Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Sep 15, 2015; 7(9): 128-131
Published online Sep 15, 2015. doi: 10.4251/wjgo.v7.i9.128
Fish oils in parenteral nutrition: Why could these be important for gastrointestinal oncology?
Lynnette R Ferguson
Lynnette R Ferguson, ACSRC/Discipline of Nutrition and Dietetics, School of Medical Sciences, Faculty of Medical and Health Sciences, the University of Auckland, Auckland 1010, New Zealand
Author contributions: Ferguson LR conceived the issues which formed the content of the manuscript and wrote the manuscript.
Supported by Auckland Division, Cancer Society of New Zealand.
Conflict-of-interest statement: The author has no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Lynnette R Ferguson, D Phil (Oxon), DSc, Professor of Nutrition, ACSRC/Discipline of Nutrition and Dietetics, School of Medical Sciences, Faculty of Medical and Health Sciences, the University of Auckland, Private Bag 92019, Wellesley St 1184, Auckland 1010, New Zealand. l.ferguson@auckland.ac.nz
Telephone: +64-9-9236372
Received: May 12, 2015
Peer-review started: May 18, 2015
First decision: June 18, 2015
Revised: July 6, 2015
Accepted: August 4, 2015
Article in press: August 7, 2015
Published online: September 15, 2015
Processing time: 128 Days and 7.4 Hours
Abstract

By the time a gastroenterology patient is moved to parenteral nutrition, he or she is usually in poor health. All parenteral nutrition formulae contain essential nutrients, avoiding components that could cause an adverse reaction. The lipid component is often provided by a soy extract, containing all the fatty acids considered to be essential in the diet. Several trials have considered parenteral nutrition formulas with added fish oils, high in the long chain omega-3 polyunsaturated fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Given the range of biological functions associated with such compounds, especially in reducing inflammatory symptoms, this move would appear rational. However, while data from such trials are often positive, there has been variability among results. Some of this variability could be caused by environmental contaminants in the fish, and/or oxidation of the lipids because of poor storage. The situation is complicated by a recent report that fish oils may counter the effects of platinum chemotherapy. However, this effect associated with a minor component, hexadeca-4,7,10,13-tetraenoic acid. It is suggested that pure DHA and EPA would be beneficial additions to parenteral nutrition, reducing the probability of carcinogenesis and enhancing rational disease management. However, the jury is still out on fish oils more generally.

Keywords: Inflammatory bowel diseases; Colorectal cancer; Fish oils; Eicosapentanoic acid; Docosahexaenoic acid

Core tip: Parenteral nutrition formulae contain essential nutrients, in which the lipid component is often provided by a soy extract, containing essential fatty acids. Several trials have considered such formulas with added fish oils, high in the long chain omega-3 polyunsaturated fatty acids, eicosapentanoic acid (EPA) and docosahexaenoic acid (DHA). Such compounds have a range of biological functions, especially in reducing inflammatory symptoms. However, there has been variability among results of clinical trials, possibly caused by environmental contaminants in the fish, and/or lipid oxidation. It is suggested that pure DHA and EPA, but possibly not fish oils per se, would be beneficial.