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A randomised controlled trial has shown that omega-3 fatty acids given as part of an oral nutritional supplement helps preserve muscle mass in patients undergoing surgery for oesopahageal cancer, a procedure normally associated with significant weight loss and quality of life issues.
Omega 3 fats are essential fats found naturally in oily fish, with highest concentrations in salmon, herring, mackerel, and sardines. Considering their health-related benefits, food manufacturers have started to add them to foods like yogurt, milk, juice, eggs, and infant formula also.
Professor John V Reynolds of Trinity College Dublin and Dr Aoife Ryan of St James’ Hospital, the pair who led the trial, said that previous studies have had already shown that nutritional supplements containing one form of omega 3 fat, eicosapentaenoic acid (EPA), significantly reduced weight loss among inoperable cancer patients.
They revealed that that finding made them hypothesise that a nutritional supplement rich in calories and a high dose of EPA could stem the debilitating weight loss seen in patients following oesophageal surgery.
The researchers said that they chose to study patients undergoing surgery for oesophageal cancer because it is considered to be one of the most stressful and serious operations a patient can undergo.
“An increasing number of patients are treated with chemotherapy alone or in combination with radiation therapy before they undergo surgery. The surgery is a serious operation lasting several hours and can take weeks to recover from surgery and up to six months to recover pre-illness quality of life. Weight loss is extremely common both before and especially after this type of surgery, and any approach that can preserve weight, in particular muscle weight and strength, may represent a real advance,” they said.
During the study, patients awaiting oesophagectomy surgery were randomly assigned to treatment and control groups. While both groups received a 240ml nutritional supplement twice daily starting five days before surgery, patients in the treatment group received an enriched formula with omega 3.
Immediately following surgery, the supplement was given through a feeding tube for 14 days while patients recovered in hospital. Once patients could resume oral feeding, they continued drinking the supplement until 21 days post surgery.
The researchers observed that the patients given the standard feed without omega 3 suffered clinically severe weight loss post surgery, while those in the omega 3 group patients maintained all aspects of their body composition. Professor John Reynolds said: “Omega 3 enriched nutrition appears to prevent loss of muscle mass by reducing the amount of inflammatory markers in the blood – this means the metabolism is not as stressed as it usually is post surgery. We also saw that the omega 3 group was less likely to have a fever in the first week post surgery which points to the ability of omega 3 to suppress inflammation. Looking at their blood tests omega 3 fed patients had much lower ‘inflammatory compounds’ circulating in their blood which points to the ability of omega 3 to reduce inflammation.”
The researchers said that using specialised nutritional feeds with a highly purified form of EPA enabled them to administer a dose of omega 3 that was much higher than that typically found in food. Professor John Reynolds said: “This study has provided an interesting insight into how nutritional therapy can positively impact on the major stress of cancer surgery. More studies need to be done, in particular to address whether such approaches lead to more rapid recovery of quality of life, reduce complications, and improve outcomes.”
He expressed his belief that similar benefits from Omega 3 enriched nutrition might accrue to patients needing complex surgical care for non-cancer problems, for instance liver transplantation or major cardiac surgery.
Sources: The Times Of India