The Relationship Between Dietary and Supplemental omega-3 Highly Unsaturated Fatty Acid Intake, Blood and Tissue omega-3 Highly Unsaturated Fatty Acid Concentrations, and Colorectal Polyp Recurrence: A Secondary Analysis of the seAFOod Polyp Prevention Trial

IF 3.7 3区医学 Q2 NUTRITION & DIETETICS Journal of Nutrition Pub Date : 2025-02-01 DOI:10.1016/j.tjnut.2024.12.004

Ge Sun , Harriett Fuller , Hayley Fenton , Amanda D Race , Amy Downing , Colin J Rees , Louise C Brown , Paul M Loadman , Elizabeth A Williams , Mark A Hull

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Abstract

Background

The seAFOod randomized controlled trial tested colorectal polyp prevention by the omega-3 (ω-3) highly unsaturated fatty acid (HUFA) eicosapentaenoic acid (EPA) and aspirin. Variable dietary intake of omega-3 HUFAs (also including docosahexaenoic acid [DHA]) and differential EPA capsule compliance could confound analysis of trial outcomes.

Objective

The objective of this study was to investigate the relationship between total (diet and capsule) daily omega-3 HUFA intake, red blood cell (RBC), and rectal mucosa omega-3 HUFA concentrations, and colorectal polyp outcomes in a secondary analysis of the seAFOod trial.

Methods

Individual-participant dietary omega-3 HUFA intake (mg/d) was derived from food frequency questionnaires using the European Prospective Investigation into Cancer and Nutrition-Norfolk fatty acid nutrient database. Capsule EPA intake (mg/d) was adjusted for compliance (capsule counting). Fatty acids were analyzed by liquid chromatography-tandem mass spectrometry (as % of total fatty acids). HUFA oxidation was measured using the HUFA/saturated fatty acid (SAT) ratio. The colorectal polyp detection rate (PDR; % with ≥1 polyps) and polyp number per participant were analyzed according to the change in RBC EPA concentrations during the trial (ΔEPA), irrespective of treatment allocation.

Results

There was a small degree of HUFA degradation over time in RBC samples stored at > −80^oC at research sites (r = −0.36, P<0.001 for HUFA/SAT ratio over time), which did not affect analysis of omega-3 HUFA concentrations. Low baseline EPA concentration, as well as allocation to EPA and % compliance, were associated with a high ΔEPA. Individuals with a ΔEPA value >+0.5% points (ΔEPA_high), irrespective of allocation to EPA or placebo, had a lower PDR than ΔEPA_low individuals (odds ratio: 0.63; 95% confidence interval [CI]: 0.40, 1.01) and reduced colorectal polyp number (incidence rate ratio: 0.74; 95% CI: 0.54, 1.02).

Conclusions

Analysis of the seAFOod trial according to the change in EPA concentration, instead of treatment allocation, revealed a protective effect of EPA treatment on colorectal polyp recurrence (ISRCTN05926847).

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膳食和补充 n-3 HUFA 摄入量、血液和组织中的 n-3 HUFA 水平与结直肠息肉复发之间的关系：seAFOod息肉预防试验的二次分析。

背景：seAFOod随机对照试验测试了omega-3高不饱和脂肪酸（HUFA）、二十碳五烯酸（EPA）和阿司匹林预防结直肠息肉的作用。不同的饮食摄入omega-3 HUFAs（也包括二十二碳六烯酸[DHA]）和不同的EPA胶囊依从性可能会混淆试验结果的分析。目的：在seAFOod试验的二次分析中，探讨每日总（饮食和胶囊）omega-3 HUFA摄入量、红细胞（RBC）和直肠粘膜omega-3 HUFA水平与结直肠息肉结局之间的关系。方法：使用EPIC-Norfolk脂肪酸营养数据库，从食物频率问卷中获得个体参与者饮食中omega-3 HUFA摄入量（mg/d）。调整胶囊EPA摄入量（mg/d）以适应（胶囊计数）。脂肪酸用液相色谱-串联质谱法分析（占总脂肪酸的百分比）。HUFA氧化测定为HUFA/饱和脂肪酸（SAT）比值。结直肠息肉检出率[PDR；根据试验期间RBC EPA水平的变化（ΔEPA），无论治疗分配如何，对每个参与者的息肉数量进行分析。结果：在研究地点储存于- 80℃以上的红细胞样本中，随着时间的推移，HUFA降解程度较低(r=-0.36, P+0.5%点（ΔEPAhigh），无论分配给EPA或安慰剂，PDR低于ΔEPAlow个体(优势比0.63(95%可信区间[CI] 0.40,1.01)，结肠直肠息肉数量减少（发病率比0.74[95%可信区间[CI] 0.54,1.02]）。结论：根据EPA水平的变化而不是治疗分配来分析seAFOod试验，揭示了EPA治疗对结直肠息肉复发的保护作用（ISRCTN05926847）。

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来源期刊

Journal of Nutrition 医学-营养学

CiteScore

7.60

自引率

4.80%

发文量

260

审稿时长

39 days

期刊介绍： The Journal of Nutrition (JN/J Nutr) publishes peer-reviewed original research papers covering all aspects of experimental nutrition in humans and other animal species; special articles such as reviews and biographies of prominent nutrition scientists; and issues, opinions, and commentaries on controversial issues in nutrition. Supplements are frequently published to provide extended discussion of topics of special interest.