Oral fish oil positively influences nutritional-inflammatory risk in patients with haematological malignancies during chemotherapy with an impact on long-term survival: a randomised clinical trial.

BACKGROUND: Studies suggest that the ingestion of fish oil (FO), a source of the omega-3 polyunsaturated fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), can reduce the deleterious side-effects of chemotherapy. The aim of this randomised clinical trial was to evaluate the effect of supplementation with oral FO for 9 weeks on nutritional parameters and inflammatory nutritional risk in patients with haematological malignancies during the beginning of chemotherapy. METHODS: Twenty-two patients with leukaemia or lymphoma were randomised to the unsupplemented group (UG) (n = 13) or supplemented group (SG) (n = 9). SG received 2 g/day of fish oil for 9 weeks. Nutritional status, serum acute-phase proteins and plasma fatty acids were evaluated before (T0) and after (T1) the intervention period. Data were analysed using two models; model 1, comprising data from all patients included in the study, and model 2, comprising data from UG patients with no increase in the proportions of EPA and DHA in plasma and data from SG patients showing an at least 100% increase in plasma EPA and DHA. RESULTS: SG showed an increased plasma proportion of EPA and DHA in both models. In model 2, C-reactive protein (CRP) and CRP/albumin ratio showed larger reductions in the SG. Overall long-term survival in both models (465 days after the start of the chemotherapy) was higher in the group ingesting fish oil (P < 0.05). CONCLUSIONS: These findings indicate an improved nutritional-inflammatory risk and potential effects on long-term survival in patients with haematological malignancies supplemented with FO during the beginning of chemotherapy.

Intestinal microbiota and HIV-1 infection

The intestinal microbiota consists of a qualitatively and quantitatively diverse range of microorganisms dynamically interacting with the host. It is remarkably stable with regard to the presence of microorganisms and their roles which, however, can be altered due to pathological conditions, diet composition, gastrointestinal disturbances and/or drug ingestion. The present review aimed at contributing to the discussion about changes in the intestinal microbiota due to HIV-1 infection, focusing on the triad infection-microbiota-nutrition as factors that promote intestinal bacterial imbalance. Intestinal microbiota alterations can be due to the HIV-1 infection as a primary factor or the pharmacotherapy employed, or they can be one of the consequences of the disease.

Lipid profile and body composition of HIV-1 infected patients treated with highly active antiretroviral therapy

Highly active antiretroviral therapy (HAART) has been associated with the development of a clinical group and metabolic disorders such as peripheral lipodystrophy syndrome in AIDS. The aim of this study was to analyse the lipid profile, the clinical aspects, and the body composition of HIV-1 infected individuals treated with or without protease inhibitor (PI) during the highly active antiretroviral therapy. In total, 62 individuals were evaluated in this study; 15 healthy individuals (Control Group; CG), 11 HIV-1 infected individuals treated without antiretroviral therapy (Group 1: G1), 14 HIV-1 infected individuals treated with antiretroviral therapy plus protease inhibitor (Group 2: G2), and 11 HIV-1 infected individuals treated with antiretroviral therapy without protease inhibitor (Group 3: G3), mean age 35 years old. The time interval for G2 and G3 was greater than or equal to nine months. Patients receiving HAART with PI had significantly lower viral loads, hypertriglyceridemia, and low HDL levels (p<0.05). There were no differences between groups in relation to the lean body mass percentage obtained by mid-arm muscle circumference adequacy or by bioelectrical impedance. The lower percentage of body fat observed in all the HIV-1 infected patients by antropometric assessment and the decreased tricipital skinfold adequacy in the group treated with PI in relation to CG may suggest lipodystrophy in the upper limbs, especially on those treated with PI