the feasibility and potential health effects of a nutrition-based intervention among adults living in communities affected by air pollution near the Port of Savannah, Georgia. Participants will be assigned to either a nutrition intervention group or a control group. The intervention group will receive biweekly grocery deliveries emphasizing foods naturally rich in antioxidants and anti-inflammatory nutrients, including vitamins C and E, omega-3 fatty acids, and polyphenols. The control group will continue their usual dietary practices during the study period.
The study will evaluate whether the nutritional intervention is associated with changes in selected respiratory, oxidative stress, and cardiometabolic health indicators. Assessments will include fractional exhaled nitric oxide (FeNO) as a marker of airway inflammation, hydrogen peroxide (H₂O₂) in exhaled breath condensate as a marker of oxidative stress, systolic and diastolic blood pressure, resting heart rate, and glycated hemoglobin (HbA1c). Indoor concentrations of particulate matter (PM), nitrogen dioxide (NO₂), and ozone (O₃) will also be monitored to characterize participants' household air-pollution exposures. Measurements will be collected at baseline and at subsequent study assessments, as specified for each outcome. Findings from this pilot study will be used to evaluate feasibility, estimate changes in health outcomes, and inform the design of a larger clinical trial investigating nutritional approaches to potentially reduce health effects associated with air-pollution exposure.
Residing in Port Wentworth or the Savannah main Channel at a 3-mile radius for the prior 12 months and not planning to move during the study.
Non-smoking status (or specified ANY smoking history)
Absence of pre-existing chronic respiratory conditions (Asthma, Chronic Obstructive Pulmonary Disease, Seasonal respiratory allergies that require the use of antihistamines or immunosuppressants more than once a month, Chronic Bronchitis, and Heart Failure or any condition that would put participants at a greater risk than other participants for a pre-existing condition.
Willingness and ability to participate in home monitoring protocols
Individuals unable to follow study procedures
Antihistamines or any immunosuppressors, ongoing cancer treatment or within the past 5 years
Individuals unable to read, speak, and/or understand English or Spanish
Any food allergy
Parallel
Antioxidant- and Nutrient-Rich Food-Based Nutrition Intervention
Other interventionParticipants assigned to the intervention will receive biweekly grocery deliveries containing selected foods naturally rich in antioxidant and anti-inflammatory dietary components, including vitamins C and E, omega-3 fatty acids, and polyphenols. Participants will receive guidance on incorporating the provided foods into their usual dietary patterns. The intervention is designed to increase consumption of nutrient-rich foods and to evaluate the feasibility and potential effects of this dietary approach on respiratory inflammation, oxidative stress, and cardiometabolic outcomes among adults living in a community affected by air pollution.
Participant Retention Rate
Through the Final Assessment Participant retention will be assessed as the proportion of enrolled participants who complete the study through the final Week 12 assessment. Retention rate will be calculated as the number of enrolled participants who complete the final assessment, divided by the total number of participants enrolled at baseline, multiplied by 100. A retention rate of ≥80% will be considered evidence of acceptable feasibility for a future larger-scale trial.
Change From Baseline in Fractional Exhaled Nitric Oxide (FeNO)
Fractional exhaled nitric oxide (FeNO) will be measured in parts per billion (ppb) using the NIOX Mini device as a non-invasive marker of airway inflammation. FeNO will be assessed using standardized procedures, and changes over time will be compared between the nutrition intervention and control groups.
Change From Baseline in Hydrogen Peroxide (H₂O₂) Concentration in Exhaled Breath Condensate
Hydrogen peroxide (H₂O₂) concentration in exhaled breath condensate (EBC) will be measured as a non-invasive marker of respiratory oxidative stress. EBC will be collected using the RTube® collection system, and H₂O₂ concentration will be quantified using the Amplex™ Red Hydrogen Peroxide/Peroxidase Assay with fluorescence detection. H₂O₂ concentrations will be reported in micromolar (µM) units. Changes from baseline will be evaluated over the intervention period and compared between the nutrition intervention and control groups.
Change From Baseline in Systolic Blood Pressure
Systolic blood pressure will be measured in millimeters of mercury (mmHg) using a validated automatic upper-arm blood pressure monitor. Participants will obtain two measurements approximately one minute apart after at least five minutes of seated rest, and the average of the two measurements will be used for analysis.
Change From Baseline in Diastolic Blood Pressure
Diastolic blood pressure will be measured in millimeters of mercury (mmHg) using a validated automatic upper-arm blood pressure monitor. Two measurements approximately one minute apart will be obtained after at least five minutes of seated rest, and the average will be used for analysis.
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