(05-11-11) 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 supplementation1,2,3


1. Barbara S van der Meij,
2. Marian AE van Bokhorst-de van der Schueren,
3. Jacqueline AE Langius,
4. Ingeborg A Brouwer, and
5. Paul AM van Leeuwen
+ Author Affiliations
1. 1From the Department of Nutrition and Dietetics, Internal Medicine (BSvdM, MAEvB-dvdS, and JAEL) and the Department of Surgery (PAMvL), VU University Medical Center Amsterdam, Amsterdam, Netherlands; and the Department of Health Sciences, Faculty of Earth and Life Sciences and the EMGO+ Institute of Health and Care Research, VU University (IAB), Amsterdam, Netherlands.
+ Author Notes
? ↵2 This project was partly carried out during an International Cancer Technology Transfer fellowship (application no. ICR/10/010/2010) funded by the Union for International Cancer Control. A part of the publication costs was funded by the Vivax foundation (Netherlands).
? ↵3 Address reprint requests and correspondence to PAM van Leeuwen, Department of Surgery, VU University Medical Center Amsterdam, PO Box 7057, 1007 MB Amsterdam, Netherlands. E-mail: [email protected].
Abstract
Background: n?3 (omega-3) Fatty acids (FAs) may have beneficial effects in patients with cancer or in patients who undergo surgery or critical care.
Objective: Our aim was to systematically review the effects of oral or enteral and parenteral n−3 FA supplementation on clinical outcomes and to describe the incorporation of n−3 FAs into phospholipids of plasma, blood cells, and mucosal tissue and the subsequent washout in these patients.
Design: We investigated the supplementation of n−3 FAs in these patients by using a systematic literature review.
Results: In cancer, the oral or enteral supplementation of n−3 FAs contributed to the maintenance of body weight and quality of life but not to survival. We did not find any studies on parenteral supplementation of n−3 FAs in cancer. In surgical oncology, we did not find any studies on enteral supplementation of n−3 FAs. However, postoperative parenteral supplementation in surgical oncology may reduce the length of a hospital stay. For general surgery, we did not find any studies on enteral supplementation of n−3 FAs, and evidence on parenteral supplementation was insufficient. In critical care, enteral supplementation of n−3 FAs had beneficial effects on clinical outcomes; evidence on parenteral supplementation in critical care was inconsistent. The incorporation of n−3 FAs in plasma and blood cells was slower with enteral supplementation (4?7 d) than with parenteral supplementation (1?3 d). The washout was 5?7 d.
Conclusions: This review shows the beneficial effects of n−3 FA supplementation in cancer, surgical oncology, and critical care patients. Supplementation in these specific patient populations could be considered with the route of administration taken into account.
1.
Am J Clin Nutr November 2011 vol. 94 no. 5 1248-1265

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