Eicosapentaenoic acid ethyl ester supplementation in cachectic cancer patients and healthy subjects: effects on lipolysis and lipid oxidation

Background & aims: Recent reports suggest that weight loss in cachectic can cer patients may be inhibited by supplementation of the n-3 fatty acid eico sapentaenoic acid (20.5n-3, EPA), presumably due to inhibition of lipolysis . The aim of the present double-blind, randomized trial was to assess wheth er short-term oral EPA ethyl ester (EE) supplementation inhibits lipolysis and lipid oxidation in weight-losing cancer patients and in healthy subject s. Methods: Seventeen weight losing, cancer patients of different tumor typ es, and 16 healthy subjects were randomized to receive EPA-EE (6 g/d) or pl acebo (oleic acid (OA)-EE; 6 g/d) for seven days. At baseline (day 0) and d uring supplementation (days 2 and 7) whole-body lipolysis and palmitic acid release were measured in the overnight fasting state using [1, 1, 2, 3, 3- H-2(5)] glycerol and [1-C-13] palmitic acid. Palmitate oxidation was determ ined by measuring (CO2)-C-13 enrichment in expired breath. Results: No sign ificant effects of EPA-EE on whole-body lipolysis, palmitic acid release, o r palmitate oxidation were detected in cancer patients nor in healthy subje cts in comparison with OA-EE. EPA-EE supplementation reduced plasma-free fa tty acid and triacylglycerol concentrations significantly in healthy subjec ts bur not in cancer patients. Conclusion: We conclude that supplementation of EPA-EE does not significant ly inhibit lipolysis or lipid oxidation in weight-losing cancer patients or in healthy subjects during short-term supplementation when using OA-EE as a placebo supplement. (C) 2000 Harcourt Publishers Ltd.