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Effects of unsaturated fat dietary supplements on blood lipids, and on markers of malnutrition and inflammation in hemodialysis patients.

Abstract

OBJECTIVE

We examined the effects of commercially available unsaturated fat dietary supplements on blood lipids, and on markers of malnutrition and inflammation, in an adult population of hemodialysis (HD) patients.

DESIGN

This was a restricted, randomized (equal blocks), investigator-blinded 2x6 week crossover trial, without a washout interval.

SETTING

This study was conducted at the Department of Nephrology, Copenhagen University Hospital Herlev, Herlev, Denmark, in spring 2007.

PATIENTS

Participants included 40 (30 males and 10 females) stable, adult patients undergoing regular HD, with a mean age of 64.6 years and a mean body mass index of 23.3kg/m(2).

INTERVENTION

In addition to patients' habitual diets, oral unsaturated fat supplements (90mL of Calogen [SHS International, Ltd., Liverpool, UK] and 4 capsules of Pikasol [Dansk Droge, Ishoej, Denmark]) were given in one period, whereas no supplements were given in the other. Dietary supplements contributed 1.8 MJ (430kcal), 47g fat, 26.5g monounsaturated fatty acids, and 3g marine n-3 polyunsaturated fatty acids per day. Blood sampling and nutritional assessments were performed at baseline, after 6 weeks, and after 12 weeks.

MAIN OUTCOME MEASURES

Dietary intakes, blood lipids, dry body weight, serum albumin, and serum C-reactive protein comprised our main outcome measures.

RESULTS

According to a per-protocol analysis of 14 study completers, fat supplementation resulted in significantly increased total energy intake (+1.6 MJ/day, or 380kcal/day) and an increased dietary fat energy percentage (+9%). We observed no significant changes in blood lipids. Dry body weight (+0.49kg, P=.04) increased, and serum C-reactive protein concentration fell (-1.69mg/L, P=.01), with fat supplementation. Intention-to-treat analysis of 39 participants confirmed the absence of adverse blood-lipid changes.

CONCLUSIONS

Unsaturated fat supplementation increased total dietary energy intake to recommended levels, had no adverse impact on blood lipids, improved nutritional status as assessed according to dry body weight, and reduced systemic inflammation as assessed according to C-reactive protein serum concentrations. Adding unsaturated fat to the diet seems to be a safe and effective way to prevent and treat malnutrition in hemodialysis patients.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Internal Medicine, Copenhagen University Hospital, Frederiksberg, Denmark.

    ,

    Source

    MeSH

    Aged
    Biomarkers
    Body Weight
    C-Reactive Protein
    Cross-Over Studies
    Dietary Fats, Unsaturated
    Dietary Supplements
    Energy Intake
    Fatty Acids, Omega-3
    Female
    Fish Oils
    Humans
    Inflammation
    Kidney Failure, Chronic
    Lipids
    Male
    Malnutrition
    Middle Aged
    Nutritional Status
    Renal Dialysis

    Pub Type(s)

    Journal Article
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    19541503

    Citation

    Ewers, Bettina, et al. "Effects of Unsaturated Fat Dietary Supplements On Blood Lipids, and On Markers of Malnutrition and Inflammation in Hemodialysis Patients." Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, vol. 19, no. 5, 2009, pp. 401-11.
    Ewers B, Riserus U, Marckmann P. Effects of unsaturated fat dietary supplements on blood lipids, and on markers of malnutrition and inflammation in hemodialysis patients. J Ren Nutr. 2009;19(5):401-11.
    Ewers, B., Riserus, U., & Marckmann, P. (2009). Effects of unsaturated fat dietary supplements on blood lipids, and on markers of malnutrition and inflammation in hemodialysis patients. Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, 19(5), pp. 401-11. doi:10.1053/j.jrn.2009.04.006.
    Ewers B, Riserus U, Marckmann P. Effects of Unsaturated Fat Dietary Supplements On Blood Lipids, and On Markers of Malnutrition and Inflammation in Hemodialysis Patients. J Ren Nutr. 2009;19(5):401-11. PubMed PMID: 19541503.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Effects of unsaturated fat dietary supplements on blood lipids, and on markers of malnutrition and inflammation in hemodialysis patients. AU - Ewers,Bettina, AU - Riserus,Ulf, AU - Marckmann,Peter, Y1 - 2009/06/21/ PY - 2008/06/08/received PY - 2009/6/23/entrez PY - 2009/6/23/pubmed PY - 2009/12/16/medline SP - 401 EP - 11 JF - Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation JO - J Ren Nutr VL - 19 IS - 5 N2 - OBJECTIVE: We examined the effects of commercially available unsaturated fat dietary supplements on blood lipids, and on markers of malnutrition and inflammation, in an adult population of hemodialysis (HD) patients. DESIGN: This was a restricted, randomized (equal blocks), investigator-blinded 2x6 week crossover trial, without a washout interval. SETTING: This study was conducted at the Department of Nephrology, Copenhagen University Hospital Herlev, Herlev, Denmark, in spring 2007. PATIENTS: Participants included 40 (30 males and 10 females) stable, adult patients undergoing regular HD, with a mean age of 64.6 years and a mean body mass index of 23.3kg/m(2). INTERVENTION: In addition to patients' habitual diets, oral unsaturated fat supplements (90mL of Calogen [SHS International, Ltd., Liverpool, UK] and 4 capsules of Pikasol [Dansk Droge, Ishoej, Denmark]) were given in one period, whereas no supplements were given in the other. Dietary supplements contributed 1.8 MJ (430kcal), 47g fat, 26.5g monounsaturated fatty acids, and 3g marine n-3 polyunsaturated fatty acids per day. Blood sampling and nutritional assessments were performed at baseline, after 6 weeks, and after 12 weeks. MAIN OUTCOME MEASURES: Dietary intakes, blood lipids, dry body weight, serum albumin, and serum C-reactive protein comprised our main outcome measures. RESULTS: According to a per-protocol analysis of 14 study completers, fat supplementation resulted in significantly increased total energy intake (+1.6 MJ/day, or 380kcal/day) and an increased dietary fat energy percentage (+9%). We observed no significant changes in blood lipids. Dry body weight (+0.49kg, P=.04) increased, and serum C-reactive protein concentration fell (-1.69mg/L, P=.01), with fat supplementation. Intention-to-treat analysis of 39 participants confirmed the absence of adverse blood-lipid changes. CONCLUSIONS: Unsaturated fat supplementation increased total dietary energy intake to recommended levels, had no adverse impact on blood lipids, improved nutritional status as assessed according to dry body weight, and reduced systemic inflammation as assessed according to C-reactive protein serum concentrations. Adding unsaturated fat to the diet seems to be a safe and effective way to prevent and treat malnutrition in hemodialysis patients. SN - 1532-8503 UR - https://www.unboundmedicine.com/medline/citation/19541503/Effects_of_unsaturated_fat_dietary_supplements_on_blood_lipids_and_on_markers_of_malnutrition_and_inflammation_in_hemodialysis_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1051-2276(09)00097-1 DB - PRIME DP - Unbound Medicine ER -