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Lipids in Parenteral Nutrition: Biological Aspects
Author(s) -
Calder Philip C.,
Waitzberg Dan L.,
Klek Stanislaw,
Martindale Robert G.
Publication year - 2020
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1002/jpen.1756
Subject(s) - fish oil , docosahexaenoic acid , eicosapentaenoic acid , polyunsaturated fatty acid , soybean oil , food science , parenteral nutrition , linoleic acid , lipid metabolism , chemistry , lipid signaling , fatty acid , biology , biochemistry , fish <actinopterygii> , medicine , fishery , receptor
Lipid emulsions are an integral part of parenteral nutrition, and traditionally have been regarded as an energy‐dense source of calories and essential fatty acids. For many years, lipids used in parenteral nutrition have been based on vegetable oils (eg, soybean‐oil emulsions). However, soybean‐oil emulsions may not have an optimal fatty‐acid composition under some circumstances when used as the only lipid source, as soybean oil is particularly abundant in the ω‐6 polyunsaturated fatty acid (PUFA), linoleic acid. Hence, a progressive series of more complex lipid emulsions have been introduced, typically combining soybean oil with 1 or more alternative oils, such as medium‐chain triglycerides (MCTs) and/or olive oil and/or fish oil. The wide range of lipid emulsions now available for parenteral nutrition offers opportunities to alter the supply of different fatty acids, which potentially modifies functional properties, with effects on inflammatory processes, immune response, and hepatic metabolism. Fish oil has become an important component of modern, composite lipid emulsions, in part owing to a growing evidence base concerning its biological effects in a variety of preclinical models. These biological activities of fish oil are mainly attributed to its ω‐3 PUFA content, particularly docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). DHA and EPA have known mechanisms of action, anti‐inflammatory, immunomodulatory, and antioxidative properties. Specialized proresolving mediators, such as resolvins, protectins, and maresins, are synthesized directly from DHA and EPA, are key for the resolution of inflammation, and improve outcomes in many cell‐ and animal‐based models and, recently, in some clinical settings.

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