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A double-blind randomized controlled trial of the effects of eicosapentaenoic acid supplementation on muscle inflammation and physical function in patients undergoing colorectal cancer resection

Hossain, Tanvir; Phillips, Bethan E.; Doleman, Brett; Lund, Jonathan N.; Williams, John P.

Authors

Tanvir Hossain

Brett Doleman

JOHN WILLIAMS john.williams7@nottingham.ac.uk
Clinical Associate Professor



Abstract

Background

Resection of colorectal cancer (CRC) initiates inflammation, mediated at least partly by NFĸB (nuclear factor kappa-light-chain-enhancer of activated B-cells), leading to muscle catabolism and reduced physical performance. Eicosapentaenoic acid (EPA) has been shown to modulate NFĸB, but evidence for its benefit around the time of surgery is limited.

Objective

To assess the effect of EPA supplementation on muscle inflammation and physical function around the time of major surgery.

Design

In a double-blind randomized control trial, 61 patients (age: 68.3 ± 0.95 y; 42 male) scheduled for CRC resection, received 3 g per day of EPA (n = 32) or placebo (n = 29) for 5-days before and 21-days after operation. Lean muscle mass (LMM) (via dual energy X-ray absorptiometry (DXA)), anaerobic threshold (AT) (via cardiopulmonary exercise testing (CPET)) and hand-grip strength (HG) were assessed before and 4-weeks after surgery, with muscle biopsies (m. vastus lateralis) obtained for the assessment of NF-ĸB protein expression.

Results

There were no differences in muscle NFĸB between EPA and placebo groups (mean difference (MD) −0.002; 95% confidence interval (CI) −0.19 to 0.19); p = 0.98). There was no difference in LMM (MD 704.77 g; 95% CI -1045.6 g–2455.13 g; p = 0.42) or AT (MD 1.11 mls/kg/min; 95% CI -0.52 mls/kg/min to 2.74 mls/kg/min; p = 0.18) between the groups. Similarly, there was no difference between the groups in HG at follow up (MD 0.1; 95% CI -1.88 to 2.08; p = 0.81). Results were similar when missing data was imputed.

Conclusion

EPA supplementation confers no benefit in terms of inflammatory status, as judged by NFĸB, or preservation of LMM, aerobic capacity or physical function following major colorectal surgery.

Citation

Hossain, T., Phillips, B. E., Doleman, B., Lund, J. N., & Williams, J. P. (2020). A double-blind randomized controlled trial of the effects of eicosapentaenoic acid supplementation on muscle inflammation and physical function in patients undergoing colorectal cancer resection. Clinical Nutrition, 39(7), 2055-2061. https://doi.org/10.1016/j.clnu.2019.09.009

Journal Article Type Article
Acceptance Date Oct 2, 2019
Online Publication Date Oct 11, 2019
Publication Date Jul 1, 2020
Deposit Date Oct 7, 2019
Publicly Available Date Oct 12, 2020
Journal Clinical Nutrition
Print ISSN 0261-5614
Electronic ISSN 1532-1983
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 39
Issue 7
Pages 2055-2061
DOI https://doi.org/10.1016/j.clnu.2019.09.009
Keywords Cancer, Colorectal, muscle, Eicosapentaenoic acid, Surgery, Inflammation
Public URL https://nottingham-repository.worktribe.com/output/2772981
Publisher URL https://www.sciencedirect.com/science/article/pii/S0261561419330705?via%3Dihub

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double-blind randomized controlled trial of the effects of eicosapentaenoic acid (1.3 Mb)
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Publisher Licence URL
http://creativecommons.org/licenses/by-nc-nd/4.0/





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