Effects of Dietary Fish Oil on Intestinal Adaptation in 20-Day-Old Weanling Rats After Massive Ileocecal Resection

Abstract

Long chain polyunsaturated fatty acids (LCPUFA) seem to be the most trophic macronutrients in inducing intestinal adaptation in adult short bowel syndrome (SBS), although their effects on intestinal adaptation in infants with SBS remain unknown. It is hypothesized that a high fat diet enriched with n-3 LCPUFA derived from fish oil (FO) will increase intestinal adaptation compared with a diet dominated by n-6 PUFA from corn oil (CO) in weanling SBS rats after massive ileocecal resection (ICR). Twentyday-old rats were sorted into four groups, CO-sham, FO-sham, CO-ICR, and FO-ICR groups, and fed ad lib with the CO or FO diet, respectively, for 7 d after sham or ICR surgery. Compared with CO-ICR rats, FO-ICR rats consumed less diet per gram of weight gain, had less diarrhea and fecal fat excretion, and demonstrated a tendency toward better weight gain. The mucosal mass, DNA and RNA levels of the colon and RNA levels of the distal jejunum, and the colonic mucosal area (%) were significantly higher in FO-ICR rats than in CO-ICR rats. These results suggest that the beneficial effect of dietary FO is associated with better adaptation in the colon in weanling rats after ICR. (Pediatr Res 68: 183-187, 2010) I ntestinal adaptation in short bowel syndrome (SBS) is a compensatory physiologic response that occurs after loss of mucosal surface area and is important in restoring the digestive and absorptive capacity of the intestine. Enteral nutrition plays a key role in the adaptive process in SBS, which depends on both the presence (1) and quality (2) of enteral nutrients. Enteral fats seem to be the most trophic macronutrients in inducing adaptation (3-5). High fat diets (5-8) and diets enriched with long chain fatty acids (9,10) have been shown to be more effective, and especially, diets rich in long chain polyunsaturated fatty acids (LCPUFA) are the most beneficial in stimulating mucosal adaptation (4,11). Fish oil (FO) is a main source of n-3 LCPUFA eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Rats with SBS were fed with a diet containing 15% FO had better mucosal adaptation than those fed with a diet containing less highly unsaturated fats (11). However, the impact of a diet with combination of high fat and LCPUFA on mucosal adaptation is unclear. Moreover, those studies (4 -11) used adult SBS rats, and thus, the effect of dietary fat on intestinal adaptation in infantile SBS remains unknown.Recently, we developed an SBS model in 20-d-old weanling rats with 50% ileocecal resection (ICR) and partial colon resection (12). This model is more appropriate for studying human infantile SBS, which most often occurs after surgical treatment for necrotizing enterocolitis in premature infants (13,14), as the intestinal resection is similar in both. Using this model in this study, we compared the trophic effects of a high fat diet enriched with n-3 LCPUFA from FO to one containing the same amount of fat, but with n-6 PUFA from corn oil (CO), on the adaptive responses in the residual jejunum and colon. METHOD...

Early Enteral Fat Supplementation Improves Protein Absorption in Premature Infants with an Enterostomy

“…We are not aware of prior similar studies, but our results are consistent with the findings in the rat models of SBS [7,19] in which dietary FO increases intestinal mucosal weight, DNA, RNA and protein [7,8]. In this study, the enhanced intestinal adaptation occurred primarily in the proximal functional stoma site, not the distal nonfunctional diverted segment of intestine.…”

“…Compared to dietary protein and carbohydrate, enteral fats appear to be the most trophic macronutrients for inducing intestinal adaptation [3,4,5], and compared to a low-fat diet, a high-fat diet promotes intestinal adaptation [6]. Especially effective are dietary long-chain polyunsaturated fatty acids (LC-PUFA) [4,7,8], including n-6 arachidonic acid (AA) [4], n-3 eicosapentaenoic acid (EPA) and n-3 docosahexaenoic acid (DHA) [4,7,8]. In our weanling rat model of SBS, high-fat diet enriched with fish oil (FO), compared to control diet, increased intestinal mucosal weight, DNA and RNA contents [8], and dietary fat absorption [9].…”

“…Especially effective are dietary long-chain polyunsaturated fatty acids (LC-PUFA) [4,7,8], including n-6 arachidonic acid (AA) [4], n-3 eicosapentaenoic acid (EPA) and n-3 docosahexaenoic acid (DHA) [4,7,8]. In our weanling rat model of SBS, high-fat diet enriched with fish oil (FO), compared to control diet, increased intestinal mucosal weight, DNA and RNA contents [8], and dietary fat absorption [9]. Recently, we translated this animal research into clinical study and reported that early enteral fat supplementation with Microlipid (ML) and FO increased fat absorption in premature infants with bowel resection and enterostomy [10].…”

Intestinal Failure in a Neonate: A Surgical Emergency and Medical Catastrophe

“…Parenteral administration of lipids derived from fish oil (rich in omega-3 fatty acids) may reduce serum bilirubin levels and intestinal failure associated with liver disease. The SMOF (soya oil, medium-chain triglycerides, olive oil, and fish oil) lipid, which contains omega-3 fatty acids, was used to manage our index case [8].…”