Mickleborough TD, Murray RL, et al. Fish Oil Supplementation Reduces Severity of Exercise-induced Bronchoconstriction in Elite Athletes.
Am. J of Resp & Critical Care Med, 2003;168: 1181-1189

In elite athletes, exercise-induced bronchoconstriction (EIB) may respond to dietary modification, thereby reducing the need for pharmacologic treatment.

Ten elite athletes with EIB and 10 elite athletes without EIB (control subjects) participated in a randomized, double-blind crossover study.

Subjects entered the study on their normal diet, and then received either fish oil capsules containing 3.2 g eicosapentaenoic acid and 2.2 g docohexaenoic acid (n-3 polyunsaturated fatty acid [PUFA] diet; n = 5) or placebo capsules containing olive oil (placebo diet; n = 5) taken daily for 3 weeks.

Diet had no effect on preexercise pulmonary function in either group or on postexercise pulmonary function in control subjects.

However, in subjects with EIB, the n-3 PUFA diet improved postexercise pulmonary function compared with the normal and placebo diets. FEV1 decreased by 3 2% on n-3 PUFA diet, 14.5 5% on placebo diet, and 17.3 6% on normal diet at 15 minutes postexercise. Leukotriene (LT)E4, 9, 11-prostaglandin F2, LTB4, tumor necrosis factor, and interleukin-1, all significantly decreased on the n-3 PUFA diet compared with normal and placebo diets and after the exercise challenge.

These data suggest that dietary fish oil supplementation has a markedly protective effect in suppressing EIB in elite athletes, and this may be attributed to their antiinflammatory properties.

Pacht ER, DeMichele SJ, et al. Enteral nutrition with eicosapentaenoic acid, gamma-linolenic acid, and antioxidants reduces alveolar inflammatory mediators and protein influx in patients. Crit Care Med, 2003; 31(2):491-500

OBJECTIVE: Previously, we showed that acute respiratory distress syndrome patients fed an enteral diet containing eicosapentaenoic acid and gamma-linolenic acid and elevated antioxidants (EPA+GLA; Oxepa) had significantly reduced pulmonary inflammation, increased oxygenation, and improved clinical outcomes. In a subset of acute respiratory distress syndrome patients from this trial, we performed a preliminary examination of the potential mechanisms underlying these clinical improvements by retrospectively testing the hypothesis that enteral feeding with EPA+GLA could reduce alveolar-capillary membrane protein permeability and the production of interleukin (IL)-8, IL-6, tumor necrosis factor-alpha, and leukotriene B4 that are responsible, in part, for pulmonary inflammation.

DESIGN: Prospective, randomized, double-blind, controlled clinical trial.

PATIENTS: A total of 67 patients were enrolled who met defined criteria for acute lung injury/acute respiratory distress syndrome.

INTERVENTIONS: A total of 43 of 67 evaluable patients randomly received either EPA+GLA or an isonitrogenous, isocaloric standard diet that was tube fed at a minimum caloric delivery of 75% of basal energy expenditure times 1.33 for at least 4 to 7 days.

MEASUREMENTS AND MAIN RESULTS: Bronchoalveolar lavage (BAL) was performed at baseline and study days 4 and 7 to obtain BAL fluid (BALF) for measurement of total protein, ceruloplasmin, and transferrin, total neutrophil count, IL-8, IL-6, tumor necrosis factor-alpha, and leukotriene B4. Oxygenation, measured as Pao2/Fio2, was assessed before BAL. Patients fed EPA+GLA had a significant reduction in BALF ceruloplasmin and IL-8 during the study as compared with patients fed the control diet. BALF levels of total protein, neutrophils, and leukotriene B4 tended to decrease in EPA+GLA patients over the course of the study as compared with control patients. BALF levels of IL-6 declined similarly during the study in both groups. A trend toward a reduction in BALF tumor necrosis factor-alpha was observed on study day 7 in the EPA+GLA group as compared with control patients. Significant improvements in oxygenation (Pao2/Fio2) occurred in EPA+GLA patients on study day 4 as compared with controls. Correlation analysis revealed significant relationships between BALF neutrophil counts and indices of alveolar-capillary membrane protein permeability, IL-8, and leukotriene B4.

CONCLUSIONS: This preliminary investigation showing a decrease in BALF levels of IL-8 and leukotriene B4 and the associated reduction of BALF neutrophils and alveolar membrane protein permeability in acute respiratory distress syndrome patients fed EPA+GLA support, in part, the potential mechanisms underlying the previously described clinical improvements with this diet. Additional controlled studies are needed to confirm these findings.

Singer P, Theilla M, Fisher H, et al. Benefit of an enteral diet enriched with eicosapentaenoic acid and gamma-linolenic acid in ventilated patients with acute lung injury. Critical Care Medicine 2006. 34(4):1033-1038.

Objective: To explore the effects of an enteral diet enriched with eicosapentaenoic acid (EPA), gamma-linolenic acid (GLA), and antioxidants on the respiratory profile and outcome of patients with acute lung injury.

Design: Single-center, prospective, randomized, controlled, unblinded study.

Setting: General intensive care department of a tertiary-care, university-affiliated hospital.

Patients: A total of 100 patients with acute lung injury, diagnosed according to the American-European Consensus Conference on ARDS.

Interventions: Patients were randomized to receive the standard isonitrogenous, isocaloric enteral diet or the standard diet supplemented with EPA and GLA for 14 days.

Measurements and Main Results: Patient demographics, Acute Physiology and Chronic Health Evaluation II score, and type of admission were noted at admission. Compared with baseline oxygenation (EPA + GLA group vs. control group), by days 4 and 7, patients receiving the EPA + GLA diet showed significant improvement in oxygenation (Pao2/Fio2, 317.3 +/- 99.5 vs. 214.3 +/- 56.4 and 296.5 +/- 165.3 vs. 236.3 +/- 79.8, respectively; p < .05). Compliance was significantly higher in the EPA + GLA group observed at day 7 (55.1 +/- 46.5 vs. 35.2 +/- 20.0 mL/mbar, p < .05). No significant difference was found in nutritional variables. Resting energy expenditure was significantly higher in patients in the EPA + GLA group, but their body mass index was also higher (p < .05). A significant difference was found in length of ventilation (p < .04) in favor of the EPA + GLA group. There was no between-group difference in survival.

Conclusions: In patients with acute lung injury, a diet enriched with EPA + GLA may be beneficial for gas exchange, respiratory dynamics, and requirements for mechanical ventilation.

(C) 2006 Lippincott Williams & Wilkins, Inc.

Mizock BA, DeMichele SJ. The Acute Respiratory Distress Syndrome: Role of Nutritional Modulation of Inflammation Through Dietary Lipids. Nutrition in Clinical Practice,2004;19(6):563-557.

The acute respiratory distress syndrome (ARDS) is the most serious form of acute hypoxic respiratory failure.

ARDS represents the expression of an acute, diffuse, inflammatory process in the lungs consequent to a variety of infectious and noninfectious conditions.
It is characterized pathologically by damage to pulmonary epithelial and endothelial cells, with subsequent alveolar-capillary leak and exudative pulmonary edema.
The main clinical features of ARDS include rapid onset of dyspnea, severe defects in gas exchange, and imaging studies demonstrating diffuse pulmonary infiltrates.

The role of nutrition in the management of ARDS has traditionally been supportive.

Recent research has demonstrated the potential of certain dietary oils (eg, fish oil, borage oil) to modulate pulmonary inflammation, thereby improving lung compliance and oxygenation, and reducing time on mechanical ventilation.

This article reviews the alterations in the immune response that underlie ARDS, discusses the physiology of dietary oils as immunonutrients, summarizes animal and human studies that explore the therapeutic effects of dietary oils, and provides clinical recommendations for their use.

The nude mouse tale: Omega-3 fats save the life of a terminal cancer patient

University of Nevada professor publishes case study of successful nutritional treatment for cancer

RENO, Nev.--Ron Pardini is not a medical doctor. Yet he is seen as a hero by his cancer-stricken neighbor, "D.H." Pardini helped the 78-year-old after D.H. was diagnosed with terminal lung cancer.

"In 2000 he was told by his doctor he had only a few months to live," said Pardini, a professor of biochemistry and associate director of the Nevada Agricultural Experiment Station at the University of Nevada, Reno. "But five years later, he is still alive, and has even gained a little weight."

The cancerous tumors found in D.H.'s lungs have shrunk to 10 percent of what they were in 2000, according to last year's computed tomography (CT) scans.

What worked with DH is not a common medical treatment such as chemotherapy or surgical excision. It was a nutritional intervention, drastically increasing the patient's intake of omega-3 fatty acids, which are often found in fish oil or golden algae oil.

Pardini's previous research showed that omega-3 fatty acids significantly depressed the growth of human mammary, ovarian, colon, prostate and pancreatic cancer cells that were injected into athymic mice--also known as nude mice.

His studies also demonstrated that fish oil consumption improves a mouse's responsiveness to chemotherapy.

Fish oil research was inspired by observations that Inuit Eskimo populations have less breast and prostate cancer deaths. So far, though, most studies in this country are limited to animal models, but a case study about D.H., which was published in the recent issue of the Nutrition and Cancer journal, could be a major step forward for human clinical trials.

While beginning to take high dose of fish oil and golden algae oil capsules daily, D.H. also reduced corn-based foods from his diet. Corn contains omega-6 fatty acids that Pardini said are found to increase cancer growth.

Pardini is optimistic of what his findings may contribute to cancer treatment.

"We have good evidence for employing nutritional interventions to improve cancer treatment and patient well-being," he said.

Pardini wants to be able to provide viable non-toxic, over-the-counter solutions for the numerous people with fear of cancer in the back of their minds. The Nutrition and Cancer article is co-authored by Nevada nutrition Professor David Wilson and University of Nevada medical school Professors Steven Schiff, Stephen Bajo and Randall Pierce.

Source: http://www.eurekalert.org/pub_releases/2005-11/uonc-tnm110905.php