A double-blind randomized controlled trial of the effects of eicosapentaenoic acid supplementation on muscle inflammation and physical function in patients undergoing colorectal cancer resection

Hossain, Tanvir; Piasecki, Mathew; Doleman, Brett; Lund, Jonathan N.; Williams, John P.

doi:10.1016/j.clnu.2019.09.009

Cited by 15 publications

(33 citation statements)

References 29 publications

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“…Other RCTs have also shown that capsule O3FA interventions are associated with greater compliance than other forms of intervention (ONS, EN, PN) (tables 2 and 3). 86 92…”

Section: Do Omega-3 Polyunsaturated Fatty Acids Alter Post-diagnosis ...mentioning

confidence: 99%

“…The two other RCTs reported no difference in LOS or POCs, however, there was a significant increase in postoperative weight recovery in the active treatment group 106 107. An RCT of 3 g/day EPA TG (in capsules) (n=61) evaluated cachexia-related inflammation using muscle biopsy nuclear factor (NF)-κB protein as a surrogate biomarker and found no difference in muscle inflammation 92 109…”

Section: Do Omega-3 Polyunsaturated Fatty Acids Alter Post-diagnosis ...mentioning

confidence: 99%

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Omega-3 polyunsaturated fatty acids: moving towards precision use for prevention and treatment of colorectal cancer

Aldoori

Cockbain

Toogood

2022

Gut

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Data from experimental studies have demonstrated that marine omega-3 polyunsaturated fatty acids (O3FAs) have anti-inflammatory and anticancer properties. In the last decade, large-scale randomised controlled trials of pharmacological delivery of O3FAs and prospective cohort studies of dietary O3FA intake have continued to investigate the relationship between O3FA intake and colorectal cancer (CRC) risk and mortality. Clinical data suggest that O3FAs have differential anti-CRC activity depending on several host factors (including pretreatment blood O3FA level, ethnicity and systemic inflammatory response) and tumour characteristics (including location in the colorectum, histological phenotype (eg, conventional adenoma or serrated polyp) and molecular features (eg, microsatellite instability, cyclooxygenase expression)). Recent data also highlight the need for further investigation of the effect of O3FAs on the gut microbiota as a possible anti-CRC mechanism, when used either alone or in combination with other anti-CRC therapies. Overall, these data point towards a precision approach to using O3FAs for optimal prevention and treatment of CRC based on mechanistic understanding of host, tumour and gut microbiota factors that predict anticancer activity of O3FAs.

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“…Other RCTs have also shown that capsule O3FA interventions are associated with greater compliance than other forms of intervention (ONS, EN, PN) (tables 2 and 3). 86 92…”

Section: Do Omega-3 Polyunsaturated Fatty Acids Alter Post-diagnosis ...mentioning

confidence: 99%

Section: Do Omega-3 Polyunsaturated Fatty Acids Alter Post-diagnosis ...mentioning

confidence: 99%

Omega-3 polyunsaturated fatty acids: moving towards precision use for prevention and treatment of colorectal cancer

Aldoori

Cockbain

Toogood

2022

Gut

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“…The basic characteristics of the selected studies are summarized in Table 2 . We included 19 RCTs ( Braga et al, 2002 ; Liang et al, 2008 ; Trabal et al, 2010 ; Chen et al, 2011 ; Silva et al, 2012 ; Zhu et al, 2012 ; Mocellin et al, 2013 ; Sorensen et al, 2014a ; Cockbain et al, 2014 ; Ma et al, 2015 ; Golkhalkhali et al, 2018 ; Bakker et al, 2020a ; Haidari et al, 2020a ; 2020b ; Hossain et al, 2020 ; Sørensen et al, 2020 ; Zhang et al, 2020 ) measuring at least one of our efficacy or safety outcomes. Studies on 11 ( Mocellin et al, 2013 ) and 179 ( Zhang et al, 2020 ) participants included the sample size.…”

Section: Resultsmentioning

confidence: 99%

“…Studies on 11 ( Mocellin et al, 2013 ) and 179 ( Zhang et al, 2020 ) participants included the sample size. The majority of studies included patients undergoing surgeries ( n = 11) ( Braga et al, 2002 ; Liang et al, 2008 ; Chen et al, 2011 ; Zhu et al, 2012 Sorensen et al, 2014a ; 2014b ; Ma et al, 2015 ; Bakker et al, 2020a ; 2020b ; Hossain et al, 2020 ; Sørensen et al, 2020 ), with the remainder conducted on patients receiving chemotherapy ( n = 2) ( Trabal et al, 2010 ; Zhang et al, 2020 ) or that in combination with surgeries ( n = 6) ( Silva et al, 2012 ; Mocellin et al, 2013 ; Cockbain et al, 2014 ; Golkhalkhali et al, 2018 ; Haidari et al, 2020b ). The duration of interventions ranged from 2 ( Bakker et al, 2020a ) to 84 days ( Trabal et al, 2010 ).…”

Section: Resultsmentioning

confidence: 99%

“…The duration of interventions ranged from 2 ( Bakker et al, 2020a ) to 84 days ( Trabal et al, 2010 ). O3FA-enriched oral capsules were used in 12 studies ( Zhang et al, 2020 ; Haidari et al, 2020a ; 2020b ; Hossain et al, 2020 ; Sørensen et al, 2020 ; Golkhalkhali et al, 2018 ; Sorensen et al, 2014a ; Cockbain et al, 2014 ; Mocellin et al, 2013 ; Silva et al, 2012 ; Trabal et al, 2010 ), total parenteral nutrition (TPN) was used in four studies ( Liang et al, 2008 ; Chen et al, 2011 ; Zhu et al, 2012 ; Ma et al, 2015 ), PN was used in two of them ( Bakker et al, 2020a ; 2020b ), and EN was used in the rest ( Braga et al, 2002 ). The prescribed dose of O3FA ranged from 0.108 g/d ( Haidari et al, 2020b ; Zhang et al, 2020 ) to 4.00 g/d ( Sørensen et al, 2020 ; Sorensen et al, 2014a ; 2014b ).…”

Section: Resultsmentioning

confidence: 99%

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Efficacy and safety of Omega-3 polyunsaturated fatty acids in adjuvant treatments for colorectal cancer: A meta-analysis of randomized controlled trials

et al. 2023

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Background: Colorectal cancer (CRC) ranks third globally. There are many adverse reactions to treatments such as surgeries and post-surgical chemotherapy, which affect patients’ prognosis and reduce their life quality. Omega-3 polyunsaturated fatty acids (O3FAs) have become an essential part of immune nutrition due to their anti-inflammatory properties, which improve body immunity and have attracted widespread attention. A systematic review focused on the efficacy and safety of O3FAs for patients undergoing surgeries in combination with chemotherapy or a surgery alone is lacking.Objectives: To evaluate the efficacy of O3FAs in the adjuvant treatment of CRC, a meta-analysis was conducted on patients with CRC who underwent surgeries in combination with chemotherapy or a surgery alone.Methods: As of March 2023, publications have been obtained using search terms from digital databases such as PubMed, Web of Science, Embase and Cochrane Library. Only randomized clinical trials (RCTs) evaluating the efficacy and safety of O3FAs following adjuvant treatments for CRC were included in the meta-analysis. Key outcomes were tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-1beta (IL-1β), albumin, body mass index (BMI), weight, the rate of infectious and non-infectious complications, the length of hospital stay (LOS), CRC mortality and life quality.Results: After screening 1,080 studies, 19 RCTs (n = 1,556) with O3FAs in CRC were included, in all of which at least one efficacy or safety outcome was examined. Compared to the control group, the level of TNF-α (MD = −0.79, 95% CI: 1.51 to −0.07, p = 0.03) and IL-6 was reduced due to O3FA-enriched nutrition during the perioperative period (MD = −4.70, 95% CI: 6.59 to −2.80, p < 0.00001). It also reduces LOS (MD = 9.36, 95% CI: 2.16 to 16.57, p = 0.01). No significant differences were found in CRP, IL-1β, albumin, BMI, weight, the rate of infectious and non-infectious complications, CRC mortality or life quality. The inflammatory status of patients with CRC undergoing adjuvant therapies decreased after a total parenteral nutrition (TPN) O3FA supplementation (TNF-α, MD = −1.26, 95% CI: 2.25 to −0.27, p = 0.01, I2 = 4%, n = 183 participants). The rate of infectious and non-infectious complications was reduced among patients with CRC undergoing adjuvant therapies after a parenteral nutrition (PN) O3FA supplementation (RR = 3.73, 95% CI: 1.52 to 9.17, p = 0.004, I2 = 0%, n = 76 participants).Conclusion: Our observations suggest that supplementation with O3FAs has little or no effect on patients with CRC undergoing adjuvant therapies and that a prolonged inflammatory state may be modified. To validate these findings, well-designed, large-scale, randomized and controlled studies on homogeneous patient populations are expected.

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Exploring the utility of bedside tests for predicting cardiorespiratory fitness in older adults

Carrick,

Doleman,

Wall

et al. 2023

Aging Medicine

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ObjectivesCardiorespiratory fitness (CRF) declines with advancing and has also, independent of age, been shown to be predictive of all‐cause mortality, morbidity, and poor clinical outcomes. In relation to the older patient, there is a particular wealth of evidence highlighting the relationship between low CRF and poor surgical outcomes. Cardiopulmonary exercise testing (CPET) is accepted as the gold‐standard measure of CRF. However, this form of assessment has significant personnel and equipment demands and is not feasible for those with certain age‐associated physical limitations, including joint and cardiovascular comorbidities. As such, alternative ways to assess the CRF of older patients are very much needed.MethodsSixty‐four participants (45% female) with a median age of 74 (65–90) years were recruited to this study via community‐based advertisements. All participants completed three tests of physical function: (1) a step‐box test; (2) handgrip strength dynamometry; and (3) a CPET on a cycle ergometer; and also had their muscle architecture (vastus lateralis) assessed by B‐mode ultrasonography to provide measures of muscle thickness, pennation angle, and fascicle length. Multivariate linear regression was then used to ascertain bedside predictors of CPET parameters from the alternative measures of physical function and demographic (age, gender, body mass index (BMI)) data.ResultsThere was no significant association between ultrasound‐assessed parameters of muscle architecture and measures of CRF. VO2peak was predicted to some extent from fast step time during the step‐box test, gender, and BMI, leading to a model that achieved an R2 of 0.40 (p < 0.001). Further, in aiming to develop a model with minimal assessment demands (i.e., using handgrip dynamometry rather than the step‐box test), replacing fast step time with non‐dominant HGS led to a model which achieved an R2 of 0.36 (p < 0.001). Non‐dominant handgrip strength combined with the step‐box test parameter of fast step time and BMI delivered the most predictive model for VO2peak with an R2 of 0.45 (p < 0.001).ConclusionsOur findings show that simple‐to‐ascertain patient characteristics and bedside assessments of physical function are able to predict CPET‐derived CRF. Combined with gender and BMI, both handgrip strength and fast step time during a step‐box test were predictive for VO2peak. Future work should apply this model to a clinical population to determine its utility in this setting and to explore if simple bedside tests are predictive of important clinical outcomes in older adults (i.e., post‐surgical complications).

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A double-blind randomized controlled trial of the effects of eicosapentaenoic acid supplementation on muscle inflammation and physical function in patients undergoing colorectal cancer resection

Cited by 15 publications

References 29 publications

Omega-3 polyunsaturated fatty acids: moving towards precision use for prevention and treatment of colorectal cancer

Omega-3 polyunsaturated fatty acids: moving towards precision use for prevention and treatment of colorectal cancer

Efficacy and safety of Omega-3 polyunsaturated fatty acids in adjuvant treatments for colorectal cancer: A meta-analysis of randomized controlled trials

Exploring the utility of bedside tests for predicting cardiorespiratory fitness in older adults

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