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. 2023 Oct 23;12(4):304–319. doi: 10.7762/cnr.2023.12.4.304

Table 4. Characteristics of the studies for omega-3 fatty acid supplementation through enteral nutrition support.

Author/Year/Country Study design Participants Control treatment, No. of subjects (M, F) Intervention, No. of subjects (M, F) Duration of the intervention Outcomes of interest Risk of bias*
Abe et al. [40]/2018/Japan Single-arm intervention • Patients with pancreatic and bile duct cancer who underwent chemotherapy n = 27 (16 M, 11 F) 8 wk • Skeletal muscle mass Moderate
• Average BMI range: 25.9 kg/m2 Racol®, an enteral nutrient formulated with omega-3 (2–4 packs/200 kcal/300 mg of omega-3 fatty acids per pack)
Van der Meij et al. [38]/2012/The Netherland RCT-parallel, double blind • Patients with non-small cell lung cancer aged 18–80 yr n = 20 (5 M, 15 F) n = 20 (16 M, 4 F) 5 wk • Handgrip strength Some concerns
• Average BMI range: 23.0-24.8 kg/m2 Two packages per day of an iso-caloric control oral nutritional supplement (Ensure, Control) Omega-3 (2.02 g EPA, 0.92 g DHA) added in same volume nutritional supplement (ProSure, Intervention) with control group
Ryan et al. [37]/2009/Ireland RCT-parallel • Patients with esophageal cancer n = 25 (M:F = 14:1) n = 28 (M:F = 24:4) 3 wk • Lean body mass Some concerns
• Average BMI range: 24.6-27.1 kg/m2 Iso-caloric and iso-nitrogenous standard nutritional feed without EPA Omega-3 (EPA 2.2 g/d + Enteral feed)
Bauer et al. [39]/2005/Australia Single-arm intervention • Patients with pancreatic cancer, or non-small cell lung cancer n = 7 (5 M, 2 F) 8 wk • Lean body mass Moderate
• Average BMI range: 26.8 kg/m2 16 g protein and 1.1 g EPA, as enriched oral nutritional supplement

RCT, randomized controlled trial; EPA, eicosapentaenoic acid; DHA, docosahexaenoic acid; BMI, body mass index.

*Risk of bias was assessed using a revised Cochrane risk-of-bias tool for randomized trials (ROB2) for RCT studies and using a “risk of bias in non-randomized studies of interventions (ROBINS-I) for single-arm interventional studies.