title: Effects of unsaturated fat dietary supplements on blood lipids, and on markers of malnutrition and inflammation in hemodialysis patients.
abstract: OBJECTIVE
  We examined the effects of commercially available unsaturated fat dietary supplements on blood lipids, and on markers of malnutrition and inflammation, in an adult population of hemodialysis (HD) patients.
  
  
  METHODS
  This was a restricted, randomized (equal blocks), investigator-blinded 2x6 week crossover trial, without a washout interval.
  
  
  METHODS
  This study was conducted at the Department of Nephrology, Copenhagen University Hospital Herlev, Herlev, Denmark, in spring 2007.
  
  
  METHODS
  Participants included 40 (30 males and 10 females) stable, adult patients undergoing regular HD, with a mean age of 64.6 years and a mean body mass index of 23.3kg/m(2).
  
  
  METHODS
  In addition to patients' habitual diets, oral unsaturated fat supplements (90mL of Calogen [SHS International, Ltd., Liverpool, UK] and 4 capsules of Pikasol [Dansk Droge, Ishoej, Denmark]) were given in one period, whereas no supplements were given in the other. Dietary supplements contributed 1.8 MJ (430kcal), 47g fat, 26.5g monounsaturated fatty acids, and 3g marine n-3 polyunsaturated fatty acids per day. Blood sampling and nutritional assessments were performed at baseline, after 6 weeks, and after 12 weeks.
  
  
  METHODS
  Dietary intakes, blood lipids, dry body weight, serum albumin, and serum C-reactive protein comprised our main outcome measures.
  
  
  RESULTS
  According to a per-protocol analysis of 14 study completers, fat supplementation resulted in significantly increased total energy intake (+1.6 MJ/day, or 380kcal/day) and an increased dietary fat energy percentage (+9%). We observed no significant changes in blood lipids. Dry body weight (+0.49kg, P=.04) increased, and serum C-reactive protein concentration fell (-1.69mg/L, P=.01), with fat supplementation. Intention-to-treat analysis of 39 participants confirmed the absence of adverse blood-lipid changes.
  
  
  CONCLUSIONS
  Unsaturated fat supplementation increased total dietary energy intake to recommended levels, had no adverse impact on blood lipids, improved nutritional status as assessed according to dry body weight, and reduced systemic inflammation as assessed according to C-reactive protein serum concentrations. Adding unsaturated fat to the diet seems to be a safe and effective way to prevent and treat malnutrition in hemodialysis patients.
authors.affiliation: Department of Internal Medicine, Copenhagen University Hospital, Frederiksberg, Denmark.
authors.forename: Bettina
authors.initials: B
authors.lastname: Ewers
authors.forename: Ulf
authors.initials: U
authors.lastname: Riserus
authors.forename: Peter
authors.initials: P
authors.lastname: Marckmann
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000032:analysis*; D001835:Body Weight; D002097:C-Reactive Protein / Q000032:analysis; D018592:Cross-Over Studies; D004042:Dietary Fats, Unsaturated / Q000008:administration & dosage*; D019587:Dietary Supplements; D002149:Energy Intake; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage; D005260:Female; D005395:Fish Oils / Q000008:administration & dosage; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000517:prevention & control*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008055:Lipids / Q000097:blood*; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000517:prevention & control*; D008875:Middle Aged; D009752:Nutritional Status; D006435:Renal Dialysis
chemical_list: D015415:Biomarkers; D004042:Dietary Fats, Unsaturated; D015525:Fatty Acids, Omega-3; D005395:Fish Oils; D008055:Lipids; D002097:C-Reactive Protein