Omega (omega)-3 polyunsaturated fatty acids appear to be effective in preventing and treating parenteral nutrition-associated liver disease, and several mechanisms were proposed for this observation. An 8-week-old male infant with cholestasis and acholic stool was diagnosed non-syndromic intrahepatic interlobular bile duct paucity by open-wedge liver biopsy. Initially he was treated with usual supportive medical therapy, including ursodeoxycholic acid. However, the clinical status and laboratory tests did not improve. Omega (omega)-3 polyunsaturated fatty acids (initially intravenous administration and oral administration later), were started and his liver function, including aminotransferase level and bilirubin levels normalized, and the ivory stool color turned green. We report the possible effectiveness of omega-3 polyunsaturated fatty acids as a potent choleretic agent for non-syndromic intrahepatic interlobular bile duct paucity, a very rare structural pediatric hepatic disease.
Administration, Intravenous ; Administration, Oral ; Bile Ducts* ; Bilirubin ; Biopsy ; Cholestasis* ; Fatty Acids, Omega-3 ; Fatty Acids, Unsaturated ; Humans ; Infant ; Liver ; Liver Diseases ; Male ; Ursodeoxycholic Acid

OBJECTIVETo evaluate systematically the effect of n-3 long-chain polyunsaturated fatty acid (n-3 LC-PUFA) supplementation of pregnant women on head circumference of newborn infants.

METHODSA thorough literature search was done for full texts which studied the effect of n-3 LC-PUFA supplementation of pregnant women on head circumference of newborn infants among PubMed, Cochrane Library, Chinese periodical full text database and Wanfang database using the mesh terms as n-3, long chain polyunsaturated fatty acids, DHA, EPA, docosahexaenoic acid, eicosapentaenoic acid, fish oil, pregnancy, infant. Only randomized controlled trials were chosen for analysis. A total of 74 relevant articles were selected. RevMan 5.0 software was used to perform the Meta analysis on those valid studies. Weighted mean difference was calculated with inverse variance method. The sensitivity analysis was also performed.

RESULTSEight articles met the inclusion criteria, among which 6 literatures were from developing countries and the other 2 from developed countries. All of them were written in English. These studies were reported from 2001 to 2011. Intervention group included 871 objects with n-3 LC-PUFA supplementation, whereas control group included 894 objects with placebo or no supplementation. Supplementation was associated with significantly greater head circumference of the infants in the intervention group than that of the control group (weighted mean difference was 0.17 cm, 95%confidence interval (CI) was 0.01 - 0.32 cm, P < 0.05). But the difference was no long significant according to the sensitivity analysis (weighted mean difference was 0.16 cm, 95%CI was -0.01 - 0.34 cm, P = 0.07). The funnel plot was symmetrical, indicating there was no publication bias between the eight studies.

CONCLUSIONIt can't be confirmed whether supplementation with n-3 LC-PUFA of pregnant women can increase the infants' head circumference at birth from present data acquired.

Body Size ; Cephalometry ; Dietary Supplements ; Fatty Acids, Omega-3 ; administration & dosage ; Female ; Humans ; Infant, Newborn ; Pregnancy ; Skull ; anatomy & histology

Omega-3 polyunsaturated fatty acids are essential fatty acids because humans cannot synthesize them de novo and must obtain them in their diet. Fish and fish oil are rich sources of omega-3 fatty acids, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Significant evidence of the beneficial role of dietary intake of omega-3 fatty acids in blood flow has been reported and putative mechanisms for improvement of blood flow include anti-thrombotic effects, lowered blood pressure, improved endothelial function, and anti-atherogenic effects. Edible oils containing omega-3 fatty acids were registered as functional ingredients in the Korea Health Functional Food Code. Although omega-3 fatty acids have been evaluated by the Korea Food and Drug Administration (KFDA) based on scientific evidence, periodic re-evaluation may be needed because emerging data related to omega-3 fatty acids have accumulated. Therefore, in this study, we re-evaluated scientific evidence for the effect of omega-3 fatty acids as a functional ingredient in health functional food on improvement of blood flow. A comprehensive literature search was conducted for collection of relevant human studies using the Medline and Cochrane, KISS, and IBIDS databases for the years 1955-2012. Search keywords were used by combination of terms related to omega-3 fatty acids and blood flow. The search was limited to human studies published in Korean, English, and Japanese. Using the KFDA's evidence based evaluation system for scientific evaluation of health claims, 112 human studies were identified and reviewed in order to evaluate the strength of the evidence supporting a relation between omega-3 fatty acids and blood flow. Among 112 studies, significant effects on improvement of blood flow were reported in 84 studies and the daily intake amount was ranged from 0.1 to 15 g. According to this methodology of systematic review, we concluded that there was possible evidence to support a relation between omega-3 fatty acid intake and blood flow. However, because inconsistent results have recently been reported, future studies should be monitored.
Asian Continental Ancestry Group ; Blood Pressure ; Diet ; Eicosapentaenoic Acid ; Fatty Acids, Essential ; Fatty Acids, Omega-3 ; Fatty Acids, Unsaturated ; Functional Food ; Humans ; Korea ; Oils ; United States Food and Drug Administration

OBJECTIVETo review the relation between dietary omega-3 polyunsaturated fatty acids (omega-3 PUFA) and non-communicable diseases.

METHODData were collected from scientific journals and conference publications, MEDLINE (1979 - 2002) and current content which included 68 prospective, cross-sectional, case control and dietary-intervention studies. Scientific paper selections were based on the association between omega-3 PUFA and non-communicable diseases.

RESULTSomega-3 PUFA has beneficial effects on increasing heart rate variability, decreasing the risk of stroke, reducing both systolic and diastolic blood pressure, insulin resistance and glucose metabolism. Long chain omega-3 PUFA has anti-cancer and anti-inflammatory activities. omega-3 PUFA has also been reported to have a beneficial effect on attention-deficit/hyperactivity disorder and schizophrenia, and may be effective in managing depression in adults.

CONCLUSIONSResults from epidemiological and dietary intervention studies have shown that omega-3 PUFA represent powerfully a class of bioactive compounds and that dietary intake of omega-3 PUFA plays a critical role in human health in relation to non-communicable diseases.

Diabetes Mellitus ; therapy ; Fatty Acids, Omega-3 ; administration & dosage ; pharmacology ; Humans ; Hypertension ; prevention & control ; Inflammation ; prevention & control ; Lipids ; blood ; Mental Disorders ; therapy ; Neoplasms ; prevention & control ; Thrombosis ; prevention & control

Nutrition, as a definite environmental factor, has been implicated in the pathogenesis of inflammatory bowel disease (IBD). Although low-fiber, high-sugar, and high-animal fat diets have been proposed as a risk factor, the role of nutrition in IBD still needs more conclusive evidence. Nutritional deficiency is a common problem in IBD patients. The goals of nutritional intervention are the prevention and correction of malnutrition, the prevention of osteoporosis, and the promotion of optimal growth and development in childhood. Enteral nutrition is effective in induction and maintenance of the clinical remission in adults and promoting growth in children with Crohn's disease. The n-3 polyunsaturated fatty acids contained in fish oil may provide short-term benefit to patients with IBD.
Adult ; Child ; Crohn Disease/*therapy ; *Enteral Nutrition ; Fatty Acids, Omega-3/administration & dosage ; Humans ; Inflammatory Bowel Diseases/*therapy ; Nutritional Support ; Osteoporosis/prevention & control

Boronic Acids ; adverse effects ; Bortezomib ; Fatty Acids, Omega-3 ; administration & dosage ; therapeutic use ; Fish Oils ; administration & dosage ; therapeutic use ; Humans ; Male ; Middle Aged ; Peripheral Nervous System Diseases ; chemically induced ; drug therapy ; Pyrazines ; adverse effects

OBJECTIVETo evaluate the efficacy, safty and economical values of immunonutrition for clinical nutritional support.

METHODSThe following electronic databases were searched: Chinese Biomedicine database (CBM), MEDLINE, EMBASE, Cochrane Library and SCI. Data were extracted by two reviewers. RevMan 4.1 was applied for statistical analysis.

RESULTSSeventeen randomised trials comparing the use of immunonutrition which comprises nucleotides, omega-3 fatty acids and arginine with standard enteral nutrition in surgical, trauma/burn and critical illness patients. Combined analysis indicated that the use of immunonutrition decreased infectious events (pooled OR was 0.51, 95%CI [0.38, 0.67], P = 0.00001), length of hospitalization, and the cost. In sensitivity analysis for mortality, we found an increased tendency in immunonutrition (pooled OR was 1.94, 95%CI [1.05, 3.57], P = 0.03). Further sub-group analysis indicated that the effects of immunonutrition were various in different patient types.

CONCLUSIONSImmunonutrition is associated with decreasing of infectious rates, length of hospitalization and cost in selective operation patients. But current evidence can't affirm the role of immunonutrition on critical illness patients. Further studies are urgently needed to clarify the reliability of immunonutrition in this group.

Arginine ; administration & dosage ; Critical Illness ; Enteral Nutrition ; methods ; Fatty Acids, Omega-3 ; administration & dosage ; Food, Formulated ; Glutamine ; administration & dosage ; Humans ; Immune System ; drug effects ; Nucleotides ; administration & dosage ; Nutritional Support ; Outcome Assessment (Health Care)

OBJECTIVEThe aim of this review is to objectively access the trial evidence on the role of omega-3, red yeast rice and garlic in preventing clinical cardiovascular events. Given the large number of clinical trials favoring statin use in cardiovascular disease, it is important to see if evidence is available for these supplements and whether they could replace statin therapy.

DATA SOURCEA PubMed search was conducted using the keywords 'trial, omega-3, red yeast rice, xuezhikang, garlic, cholesterol, cardiovascular, outcomes'; the resulting trials were reviewed together with the references quoted in the papers obtained.

STUDY SELECTIONThe studies selected are prospective, randomized, placebo-controlled studies with predefined clinical cardiovascular end-points recruiting at least 2000 patients, with a follow-up over 2 years.

RESULTSModest dose omega-3 fatty acid has been shown in GISSI-P (11 324 patients, follow-up 3.5 years) to produce a reduction in sudden death of 45%, and in cardiac death of 35%, acting probably via an anti-arrhythmic effect. In JELIS (18 645 patients, follow-up 4.6 years), high dose omega-3 given to Japanese patients on a high fish diet and already on statin treatment produced further benefit with a 19% reduction of nonfatal cardiovascular outcomes; fatal cardiac events are not affected. CCSPS (4870 patients, follow-up 4 years), a secondary prevention trial using xuezhikang, a commercial red yeast rice preparation, produced a 46% reduction in nonfatal myocardial infarction and coronary death. There has been no trial to show that garlic reduces clinical cardiovascular outcomes. A rigorous trial with constant assessment of chemicals in the study material in 192 patients found that over a 6-month follow-up, raw garlic and 2 commercial preparations do not significantly affect lipid levels.

CONCLUSIONSOmega-3 in modest doses reduces cardiac deaths, and in high doses reduces nonfatal cardiovascular events. Red yeast rice reduces adverse cardiac events to a similar degree as the statins. It is unlikely that garlic is useful in preventing cardiovascular disease.

Biological Products ; administration & dosage ; Cardiovascular Diseases ; prevention & control ; Fatty Acids, Omega-3 ; administration & dosage ; Garlic ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; therapeutic use ; Phytotherapy ; Prospective Studies ; Randomized Controlled Trials as Topic

The aim of this study was to explore the effects of parenteral supplementation with omega-3 fish oil emulsion (Omegaven) on systemic inflammatory response syndrome (SIRS) during the initial stage of severe acute pancreatitis (SAP). In a prospective, randomized and controlled trial, 60 patients with SAP were randomized either to treat with conventional therapy (Con group, n=30) or conventional therapy plus intravenous supplementation with omega-3 fish oil emulsion 0.2 g/kg every day (FO group, n=30). The effects were analyzed by the SIRS-related indexes. The results showed that APACHE-II scores in FO group were significantly lower, and the gap increased much farther after the 4th day than those in Con group (P<0.05). Fluid equilibrium time became shorter markedly in FO group than in Con group (5.1+/-2.2 days vs 8.4+/-2.3 days). In FO group, SIRS scores were markedly decreased and the SIRS state vanished after the 4th day; Plasma level of TNF-alpha was significantly reduced, while IL-10 decreased markedly, most prominently between the 4th and 7th day, and the ratio of IL-10/TNF-alpha raised as compared with Con group (P<0.05). During the initial stage of SAP, parenteral supplementation with omega-3 fish oil emulsion could efficiently lower the magnitude and persistence time of the SIRS, markedly retrieve the unbalance of the pro-/anti-inflammatory cytokines, improve severe condition of illness and may provide a new way to regulate the SIRS.
Dietary Supplements ; Emulsions ; Fatty Acids, Omega-3/*administration & dosage ; Fish Oils/*administration & dosage ; Pancreatitis, Acute Necrotizing/complications ; Pancreatitis, Acute Necrotizing/*therapy ; Parenteral Nutrition/methods ; Prospective Studies ; Systemic Inflammatory Response Syndrome/etiology ; Systemic Inflammatory Response Syndrome/*therapy ; Young Adult

Intestinal hypoganglionosis is a rare innervation disorder that provides numerous nutritional, medical and surgical challenges. In this case report, we present a case of a newborn with intestinal hypoganglionosis leading to intestinal failure and intestinal failure-associated liver disease who responded to Omegaven™, a fat emulsion comprised of omega-3 fatty acids. Omegaven™ has been shown to be beneficial in the management of cholestatic liver injury. Clinical success with Omegaven™ was seen in this patient with a clear decrease in aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and complete resolution of cholestasis with a direct bilirubin of zero within two weeks of initiation of Omegaven™. No current guidelines for the diagnosis and management of hypoganglionosis are available. We recommend a multidisciplinary approach and the use of novel therapies such as fat emulsions composed of omega-3 fatty acids for improved patient outcomes. Appropriate compassionate use protocols should be obtained from the Food and Drug Administration prior to initiation of Omegaven™.
Alanine Transaminase ; Alkaline Phosphatase ; Aspartate Aminotransferases ; Bilirubin ; Cholestasis ; Compassionate Use Trials* ; Diagnosis ; Empathy* ; Emulsions ; Fatty Acids, Omega-3 ; Hirschsprung Disease ; Humans ; Infant, Newborn ; Liver ; Liver Diseases ; Parenteral Nutrition, Total ; United States Food and Drug Administration