Publication: The effects of combined omega-3 and vitamin d supplementation on nutritional status, quality of life and inflammatory biomarkers among the breast cancer women in gaza strip, Palestine: a randomised controlled trial
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Date
2025-01
Authors
Almassri, Heba F. H.
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Abstract
Breast cancer (BC) is a leading cause of cancer-related mortality worldwide, particularly among women. Early nutritional care is essential to prevent cancer cachexia, improve overall health, and enhance the quality of life (QoL) for BC patients. This study aimed to assess the impact of omega-3 fatty acids (ω3) and vitamin D3 (VitD) supplementation on nutritional status, QoL, blood biomarkers, and dietary intake in newly diagnosed BC women in Gaza, Palestine. In this 9-week randomized, controlled, open-labelled trial, 96 participants were recruited and randomly assigned to one of four groups: i) ω3 group, ii) VitD group, iii) ω3+VitD group, and iv) control group. The intervention groups received either two daily 300mg ω3 capsules and/or one weekly 50,000 IU VitD tablet. Outcome measures included patient-generated subjective global assessment (PG-SGA) scores, anthropometric measurements, dietary intake analysis via 24-hour recall, and QoL assessments using the EORTC QLQ-C30 and QLQ-BR23, serum albumin, serum tumour necrosis factor-alpha (TNF-α), serum high-sensitive C-reactive protein (hsCRP). Of the total 96 participants, 88 had completed at the end of study, achieving a 91.7% response rate. There was a significant increase in PG-SGA-derived nutritional risk scores (p<0.01), body weight, and body mass index (BMI) (both p<0.05) in the ω3+ VitD group compared to other groups. Furthermore, there was a significant rise in blood albumin levels (p< 0.05) compared
to baseline in the ω3+ VitD group. Dietary nutrient intake analysis demonstrated substantial increases in daily energy and protein intake in both the ω3+VitD group and the ω3 group alone (both p<0.05) compared to the baseline. Significant differences in total global health status (p<0.01) among ω3+VitD group were observed compared to other groups, and women in the ω3+ VitD group reported significantly higher functional scores (all p<0.05), and lower scores for fatigue (p<0.01), nausea and vomiting, pain, and appetite loss (all p<0.05), compared to the baseline. Notably, the ω3+ VitD group showed a significant reduction in serum hsCRP and TNF-α (both p<0.05) from the baseline, and significant differences in TNF-α (p<0.05) and hsCRP (p< 0.001) were noted between groups at the trial's end. Overall, combined ω3 and VitD supplementation significantly improved nutritional status, QoL, and inflammatory markers among BC women who had undergoing an active treatment. These findings highlight the potential use of ω3 and VitD supplements as an effective adjuvant therapy in BC patient management, improving health outcomes and reducing inflammation, particularly in resource-limited settings. Hence, tailored nutritional guidelines and interventions are crucial for optimizing their nutritional care integration into the medical oncology care.