Receipt of omega-3 PUFA-enriched ONS was associated with a potential myeloprotective effect and more favorable short-term weight outcomes, but not with a consistent reduction in systemic inflammation in malnourished GI cancer patients.
Key Findings
Results
Omega-3 PUFA-enriched ONS was associated with higher week-3 body weight compared to dietary counseling alone in malnourished GI cancer patients.
Adjusted difference in body weight at week 3: 1.49 kg (95% CI, 0.58–2.39; P = 0.002)
Adjusted difference in BMI at week 3: 0.51 kg/m² (95% CI, 0.19–1.02; P = 0.002)
Linear regression models were adjusted for corresponding baseline value, tumor site, and weight-loss status
Study population was 87 malnourished or nutritionally at-risk GI cancer patients observed over 3 weeks
Results
ONS receipt was associated with higher week-3 white blood cell and neutrophil counts, suggesting a potential myeloprotective effect.
Adjusted difference in WBC count: 1.08 × 10⁹/L (95% CI, 0.24–1.92; P = 0.012)
Adjusted difference in neutrophil (NE) count: 0.97 × 10⁹/L (95% CI, 0.30–1.64; P = 0.005)
Unadjusted change analyses showed a smaller decline in neutrophil count in the ONS group (P for Δ = 0.007)
Between-group differences in WBC and platelet changes were not statistically significant in unadjusted analyses
Results
Omega-3 PUFA-enriched ONS was not associated with a consistent reduction in systemic inflammation markers.
Platelet (PLT), C-reactive protein (CRP), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), albumin (ALB), and prognostic nutritional index (PNI) did not differ significantly between groups in adjusted models
Adjusted NLR was higher in the ONS group (adjusted difference, 0.60; 95% CI, 0.07–1.13; P = 0.028), not lower
Larger reductions in NLR, PLR, and SII in the control group coincided with greater declines in NE and PLT and were not interpreted as evidence of anti-inflammatory benefit
Methods
The two study groups differed at baseline in tumor site, body-weight status, and recent weight loss, but not in oncological treatment category or supportive treatment.
46 patients received omega-3 PUFA-enriched ONS plus dietary counseling; 41 received dietary counseling alone
Baseline differences included tumor site, body-weight status, and recent weight loss
Oncological treatment category and supportive treatment did not differ statistically between groups
This was a retrospective cohort study with an observation period of 3 weeks
Results
The unadjusted reduction in NLR, PLR, and SII observed in the control group was attributed to declines in neutrophil and platelet counts rather than genuine anti-inflammatory benefit.
Larger reductions in NLR, PLR, and SII occurred in the control (dietary counseling only) group
These reductions coincided with greater declines in NE and PLT in the control group
Authors explicitly stated these patterns were 'not interpreted as evidence of an anti-inflammatory benefit'
This finding highlights a potential confound in interpreting ratio-based inflammation indices in oncology nutritional studies
What This Means
This research suggests that giving malnourished gastrointestinal cancer patients a specialized nutritional supplement enriched with omega-3 fatty acids (a type of healthy fat found in fish oil) after hospital discharge may help them maintain or gain body weight and protect certain blood cells. In this study of 87 patients observed over three weeks, those who received the supplement along with dietary counseling had significantly better outcomes for body weight, body mass index, and white blood cell and neutrophil counts compared to patients who received dietary counseling alone. Neutrophils are a type of immune cell important for fighting infection, and cancer treatments can often reduce their numbers, so preserving them may be clinically meaningful.
However, the supplement did not clearly reduce markers of systemic inflammation such as C-reactive protein, albumin, or several inflammation ratio scores. Interestingly, the control group (no supplement) showed larger apparent reductions in inflammation ratio scores, but this was because their neutrophil and platelet counts fell more sharply — meaning the ratios looked better mathematically, but not because inflammation was actually improving. The authors caution that these ratio-based measures can be misleading in this context.
This research suggests omega-3-enriched oral nutritional supplements may offer meaningful nutritional and blood cell benefits for cancer patients recovering at home after hospitalization, particularly in preserving body weight and immune cell counts. However, the study's retrospective and non-randomized design means the groups were not perfectly matched at the start, and longer or more controlled studies would be needed to draw firmer conclusions about inflammation and other outcomes.
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Hu S, McDonald S, Hu Z, Yu H. (2026). Association of Omega-3 PUFA Oral Nutritional Supplementation with Hematological and Nutritional Status in Discharged Malnourished GI Cancer Patients.. Journal of visualized experiments : JoVE. https://doi.org/10.3791/71894