• Intervention
    Can lean body mass in advanced cancer patients can be altered by fatty acids?
    • Conclusion
      Three studies (two positive quality RCTs, one neutral quality time series) evaluated the impact of omega-3 fatty acid supplementation on LBM in advanced cancer. One study (positive quality RCT) comparing an omega-3 fatty acid enriched liquid nutritional supplement which provided a mean dose of 1.6g EPA daily to an arginine enriched liquid nutritional supplement in weight stable patients, found an increase in triceps skinfold (p<0.05) and arm circumference (p<0.0.5) at 3 months, but no increase in fat-free mass as determined by BIA. A second study positive quality RCT), comparing fish oil supplements at a mean dose of 1.8g EPA/day to placebo found no change in LBM, as measured by BIA, with omega-3 fatty acid supplementation.  The third study (neutral qualty time series) utilized a complicated dietary and pharmacologic intervention which included an omega-3 fatty acid enriched liquid nutritional supplement which provided a mean dose of 2.2g EPA daily, indicated an increase in LBM, as measured by BIA, at 8 weeks (p=0.045) and 12 weeks (p=0.023). It is hard to identify which component of this intervention produced this effect.  Further research is needed to clarify these results.
    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    • Search Plan and Results: Catabolic Process: Fatty Acids 2006
       
    Can lean body mass in pancreatic cancer patients be altered by fatty acids?
    • Conclusion

      Six studies (two neutral quality time series, one negative quality time series, three positive quality RCTs) evaluated the impact of omega-3 fatty acid supplementation on LBM in pancreatic cancer. One study, without a control group, indicated an increase in LBM (p=0.0047) after 7 weeks of supplementation with an omega-3 fatty acid-enhanced MFS which provided a mean dose of 2.09g EPA daily. Two large RCT of positive design with a dose of 1.5-1.65g EPA daily, one small RCT of positive design with a dose of 2.09g EPA daily, and two small timeseries (one negative and one neutral quality) with a dose of 2.0g EPA daily indicated no increase in LBM over the study period.

    • Grade: I
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    • Search Plan and Results: Catabolic Process: Fatty Acids 2006
       
    Can pro-inflammatory markers in cancer patients be altered by fatty acids?
    • Conclusion
      Three studies (two positive rated RCTs, one neutral rated time series and one negative rated time series) evaluated serum cytokine concentrations in patients with advanced cancer and ongoing weight loss with conflicting results. Two studies (negative rated time series, neutral rated time series) found decrease in serum IL-6, one found no change (positive rated RCT) and one found increases (positive rated RCT). Two studies found no change in serum TNF (negative rated time series, positive rated RCT), one found decreases (neutral rated time series) and one found increases (positive rated RCT). Two studies (negative rated time series, positive rated RCT) looked at IL-1 and found no significant change. One study (negative rated time series) looked at PIF and found a significant fall in the number of patients with detectable urine PIF at three weeks. Multiple doses of fish oil were used in these studies and three of the studies used fish oil in conjunction with other interventions. More research is needed to clarify these results.
    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    • Search Plan and Results: Catabolic Process: Fatty Acids 2006
       
    Can the acute phase response in cancer patients can be altered by fatty acids?
    • Conclusion

      Four studies (two neutral quality time series, one neutral quality non-randomized trial, and one negative quality time series), published by the same group of researchers, evaluated acute-phase response as measured by serum CRP, in patients with pancreatic cancer and ongoing weight loss instructed to consume an omega-3 fatty acid enriched liquid nutritional supplement which provided a mean dose of 2.2g EPA daily. Three studies (two neural time series, one neutral rated non-randomized trial) indicated no change in APP over the treatment period of 7-12 weeks. The negative quality time series indicated a reduction in CRP concentration after four weeks of supplementation with 2g of EPA daily (p<0.002), however the change was no longer significant at 12 weeks. Further research is needed to clarify these results.

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    • Search Plan and Results: Catabolic Process: Fatty Acids 2006