Antioxidant Micronutrients and Essential Fatty Acids Supplementation on Cystic Fibrosis Outcomes: A Systematic Review.
Study Goal
The researchers aimed to evaluate the effects of choline supplementation, among other nutrients, on nutritional and clinical outcomes in patients with cystic fibrosis.
Results Summary
The study found that choline was part of a lipid matrix supplementation, but specific effects of choline alone were not detailed. Overall, fatty acids supplementation showed some improvements in pulmonary function and nutritional status.
Population
Patients with cystic fibrosis.
Effective Dosage
Not specified for choline alone.
Duration
Not specified for choline alone.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
magnesium supplementation | increase | pulmonary function | patients with cystic fibrosis (CF) | - | A significant improvement was observed | #1 |
essential fatty acids supplementation | increase | pulmonary function | patients with cystic fibrosis (CF) | - | A significant improvement was observed | #2 |
beta-carotene supplementation | decrease | pulmonary exacerbations | patients with cystic fibrosis (CF) | - | less pulmonary exacerbations | #3 |
zinc supplementation | decrease | pulmonary exacerbations | patients with cystic fibrosis (CF) | - | less pulmonary exacerbations | #4 |
antioxidant-enriched multivitamin supplementation | decrease | pulmonary exacerbations | patients with cystic fibrosis (CF) | - | less pulmonary exacerbations | #5 |
essential fatty acids supplementation | decrease | pulmonary exacerbations | patients with cystic fibrosis (CF) | - | less pulmonary exacerbations | #6 |
antioxidant-enriched multivitamin supplementation | decrease | inflammatory markers | patients with cystic fibrosis (CF) | - | significant reductions | #7 |
EPA/DHA supplementation | decrease | inflammatory markers | patients with cystic fibrosis (CF) | - | significant reductions | #8 |
antioxidants supplementation | no change | nutritional status | patients with cystic fibrosis (CF) | - | was not modified | #9 |
fatty acids supplementation | increase | nutritional status | patients with cystic fibrosis (CF) | - | there was an improvement | #10 |
BACKGROUND: Antioxidant micronutrients and essential fatty acids supplementation intake appears to have a protective effect in some diseases such as cardiovascular disease, cancer, and asthma. OBJECTIVE: The aim of this study was to perform a systematic review to evaluate the effects of these nutrients on nutritional and clinical outcomes of patients with cystic fibrosis (CF). METHODS: This is a systematic review of randomized clinical trials (RCTs) in CF. MEDLINE (via PubMed), Embase, and Scopus databases were searched for RCTs published from 1948 through February 2019. Two investigators independently reviewed the titles and abstracts and then extracted the data from the included studies using a standardized predesigned form. Two reviewers independently performed the quality assessment of the RCTs according to the Cochrane risk of bias tools. RESULTS: A total of 4,792 studies were identified, and 23 were eligible (8 antioxidant micronutrient and 15 essential fatty acids). The interventions found were beta-carotene, zinc, magnesium, multivitamin, docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), linoleic acid and lipid matrix with choline supplementation. A significant improvement was observed in: (a) pulmonary function with magnesium (n=1) and essential fatty acids (n=2) supplementation; (b) less pulmonary exacerbations with beta-carotene (n=1), zinc (n=1), antioxidant-enriched multivitamin (n=1) and essential fatty acids (n=2) supplementation. One study with antioxidant-enriched multivitamin and four studies with EPA/DHA supplementation reported significant reductions in inflammatory markers. Nutritional status was not modified by antioxidants supplementation in any of the studies, while in five studies there was an improvement with fatty acids supplementation. The risk of bias of the majority of the parallel studies was high. CONCLUSIONS: The benefits of antioxidants or DHA/EPA supplementation for CF, although observed in some studies, are not consistent enough to recommend routine use of these supplements. The mechanisms of action of these nutrients, dose levels and timing should be further explored in future studies.