In That Vein:  Parenteral Nutrition Education & Resources

Sharing the science behind PN therapies.

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The Role of Omega-9 (Olive Oil) in Parenteral Nutrition

Research shows olive oil-based intravenous lipid emulsion (ILE) may preserve immune function as it supports the innate immune system based on less infections seen in a large, randomized, controlled trial in ICU patients.21 Further, probably due to its high monounsaturated fatty acid (MUFA) and low polyunsaturated fatty acid (PUFA) content, olive oil-based ILE was shown to result in less lipid peroxidation compared to soybean oil-based ILEs.21

A review by Cai et al. provides a summary of evidence for how olive oil-based ILEs affect immune function and lipid peroxidation in vitro, in vivo (animal and human) and in clinical studies. Evidence suggests that olive oil-based ILE is a valuable option for a variety of patient populations requiring PN.22 

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Omega-9 in Acute Care

In a prospective, randomized, multi-center clinical trial, Jia et al. found significantly more patients (10.4%) who received omega-6 soybean oil-based ILE experienced infection compared to the patients who received omega-9 olive oil-based ILE (3.6%). Olive oil-based ILE improved the anabolic status of hospitalized patients compared to soybean oil-based lipids. Infections in patients who received olive oil were significantly lower than those who received soybean oil.1,21 

Salazar and colleagues, in a double-blind, randomized controlled trial found olive oil-based lipid emulsion to be non-inferior to soybean oil-based lipid emulsion in the acute care setting.23 

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Omega-9 in Home Care

In a prospective, comparative study, Osowska et al. found olive oil-based ILE resulted in reductions in gamma-glutamyl transferase (GGT) and interleukin 8, suggesting a favorable hepatobiliary response and reduced inflammation.24

Why Use More Omega-9 MUFA in Parenteral Nutrition?

Omega-9 fatty acids are a family of monounsaturated fatty acids that have only one double bond. Fatty acids have different effects on inflammation and cellular immunity.1-20

Inflammation and immune functions are essential biological activities in response to illness. Therefore, caution is advised when using ILEs with immune suppressive effects in patients with underlying immune suppression.3,16

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Omega-9 (olive oil)

Omega-9 (olive oil) monounsaturated fatty acids or MUFAs are considered immune neutral.2-4,17

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Omega-6 (soybean oil)

Omega-6 (soybean oil) polyunsaturated fatty acids or PUFAs stimulate2,5,6 or suppress2-4,8,17,18 inflammatory responses and suppress cellular immune functions.

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Omega-3 (fish oil)

Omega-3 (fish oil) fatty acids suppress inflammatory and immune responses2,6,7,13,14,17-19 and are associated with increased lipid peroxidation.9,10,12,15

Play Your Cards Right With Science Part III

Camilia R. Martin, MD, MS
The Real Science Behind Fatty Acids Metabolism

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LIPID FACTS: Biologic Effects of Fatty Acids

Fatty acids have different effects on inflammation and cellular immunity.1-20

Fatty Acid: Oleic

Cellular Inflammation: Neutral2-3

Cellular Immune Functions: Neutral2-4,17

Oxidation Potential (double bonds): Low3,9-12,15

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LIPID FACTS: Biologic Effects of Fatty Acids

Fatty acids have different effects on inflammation and cellular immunity.1-20

Fatty Acid: Linoleic, arachidonic

Cellular Inflammation: Stimulation2,5,6 and Suppression3,16

Cellular Immune Functions: Suppression2-4,8,17-18

Oxidation Potential (double bonds): Moderate3,9-12,15

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LIPID FACTS: Biologic Effects of Fatty Acids

Fatty acids have different effects on inflammation and cellular immunity.1-20

Fatty Acid: DHA, EPA (ALA)

Cellular Inflammation: Suppression2,6-7,14

Cellular Immune Functions: Suppression13-14,17-19

Oxidation Potential (double bonds): High9-10,12,15

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