Fish oil and CF...

[Guest guest]

I found this while surfing the net. A while back we talked about the

omega diet and so on and so forth here is a little more...

Lung disease and fish oils - A review of the evidence

BOSTON, MASSACHUSETTS. The idea that fish and fish oils may protect

against lung disease developed from early studies of the dietary

habits of Greenland Eskimos. Dr. D.F. Horrobin hypothesized that the

high content of omega-3 fatty acids in the Eskimo diet is at least

partially responsible for the low prevalence of lung disease in this

population group. This makes biological sense inasmuch as omega-3

fatty acids (notably from fish and fish oils) are known to inhibit

the synthesis of the inflammatory eicosanoids involved in lung

diseases.

Dr. Schwartz, MD of the Harvard Medical School has just

published a review of the evidence concerning omega-3 fatty acids and

lung disease. Dr. Schwartz concludes that there is good evidence that

a high intake of fish helps retard the age-related decline in lung

capacity observed among both smokers and non-smokers. He also points

out that one long term trial of fish oil supplementation in adult

asthma patients showed significant benefits, but that shorter trials

(less than 1 year) have not confirmed these findings. Two Australian

studies have shown that consumption of fresh fish (particularly oily

fish) protects children against wheezing and asthma. The evidence

concerning cystic fibrosis is controversial. Some studies have shown

that fish oil supplementation suppresses the formation of the

inflammatory eicosanoids which are characteristic of cystic fibrosis;

however, little or no clinical improvements are noted in these

studies. Other studies have found a significant protective effect of

fish and fish oil in regard to chronic bronchitis and emphysema

(chronic obstructive pulmonary disease) especially among smokers.

Dr. Schwartz concludes that there is a good case for fish and fish

oils being protective against the development of chronic lung

diseases, but that more research is needed to establish conclusive

proof of benefits.

Schwartz, . Role of polyunsaturated fatty acids in lung disease.

American Journal of Clinical Nutrition, Vol. 71 (suppl), January

2000, pp. 393S-96S

Intravenous fish oil infusion safe for CF patients

NEW YORK, NY. Seriously ill cystic fibrosis (CF) patients cannot

absorb fats and other nutrients properly and therefore often need

infusions of essential fatty acids. These infusions are most often

based on linoleic acid as many CF patients have been found to have a

deficiency of this omega-6 fatty acid. There is now substantial

evidence that long-chain omega-3 fatty acids found in fish oils can

suppress inflammatory processes such as those involved in CF.

A team of American, Finnish, and German researchers completed a small

clinical trial aimed at determining if it would be safe and effective

to use a fish oil fortified emulsion in the intravenous feeding of CF

patients. The trial involved 12 patients; 6 were given infusions of a

lipid emulsion enriched with fish oils while the remaining 6 (control

group) were given infusions of the standard linoleic acid-based

emulsion. The fish oil emulsion contained 18.3% eicosapentaenoic acid

(EPA), 27.6% docosahexaenoic acid (DHA), 12.7% oleic acid, and 2.5%

linoleic acid. The standard emulsion contained 54.5% linoleic acid,

22.4% oleic acid, and 0% EPA and DHA. Both emulsions were

administered daily (over a 4-hour period) for 1 month at a dose of

150 mg/kg of body weight. The researchers found no adverse effects on

liver function or coagulation parameters and no toxic or allergic

reactions in the patients receiving the fish oil emulsion. There was

a tendency to improved lung function in the fish oil group and a

tendency towards a worsening in the control group during the trial;

however, these effects were not statistically significant. The

researchers conclude that intravenous infusions of lipid emulsions

containing fish oils are safe for CF patients. They urge additional,

longer-term studies to determine if such infusions would be of

clinical benefit.

Katz, P., et al. The use of an intravenous fish oil emulsion

enriched with omega-3 fatty acids in patients with cystic fibrosis.

Nutrition, Vol. 12, No. 5, 1996, pp. 334-39

Fish oils may protect against emphysema

MINNEAPOLIS, MINNESOTA. Researchers at the University of Minnesota

report that smokers who eat fish regularly are much less likely to

develop chronic obstructive pulmonary diseases such as chronic

bronchitis and emphysema. They believe the protective effect is due

to the eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)

content of fish. Other studies have shown that fish oils have anti-

inflammatory properties and benefit patients with rheumatoid

arthritis and ulcerative colitis. The study included 8960 people, 55

per cent of which were former smokers and 45 per cent current

smokers. The researchers found that present or former smokers who ate

four servings of fish per week had about half the risk of developing

chronic bronchitis as did smokers who only ate 0.5 serving or less

per week. Heavy fish eaters had only one third the risk of getting

emphysema as did smokers who ate little fish. Eating four servings of

fish per week corresponds to a daily intake of about 480 mg of fish

oils (EPA and DHA). The researchers conclude that a high dietary

intake of fish oils (n-3 fatty acids) may protect cigarette smokers

against chronic obstructive pulmonary diseases.

Shahar, Eyal, et al. Dietary n-3 polyunsaturated fatty acids and

smoking-related chronic obstructive pulmonary disease. The New

England Journal of Medicine, Vol. 331, No. 4, July 28, 1994, pp. 228-

33

Fish oil helps cystic fibrosis victims

NEW SOUTH WALES, AUSTRALIA. Researchers at the University of Sydney

have found that daily supplementation with fish oil capsules

alleviates many of the symptoms of cystic fibrosis. Cystic fibrosis

is a serious, inherited childhood disease which involves a

malfunctioning of the body's mucus glands. An abnormally thick mucus

is produced which clogs the lungs and results in breathing

difficulties. Other symptoms include persistent cough and wheezing,

repeated lung infections, and a failure to gain weight. Sixteen

cystic fibrosis patients aged 12 to 26 took part in the experiment.

Half the group received fish oil capsules providing 2.7 g of

eicosapentaenoic acid (EPA) per day while the other half received

identical olive oil capsules as a placebo. After six weeks of

treatment the patients receiving EPA coughed up significantly less

sputum, were breathing easier (both forced expiatory volume and vital

capacity were up) and generally felt better. The Australian

researchers believe that the EPA acts by modifying the role of

leukotriene B4. Leukotriene B4 is thought to be the main culprit in

the excessive inflammatory response to bacteria which characterizes

cystic fibrosis.

Lawrence, R. and Sorrell, T. Eicosapentaenoic acid in cystic

fibrosis: evidence of a pathogenetic role for leukotriene B4. The

Lancet, Vol. 342, August 21, 1993, pp. 465-69

Cystic fibrosis and fish oils

GENT, BELGIUM. There is evidence that cystic fibrosis patients with

high plasma phospholipid levels of omega-3 fatty acids have better

lung function than patients with lower levels. Cystic fibrosis (CF)

is, unfortunately, often accompanied by fat malabsorption so it is

not clear whether oral fat supplementation with omega-3 fatty acids

would benefit CF patients.

Researchers at the State University of Gent set up an experiment to

see if CF patients are able to absorb omega-3s effectively by mouth.

The trial involved 9 CF patients (4 females and 5 males) ranging in

age from 7 to 20 years. All had been diagnosed with pancreatic

insufficiency and had poor fat absorption despite supplementing with

pancreatic enzyme preparations. The patients were assigned to receive

either 6 fish oil capsules per day for a month followed by 6 placebo

capsules for a month or 6 placebo capsules daily for a month followed

by 6 fish oil capsules daily for a month. Each fish oil capsule

contained 335 mg of salmon oil and 165 mg of commercial soy lecithin

and provided 152 mg of omega-3 fatty acids. The placebo capsules

contained 500 mg of pharmaceutical-grade liquid paraffin.

The researchers found that the CF patients who took fish oil showed a

marked increase in their phospholipid levels of eicosapentaenoic acid

[EPA] (increase of 327%) and docosahexaenoic acid [DHA] (increase of

215%). The levels of EPA and DHA returned to baseline 2 weeks after

discontinuing supplementation. The researchers also noted that

patients with low initial levels of EPA showed the greatest increase

in EPA levels after supplementation. They conclude that oral

supplementation with fish oil and lecithin is effective in increasing

the levels of omega-3 fatty acids especially EPA and DHA in cystic

fibrosis patients.

Christophe, Armand, et al. Increase of long chain omega-3 fatty acids

in the major serum lipid classes of patients with cystic fibrosis.

Ann Nutr Metab, Vol. 36, 1992, pp. 304-12