The effect of oral omega-3 polyunsaturated fatty acid supplementation on muscle maintenance and quality of life in patients with cancer: A systematic review and meta-analysis

Chung Nga Lam; Elisabeth Isenring; Marian de van der Schueren; Barbara S Van der Meij

doi:10.1016/j.clnesp.2020.09.788

Abstract

Rationale: Omega-3 polyunsaturated fatty acid (PUFA) supplementation is a promising therapy for cancer-relatedmalnutrition, which affects 20-70% of patients with cancer1,2. This systematic review aimed to examine the effects of oralomega-3 PUFA supplementation on muscle maintenance and quality of life in patients with cancer.
Methods: Randomised controlled trials in cancer patients aged >18 years were retrieved from 5 electronic databases;MEDLINE (via PubMed), EMBASE, CENTRAL, CINAHL (via EBSCOhost), and Web of Science, from database inceptionuntil 31st of December 2019. Trials supplementing ≥600 mg/d omega-3 PUFA (oral capsules, pure fish oil or oralnutritional supplements) or a control intervention for ≥3 weeks were included. Meta-analyses were performed in RevManto determine the mean differences (MD) in muscle mass and quality of life between omega-3 PUFA and control groupswith 95% confidence intervals (CI) and I2 for heterogeneity.
Results: We included 33 studies in patients with various types of cancers and degrees of malnutrition. The Cochrane riskof bias tool graded most trials as ‘unclear’ or ‘high’ risk of bias. Meta-analyses showed oral omega-3 PUFA supplementsimproved physical functioning (MD: 6.33; 95% CI: 0.32, 12.34, p=0.04; I2=0%) and potentially reduced fatigue (MD: -6.21;95% CI: -13.473, 1.05, p=0.09; I2=14%). However, there was no significant effect of omega-3 PUFA supplements onmuscle mass, global health status, emotional functioning and symptoms (nausea and vomiting, loss of appetite anddiarrhoea).
Conclusion: This review provides evidence for the benefits of oral omega-3 PUFA supplementation on quality of life butnot on muscle maintenance in patients with cancer. Well-designed large-scale randomised controlled trials inhomogenous patient cohorts are required to confirm these findings.

Original language	English
Article number	LB-237
Number of pages	667
Journal	Clinical Nutrition ESPEN
Volume	40
Early online date	9 Nov 2020
DOIs	https://doi.org/10.1016/j.clnesp.2020.09.788
Publication status	Published - Dec 2020
Event	42nd ESPEN Virtual Congress - Online Duration: 19 Sept 2020 → 21 Sept 2020 Conference number: 42nd https://espencongress.com/

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10.1016/j.clnesp.2020.09.788

The effect of oral omega-3 polyunsaturated fatty acid supplementation on muscle maintenance and quality of life in patients with cancer: A systematic review and meta-analysisAccepted author manuscript, 97.5 KBLicence: CC BY-NC-ND

2 Active

Research by Master of Nutrition and Dietetic Practice Students
Isenring, E. (Supervisor), Marshall, S. (Supervisor), Reidlinger, D. (Project Lead), Kelly, J. (Supervisor), Cox, G. (Supervisor), Van der Meij, B. (Supervisor), MacKenzie-Shalders, K. (Supervisor), Mayr, H. (Supervisor), Utter, J. (Associate Professor), Dahl, C. (Masters by Coursework Student), Crichton, M. (Masters by Coursework Student), O'Bryan, K. R. (Masters by Coursework Student), Norris, R. (Masters by Coursework Student), Fahey, M. (Masters by Coursework Student), Davidson, A. (Masters by Coursework Student), Naranjo, A. (Masters by Coursework Student), Mahoney, S. (Masters by Coursework Student), Eberhardt, F. (Masters by Coursework Student), Dalwood, P. (Masters by Coursework Student), Lopez, E. (Masters by Coursework Student), Hofto, S. (Masters by Coursework Student), Innerarity, C. (Masters by Coursework Student), So, D. (Masters by Coursework Student), McIntosh, A. (Masters by Coursework Student), Gadd, N. (Masters by Coursework Student), Chan, H. C. (Masters by Coursework Student), Lan, X. (Masters by Coursework Student), Fei, X. (Masters by Coursework Student), Kostjasyn, S. (Masters by Coursework Student), Adhyaru, P. (Masters by Coursework Student), Giang, J. (Masters by Coursework Student), Leung, E. L. Y. (Masters by Coursework Student), Strike, K. (Project Roles), Pearcy, J. (Masters by Coursework Student), Somani, A. (Masters by Coursework Student), Wright, C. (Masters by Coursework Student), Matthews, C. (Masters by Coursework Student), Lee, G. (Masters by Coursework Student), Tang, X. (Associate Investigator) & Eso, A. (Associate Investigator)
1/01/14 → 31/12/27
Project: Research
Oncology Nutrition Research
Isenring, E. (Project Lead), Marshall, S. (Senior Research Fellow), Van der Meij, B. (Senior Research Fellow), Rigby, R. (Associate Investigator), Teleni, L. (HDR Student), Crichton, M. (HDR Student) & Tang, X. (Admin)
1/01/14 → …
Project: Research

1 Non-HDR Student Supervision

Chung Nga Lam - Masters of Nutrition and Dietetic Practice research project
Lam, C. N. (Student ), Watt, A. (Supervisor), Isenring, E. (Supervisor), de van der Schueren, M. (Researcher) & Van der Meij, B. (Supervisor)
1 Sept 2018 → 30 Apr 2019
Activity: Professional Development, Mentorship, Supervision and Other Activities › Non-HDR Student Supervision

1 Review article

The effect of oral omega-3 polyunsaturated fatty acid supplementation on muscle maintenance and quality of life in patients with cancer: A systematic review and meta-analysis
Lam, C. N., Watt, A. E., Isenring, E. A., de van der Schueren, M. A. E. & van der Meij, B. S., Jun 2021, In: Clinical Nutrition. 40, 6, p. 3815-3826 12 p.
Research output: Contribution to journal › Review article › Research › peer-review
41 Citations (Scopus)

Cite this

@article{0260b4d640e84e8c83a46ac676b37509,

title = "The effect of oral omega-3 polyunsaturated fatty acid supplementation on muscle maintenance and quality of life in patients with cancer: A systematic review and meta-analysis",

abstract = "Rationale: Omega-3 polyunsaturated fatty acid (PUFA) supplementation is a promising therapy for cancer-relatedmalnutrition, which affects 20-70% of patients with cancer1,2. This systematic review aimed to examine the effects of oralomega-3 PUFA supplementation on muscle maintenance and quality of life in patients with cancer.Methods: Randomised controlled trials in cancer patients aged >18 years were retrieved from 5 electronic databases;MEDLINE (via PubMed), EMBASE, CENTRAL, CINAHL (via EBSCOhost), and Web of Science, from database inceptionuntil 31st of December 2019. Trials supplementing ≥600 mg/d omega-3 PUFA (oral capsules, pure fish oil or oralnutritional supplements) or a control intervention for ≥3 weeks were included. Meta-analyses were performed in RevManto determine the mean differences (MD) in muscle mass and quality of life between omega-3 PUFA and control groupswith 95% confidence intervals (CI) and I2 for heterogeneity.Results: We included 33 studies in patients with various types of cancers and degrees of malnutrition. The Cochrane riskof bias tool graded most trials as {\textquoteleft}unclear{\textquoteright} or {\textquoteleft}high{\textquoteright} risk of bias. Meta-analyses showed oral omega-3 PUFA supplementsimproved physical functioning (MD: 6.33; 95% CI: 0.32, 12.34, p=0.04; I2=0%) and potentially reduced fatigue (MD: -6.21;95% CI: -13.473, 1.05, p=0.09; I2=14%). However, there was no significant effect of omega-3 PUFA supplements onmuscle mass, global health status, emotional functioning and symptoms (nausea and vomiting, loss of appetite anddiarrhoea).Conclusion: This review provides evidence for the benefits of oral omega-3 PUFA supplementation on quality of life butnot on muscle maintenance in patients with cancer. Well-designed large-scale randomised controlled trials inhomogenous patient cohorts are required to confirm these findings.",

author = "Lam, {Chung Nga} and Elisabeth Isenring and {de van der Schueren}, Marian and {Van der Meij}, {Barbara S}",

year = "2020",

month = dec,

doi = "10.1016/j.clnesp.2020.09.788",

language = "English",

volume = "40",

journal = "Clinical Nutrition ESPEN",

issn = "2405-4577",

publisher = "Elsevier",

note = "42nd ESPEN Virtual Congress ; Conference date: 19-09-2020 Through 21-09-2020",

url = "https://espencongress.com/",

}

The effect of oral omega-3 polyunsaturated fatty acid supplementation on muscle maintenance and quality of life in patients with cancer: A systematic review and meta-analysis. / Lam, Chung Nga; Isenring, Elisabeth; de van der Schueren, Marian et al.
In: Clinical Nutrition ESPEN, Vol. 40, LB-237, 12.2020.

Research output: Contribution to journal › Meeting Abstract › Research › peer-review

TY - JOUR

T1 - The effect of oral omega-3 polyunsaturated fatty acid supplementation on muscle maintenance and quality of life in patients with cancer: A systematic review and meta-analysis

AU - Lam, Chung Nga

AU - Isenring, Elisabeth

AU - de van der Schueren, Marian

AU - Van der Meij, Barbara S

N1 - Conference code: 42nd

PY - 2020/12

Y1 - 2020/12

N2 - Rationale: Omega-3 polyunsaturated fatty acid (PUFA) supplementation is a promising therapy for cancer-relatedmalnutrition, which affects 20-70% of patients with cancer1,2. This systematic review aimed to examine the effects of oralomega-3 PUFA supplementation on muscle maintenance and quality of life in patients with cancer.Methods: Randomised controlled trials in cancer patients aged >18 years were retrieved from 5 electronic databases;MEDLINE (via PubMed), EMBASE, CENTRAL, CINAHL (via EBSCOhost), and Web of Science, from database inceptionuntil 31st of December 2019. Trials supplementing ≥600 mg/d omega-3 PUFA (oral capsules, pure fish oil or oralnutritional supplements) or a control intervention for ≥3 weeks were included. Meta-analyses were performed in RevManto determine the mean differences (MD) in muscle mass and quality of life between omega-3 PUFA and control groupswith 95% confidence intervals (CI) and I2 for heterogeneity.Results: We included 33 studies in patients with various types of cancers and degrees of malnutrition. The Cochrane riskof bias tool graded most trials as ‘unclear’ or ‘high’ risk of bias. Meta-analyses showed oral omega-3 PUFA supplementsimproved physical functioning (MD: 6.33; 95% CI: 0.32, 12.34, p=0.04; I2=0%) and potentially reduced fatigue (MD: -6.21;95% CI: -13.473, 1.05, p=0.09; I2=14%). However, there was no significant effect of omega-3 PUFA supplements onmuscle mass, global health status, emotional functioning and symptoms (nausea and vomiting, loss of appetite anddiarrhoea).Conclusion: This review provides evidence for the benefits of oral omega-3 PUFA supplementation on quality of life butnot on muscle maintenance in patients with cancer. Well-designed large-scale randomised controlled trials inhomogenous patient cohorts are required to confirm these findings.

AB - Rationale: Omega-3 polyunsaturated fatty acid (PUFA) supplementation is a promising therapy for cancer-relatedmalnutrition, which affects 20-70% of patients with cancer1,2. This systematic review aimed to examine the effects of oralomega-3 PUFA supplementation on muscle maintenance and quality of life in patients with cancer.Methods: Randomised controlled trials in cancer patients aged >18 years were retrieved from 5 electronic databases;MEDLINE (via PubMed), EMBASE, CENTRAL, CINAHL (via EBSCOhost), and Web of Science, from database inceptionuntil 31st of December 2019. Trials supplementing ≥600 mg/d omega-3 PUFA (oral capsules, pure fish oil or oralnutritional supplements) or a control intervention for ≥3 weeks were included. Meta-analyses were performed in RevManto determine the mean differences (MD) in muscle mass and quality of life between omega-3 PUFA and control groupswith 95% confidence intervals (CI) and I2 for heterogeneity.Results: We included 33 studies in patients with various types of cancers and degrees of malnutrition. The Cochrane riskof bias tool graded most trials as ‘unclear’ or ‘high’ risk of bias. Meta-analyses showed oral omega-3 PUFA supplementsimproved physical functioning (MD: 6.33; 95% CI: 0.32, 12.34, p=0.04; I2=0%) and potentially reduced fatigue (MD: -6.21;95% CI: -13.473, 1.05, p=0.09; I2=14%). However, there was no significant effect of omega-3 PUFA supplements onmuscle mass, global health status, emotional functioning and symptoms (nausea and vomiting, loss of appetite anddiarrhoea).Conclusion: This review provides evidence for the benefits of oral omega-3 PUFA supplementation on quality of life butnot on muscle maintenance in patients with cancer. Well-designed large-scale randomised controlled trials inhomogenous patient cohorts are required to confirm these findings.

U2 - 10.1016/j.clnesp.2020.09.788

DO - 10.1016/j.clnesp.2020.09.788

M3 - Meeting Abstract

SN - 2405-4577

VL - 40

JO - Clinical Nutrition ESPEN

JF - Clinical Nutrition ESPEN

M1 - LB-237

T2 - 42nd ESPEN Virtual Congress

Y2 - 19 September 2020 through 21 September 2020

ER -

The effect of oral omega-3 polyunsaturated fatty acid supplementation on muscle maintenance and quality of life in patients with cancer: A systematic review and meta-analysis

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Research by Master of Nutrition and Dietetic Practice Students

Oncology Nutrition Research

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Chung Nga Lam - Masters of Nutrition and Dietetic Practice research project

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The effect of oral omega-3 polyunsaturated fatty acid supplementation on muscle maintenance and quality of life in patients with cancer: A systematic review and meta-analysis

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