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Lookup NU author(s): Professor Colin Rees
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2024 The Author(s). Background: The seAFOod randomized controlled trial tested colorectal polyp prevention by the omega-3 (ω-3) highly unsaturated fatty acid (HUFA) eicosapentaenoic acid (EPA) and aspirin. Variable dietary intake of omega-3 HUFAs (also including docosahexaenoic acid [DHA]) and differential EPA capsule compliance could confound analysis of trial outcomes. Objective: The objective of this study was to investigate the relationship between total (diet and capsule) daily omega-3 HUFA intake, red blood cell (RBC), and rectal mucosa omega-3 HUFA concentrations, and colorectal polyp outcomes in a secondary analysis of the seAFOod trial. Methods: Individual-participant dietary omega-3 HUFA intake (mg/d) was derived from food frequency questionnaires using the European Prospective Investigation into Cancer and Nutrition-Norfolk fatty acid nutrient database. Capsule EPA intake (mg/d) was adjusted for compliance (capsule counting). Fatty acids were analyzed by liquid chromatography-tandem mass spectrometry (as % of total fatty acids). HUFA oxidation was measured using the HUFA/saturated fatty acid (SAT) ratio. The colorectal polyp detection rate (PDR; % with ≥1 polyps) and polyp number per participant were analyzed according to the change in RBC EPA concentrations during the trial (ΔEPA), irrespective of treatment allocation. Results: There was a small degree of HUFA degradation over time in RBC samples stored at > −80oC at research sites (r = −0.36, P<0.001 for HUFA/SAT ratio over time), which did not affect analysis of omega-3 HUFA concentrations. Low baseline EPA concentration, as well as allocation to EPA and % compliance, were associated with a high ΔEPA. Individuals with a ΔEPA value >+0.5% points (ΔEPAhigh), irrespective of allocation to EPA or placebo, had a lower PDR than ΔEPAlow individuals (odds ratio: 0.63; 95% confidence interval [CI]: 0.40, 1.01) and reduced colorectal polyp number (incidence rate ratio: 0.74; 95% CI: 0.54, 1.02). Conclusions: Analysis of the seAFOod trial according to the change in EPA concentration, instead of treatment allocation, revealed a protective effect of EPA treatment on colorectal polyp recurrence (ISRCTN05926847).
Author(s): Sun G, Fuller H, Fenton H, Race AD, Downing A, Rees CJ, Brown LC, Loadman PM, Williams EA, Hull MA
Publication type: Article
Publication status: Published
Journal: Journal of Nutrition
Year: 2025
Pages: Epub ahead of print
Online publication date: 13/12/2024
Acceptance date: 06/12/2024
Date deposited: 04/02/2025
ISSN (print): 0022-3166
ISSN (electronic): 1541-6100
Publisher: Elsevier BV
URL: https://doi.org/10.1016/j.tjnut.2024.12.004
DOI: 10.1016/j.tjnut.2024.12.004
Data Access Statement: The biomarker, as well as linked clinical and trial outcomes, datasets described in this report contain identifiable data, which are stored in a secure virtual research environment at the University of Leeds. Data will be anonymized and exported upon request to the Principal Investigator (Professor Hull) and the Study Sponsor (University of Leeds).
PubMed id: 39675479
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