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
Sun, G. Fuller, H. Fenton, H. Race, Amanda D. Downing, A. Rees, C.J. Brown, L.C. Williams, E.A. Hull, M.A.
Sun, G.
Fuller, H.
Fenton, H.
Race, Amanda D.
Downing, A.
Rees, C.J.
Brown, L.C.
Williams, E.A.
Hull, M.A.
Publication Date
2024-02
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© 2024 The Author(s). Published by Elsevier Inc. on behalf of American Society for Nutrition. This is an open access article under the CC BY license
(http://creativecommons.org/licenses/by/4.0/).
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openAccess
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2024-12-06
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Abstract
Background: The seAFOod randomised controlled trial tested colorectal polyp prevention by the omega-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: To investigate the relationship between total (diet and capsule) daily omega-3 HUFA intake, red blood cell (RBC) and rectal mucosa omega-3 HUFA levels, 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 EPIC-Norfolk fatty acid nutrient database. Capsule EPA intake (mg/d) was adjusted for compliance (capsule counting). Fatty acids were analysed by liquid chromatography-tandem mass spectrometry (as % of total fatty acids). HUFA oxidation was measured as the HUFA/saturated fatty acid (SAT) ratio. The colorectal polyp detection rate [PDR; % with one or more polyps] and polyp number per participant were analysed according to the change in RBC EPA level during the trial (ΔEPA), irrespective of treatment allocation.
Results: There was a small degree of HUFA degradation over time in RBC samples stored at higher than minus 80oC at research sites (r=-0.36, P+0.5% points (ΔEPAhigh), irrespective of allocation to EPA or placebo, had a lower PDR than ΔEPAlow 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 level, instead of treatment allocation, revealed a protective effect of EPA treatment on colorectal polyp recurrence (ISRCTN05926847).
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Sun G, Fuller H, Fenton H et al (2024) 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. The Journal of Nutrition. 155(2): 549-558.
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Article