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.

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
• Contract Date: Oct 7, 2019