title: Gender differences in the effect of fish oil on appetite, inflammation and nutritional status in haemodialysis patients.
abstract: BACKGROUND
  Haemodialysis patients show signs of chronic inflammation and reduced appetite, which is associated with a worse clinical status and an increased mortality risk. Fish oil has anti-inflammatory properties and may be useful as a therapeutic treatment. There is limited evidence to indicate the feasibility and efficacy of this intervention in dialysis patients. The present study aimed to compare the effect of 12 weeks of supplementation with fish oil on markers of appetite and inflammation in male and female haemodialysis patients.
  
  
  METHODS
  The study was conducted in 28 haemodialysis patients. All patients were prescribed 3 g of fish oil per day for 12 weeks. Changes in appetite, plasma fatty acid profiles and inflammatory markers were measured at baseline and at 12 weeks.
  
  
  RESULTS
  The mean (SD) increase in percent plasma eicosapentaenoic acid was statistically significant [1.1 (0.8) to 4.1 (2.2), P < 0.001], which was a strong indicator of good adherence. There were trends towards reductions in peptide YY (-9%; P = 0.078) and an increase in subjective sensations of hunger (+12%; P = 0.406), which reflects an increase in motivation to eat. Males (n = 13) experienced a more marked increase in hunger compared to females (+23% versus -6%), which was associated with maintenance in C-reactive protein and interleukin-6, and a reduction in soluble intercellular adhesion molecule-1.
  
  
  CONCLUSIONS
  The results obtained demonstrate meaningful trends towards improvements in subjective appetite and certain inflammatory markers (although no change in dietary intake) and this effect was more pronounced in males. However, the levels of some inflammatory markers increased in females and this requires further study. The high level of adherence achieved indicates that an intervention requiring patients to consume four fish oil capsules per day is achievable. This was a short-term study and the effects need to be confirmed in a randomised controlled trial.
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia. r.zabel@qut.edu.au
authors.forename: R
authors.initials: R
authors.lastname: Zabel
authors.forename: S
authors.initials: S
authors.lastname: Ash
authors.forename: N
authors.initials: N
authors.lastname: King
authors.forename: E
authors.initials: E
authors.lastname: Naslund
authors.forename: J
authors.initials: J
authors.lastname: Bauer
mesh_terms: D000368:Aged; D001066:Appetite / Q000187:drug effects*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000187:drug effects; D019587:Dietary Supplements; D005227:Fatty Acids / Q000097:blood; D005240:Feasibility Studies; D001068:Feeding and Eating Disorders / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005395:Fish Oils / Q000097:blood / Q000627:therapeutic use*; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000209:etiology / Q000517:prevention & control; D015850:Interleukin-6 / Q000097:blood; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status / Q000187:drug effects*; D006435:Renal Dialysis / Q000009:adverse effects*; D017678:Sex Distribution; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D005227:Fatty Acids; D005395:Fish Oils; D015850:Interleukin-6; D002097:C-Reactive Protein