Fish Oil Supplement Alters Markers of Inflammatory and Nutritional Status in Colorectal Cancer Patients

Abstract

Inflammation is a common feature in cancer. The presence and magnitude of the chronic systemic inflammatory responses may produce progressive nutritional decline. This study aims at investigating whether there are changes in inflammation markers and/or in nutritional status of patients with colorectal cancer undergoing chemotherapy who were supplemented with fish oil. The clinical trial was conducted with 23 patients randomly distributed in 2 groups. The supplemented group (SG) consumed 2 g of fish oil containing 600 milligrams of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) for 9 wk. Nutritional and inflammatory markers status was available, both at a baseline (M0), and after 9 wk of chemotherapy (M9) in the SG and in the nonsupplemented group (NSG). Statistical analysis was conducted with STATA 11.0 software. SG and NSG presented the same baseline characteristics (P > 0.05). Nutritional status indicators such as body mass index and body weight were modified only in the NSG when comparing baseline and M9, P = 0.03 and P = 0.01 respectively, whereas in SG these indicators did not vary. Patients supplemented with fish oil (SG) showed a clinically relevant decrease in the C-reactive protein/albumin relation (P = 0.005). Low doses of fish oil supplement can positively modulate the nutritional status and the C-reative protein/albumin ratio.

Omega-3 supplements for patients in chemotherapy and/or radiotherapy: A systematic review

“…Lower levels of systemic inflammation, as measured according to C-reactive protein levels, were observed in all of the studies in which it was measured [18,22,23,25,26,28]. These results confirm the previous studies about anti-inflammatory activity of fish oil PUFA, and they further indicate that this supplement may benefit oncologic patients [35].…”

“…In the 2013) both evaluated the ratio of C-reactive protein to albumin, which is an inflammatory and nutritional index that is considered to be a relevant clinical marker. For patients in the supplement groups, this ratio remained unchanged or reduced (P ¼ 0.05 and P ¼ 0.006, respectively) while the value for the control groups increased [22,23]. Plasma concentrations of cytokines remained unchanged [22,23].…”

“…For patients in the supplement groups, this ratio remained unchanged or reduced (P ¼ 0.05 and P ¼ 0.006, respectively) while the value for the control groups increased [22,23]. Plasma concentrations of cytokines remained unchanged [22,23]. However, in the study Van der Meij et al (2010), the intervention group exhibited a tendency towards reduced levels of interleukin-6 (IL-6) (P ¼ 0.08) [18].…”

“…In the Bonatto et al (2012) study, the oncologic patients that received fish oil gained an average of 1.7 kg (P ¼ 0.002), while the control group lost an average of 2.5 kg [20]. In the Silva et al (2012) study that included only colorectal cancer patients, no change in body weight and body mass index was observed for the patients that received fish oil (P > 0.05), while both indicators decreased for the patients that did not receive fish oil (P ¼ 0.01 and P ¼ 0.03, respectively) [22]. In the Mocellin et al (2013) study, no significant changes in body weight or body mass index were observed by the end of the study period [23].…”

“…Moreover, these patients were compared with those that did not receive a nutritional supplement [20,22,23]. In the Bonatto et al (2012) study, the oncologic patients that received fish oil gained an average of 1.7 kg (P ¼ 0.002), while the control group lost an average of 2.5 kg [20].…”