Consumption of Fish Oil Leads to Prompt Incorporation of Eicosapentaenoic Acid into Colonic Mucosa of Patients Prior to Surgery for Colorectal Cancer, But Has No Detectable Effect on Epithelial Cytokinetics

Abstract

Fish oil (FO) was previously reported to partially normalize colorectal crypt cell cytokinetics in patients with colorectal neoplasms. We determined the effect of FO on the fatty acid composition of colonic mucosa and mesenteric adipose tissue and on rectal crypt cell proliferation in patients undergoing surgery for colonic carcinoma. Patients (49-28 males; 21 females) were randomly assigned to consume FO capsules (2 g b.d.; FO group) containing 1.4 g eicosapentaenoic acid (EPA) and 1.0 g docosahexaenoic acid per day, or safflower oil capsules (2 g b.d.; placebo group) for an average of 12.3 +/- 0.5 d prior to surgery. Rectal biopsies were obtained at entry, at surgery, and 8-12 wk postsurgery. Colonic biopsies and samples of mesenteric adipose tissue were analyzed for fatty acids by gas-liquid chromatography. Mitosis was determined in whole crypt mounts. The proportion of EPA (g/100 g total fatty acids) in mucosal lipids was significantly greater in FO patients compared to the placebo group, but there was no effect on mesenteric adipose tissue. However self-reported use of FO supplements prior to surgery was associated with higher levels of EPA in adipose tissue. There was no significant effect of FO on the frequency or spatial distribution of crypt cell mitosis. EPA from marine oil supplements is rapidly incorporated into the colonic mucosal lipids of humans, but the levels achieved in the present study did not modify colorectal cytokinetics.

Fish fatty acids alter markers of apoptosis in colorectal adenoma and adenocarcinoma cell lines but fish consumption has no impact on apoptosis-induction ex vivo

“…However this is likely to be rapidly metabolised by the luminal bacteria and the significant increase of n-3 PUFAs in colonic mucosa after alimentary supplementation is assumed to be absorbed from the blood where concentrations may reach as high as 400 lmol/l following supplementation [45][46][47]. We have therefore taken a novel ex vivo biomarker approach to investigate this possibility.…”

n–3 PUFAs in cancer, surgery, and critical care: a systematic review on clinical effects, incorporation, and washout of oral or enteral compared with parenteral supplementation

“…In total, we n23 PUFAs IN CANCER, SURGERY, AND CRITICAL CARE retrieved 23 RCTs and 13 open-label studies that reported incorporation or washout in cancer, surgery, and critical care after supplementation of n23 FAs via fish-oil capsules (7,(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59), ONSs (4,17,20,26,60), and/or enteral nutrition (23,24,26), or n23 FA lipid emulsions for parenteral administration (27,32,33,37,40,(61)(62)(63)(64) (see Supplemental Tables 1-3 under ''Supplemental data'' in the online issue). The following paragraphs summarize the most important findings.…”

“…Eight RCTs reported on the incorporation and washout in patients who underwent surgery after enteral supplementation (24,26,56) or parenteral supplementation of n23 FAs (27,32,33,61,62) (see Supplemental Table 2 under ''Supplemental data'' in the online issue).…”

“…Perioperative enteral supplementation of n23 FAs was applied in 3 studies; the methodologic quality was rated to be excellent (26), good (56), and average (24). One study applied fish-oil capsules (56), and the other studies used ONSs and/or enteral nutrition that contained n23 FAs (24,26).…”

“…One study applied fish-oil capsules (56), and the other studies used ONSs and/or enteral nutrition that contained n23 FAs (24,26).…”