Fish oil supplementation in cancer patients. Capsules or nutritional drink supplements? A controlled study of compliance
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Fish oil supplementation in cancer patients. Capsules or nutritional drink supplements? A controlled study of compliance. / Schmidt, Nina; Møller, Grith; Bæksgaard, Lene; Østerlind, Kell; Stark, Ken D; Lauritzen, Lotte; Andersen, Jens Rikardt.
I: Clinical Nutrition ESPEN, Bind 35, 2020, s. 63-68.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Fish oil supplementation in cancer patients. Capsules or nutritional drink supplements? A controlled study of compliance
AU - Schmidt, Nina
AU - Møller, Grith
AU - Bæksgaard, Lene
AU - Østerlind, Kell
AU - Stark, Ken D
AU - Lauritzen, Lotte
AU - Andersen, Jens Rikardt
N1 - CURIS 2020 NEXS 006
PY - 2020
Y1 - 2020
N2 - Background & aims: Fish-oil, rich in Omega-3 long chain polyunsaturated fatty acids (n-3 LC PUFAs), may in high doses inhibit the development or progression of cancer cachexia. However, poor compliance to oral nutritional supplements is a well-known problem. We aimed to investigate acceptability and compliance to a nutritional drink with fish-oil compared to an equivalent dose of fish-oil administered as capsules in patients receiving chemotherapy for GI tract cancers. Moreover, we aimed to investigate, if there was a difference between a nutritional drink or capsules with respect to nutritional status and side effects. Finally, we aimed to examine, if n-3 LC PUFAs affect leukocyte and platelet counts, and markers of dose-limiting toxicities of chemotherapy.Methods: We consecutively included 41 patients with advanced cancer in the controlled study. Patients were allocated (not randomized) to ingest either 10 capsules/day for four weeks or 400 mL/day of a nutritional drink with same dose of n-3 LC PUFA dose. Compliance was assessed by daily self-registration and n-3 LC PUFAs in whole blood. Side effects were assessed by 10 cm visual analog scales.Results: Compliance and daily consumption of n-3 LC PUFAs were 96.4% (94.1e99.3) and 4.8 (4.7e4.9) g/day in the capsule group and 80.8 (55.4e93.6) % and 4.0 (2.8e4.7) g/day in the group, respectively (p 0.02). We found no differences between the groups with respect to changes in whole blood n-3 LCPUFAs, weight, nutritional status, acceptability or side effects. However, in the capsule group the whole blood n-3 LC PUFAs correlated negatively with the increase in nausea (rs ¼ 0.39, p ¼ 0.05), but not in the nutritional drink group. Nausea, reduced appetite and loose stools were of greatest importance for the deviations from recommended doses. The number of capsules had a negative impact on acceptability and compliance, whereas this was mainly related to taste and texture in the nutritional drink group. No changes in median thrombocyte or leukocyte blood counts were observed.Conclusions: Fish oil in capsules appeared to result in better compliance compared to a nutritional drink with an equivalent dose of n-3 LC PUFAs. However, capsules and the drink did not differ with respect to the effect on nutritional status or side effects.Trial registration ClinicalTrials.gov Identifier: NCT03751384.
AB - Background & aims: Fish-oil, rich in Omega-3 long chain polyunsaturated fatty acids (n-3 LC PUFAs), may in high doses inhibit the development or progression of cancer cachexia. However, poor compliance to oral nutritional supplements is a well-known problem. We aimed to investigate acceptability and compliance to a nutritional drink with fish-oil compared to an equivalent dose of fish-oil administered as capsules in patients receiving chemotherapy for GI tract cancers. Moreover, we aimed to investigate, if there was a difference between a nutritional drink or capsules with respect to nutritional status and side effects. Finally, we aimed to examine, if n-3 LC PUFAs affect leukocyte and platelet counts, and markers of dose-limiting toxicities of chemotherapy.Methods: We consecutively included 41 patients with advanced cancer in the controlled study. Patients were allocated (not randomized) to ingest either 10 capsules/day for four weeks or 400 mL/day of a nutritional drink with same dose of n-3 LC PUFA dose. Compliance was assessed by daily self-registration and n-3 LC PUFAs in whole blood. Side effects were assessed by 10 cm visual analog scales.Results: Compliance and daily consumption of n-3 LC PUFAs were 96.4% (94.1e99.3) and 4.8 (4.7e4.9) g/day in the capsule group and 80.8 (55.4e93.6) % and 4.0 (2.8e4.7) g/day in the group, respectively (p 0.02). We found no differences between the groups with respect to changes in whole blood n-3 LCPUFAs, weight, nutritional status, acceptability or side effects. However, in the capsule group the whole blood n-3 LC PUFAs correlated negatively with the increase in nausea (rs ¼ 0.39, p ¼ 0.05), but not in the nutritional drink group. Nausea, reduced appetite and loose stools were of greatest importance for the deviations from recommended doses. The number of capsules had a negative impact on acceptability and compliance, whereas this was mainly related to taste and texture in the nutritional drink group. No changes in median thrombocyte or leukocyte blood counts were observed.Conclusions: Fish oil in capsules appeared to result in better compliance compared to a nutritional drink with an equivalent dose of n-3 LC PUFAs. However, capsules and the drink did not differ with respect to the effect on nutritional status or side effects.Trial registration ClinicalTrials.gov Identifier: NCT03751384.
KW - Faculty of Science
KW - n-3 LC PUFA
KW - EPA
KW - Cancer cachexia
KW - Chemotherapy
KW - Product acceptability
U2 - 10.1016/j.clnesp.2019.12.004
DO - 10.1016/j.clnesp.2019.12.004
M3 - Journal article
C2 - 31987122
VL - 35
SP - 63
EP - 68
JO - Clinical Nutrition ESPEN
JF - Clinical Nutrition ESPEN
SN - 2405-4577
ER -
ID: 233583111