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. 2021 Aug 7;151(8):2125-2133.
doi: 10.1093/jn/nxab109.

Erythrocyte Long-Chain ω-3 Fatty Acids Are Positively Associated with Lean Mass and Grip Strength in Women with Recent Diagnoses of Breast Cancer

Martha A Belury  1 , Rachel M Cole  1   2 , Rebecca Andridge  3 , Ashleigh Keiter  3 , Subha V Raman  4 , Maryam B Lustberg  5 , Janice K Kiecolt-Glaser  6
Affiliations

Erythrocyte Long-Chain ω-3 Fatty Acids Are Positively Associated with Lean Mass and Grip Strength in Women with Recent Diagnoses of Breast Cancer

Martha A Belury et al. J Nutr. .

Abstract

Background: Sarcopenia may hasten the risk of mortality in women with breast cancer. Long-chain omega-3 (n-3) polyunsaturated fatty acids (LCn-3PUFAs) may favor muscle mass which, in turn, could enhance resilience of cancer patients toward cancer treatment.

Objectives: The objective of this study was to measure the relation of erythrocyte LCn-3PUFA concentrations with lean mass, grip strength, and postprandial energy metabolism in women with newly diagnosed breast cancer.

Methods: This cross-sectional analysis evaluated women (n = 150) ages 65 y and younger who were recently diagnosed with breast cancer (stages I-III). Erythrocyte LCn-3PUFA composition was measured using GC. Body composition was measured by DXA. Grip strength was assessed at the same visit. Postprandial energy metabolism was measured for 7.5 h after the consumption of a high-calorie, high-saturated-fat test meal using indirect calorimetry. Associations of fatty acids with outcomes were analyzed using multiple linear regression models and linear mixed-effects models.

Results: The ω-3 index, a measurement of LCn-3PUFA status, was positively associated with appendicular lean mass (ALM)/BMI (β = 0.015, P = 0.01) and grip strength (β = 0.757, P = 0.04) after adjusting data for age and cancer stage. However, when cardiorespiratory fitness was also included in the analyses, these relations were no longer significant (P > 0.08). After a test meal, a higher ω-3 index was associated with a less steep rise in fat oxidation (P = 0.02) and a steeper decline in glucose (P = 0.01) when adjusting for age, BMI, cancer stage, and cardiorespiratory fitness.

Conclusions: The ω-3 index was positively associated with ALM/BMI and grip strength in women newly diagnosed with breast cancer and was associated with altered postprandial substrate metabolism. These findings warrant further studies to determine whether enriching the diet with LCn-3PUFAs during and after cancer treatments is causally linked with better muscle health and metabolic outcomes in breast cancer survivors.

Keywords: breast cancer; diet history questionnaire; fatty acid composition; fish oil; grip strength; lean mass; omega-3 PUFAs; postprandial metabolism.

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Figures

FIGURE 1
FIGURE 1
Flow diagram of screening and enrollment for the study cohort. DCIS, ductal carcinoma in situ; LCIS, lobular carcinoma in situ; V, visit.
FIGURE 2
FIGURE 2
Predicted slopes of postprandial fat oxidation (A), glucose (B), insulin (C), and REE (D) as a function of premeal ω-3 index, among women newly diagnosed with breast cancer. Low and high values of the ω-3 index used for plotting are the 25th (3.24%) and 75th (4.81%) percentiles, respectively. REE, resting energy expenditure.
FIGURE 3
FIGURE 3
The ω-3 index in FO supplement users compared with FO supplement nonusers differs among women newly diagnosed with breast cancer. *P < 0.05. FO, fish oil.
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