Omega 3 Fish Oil for Liver Disease
Studies have shown that people with liver disease tend to have low concentrations of long chain Omega 3 polyunsaturated fatty acids in their liver cells. For example, an increase in fat droplet size in the liver cells has been associated with a reduction in the Omega 3 fatty acid Eicosapentaenoic acid or EPA. Why this is the case is currently unclear but the role of fish oil as a possible treatment and perhaps preventative measure for liver disease remains an area of investigation.
Can Omega 3 inhibit liver cancer cells?
Two recent studies by the University of Pittsburgh and presented at the annual meeting of the American Association for Cancer Research in Washington DC, (April 2006) indicate that Omega 3 fatty acids appear to slow down the growth of liver cancer cells and reduce levels of beta-catenin. Elevated levels of beta-catenin have been associated with the development of a variety of tumours.
One of the studies investigated hepatocellular cancer, the most common type of liver cancer, the other investigated cholangiocarcinoma a form of cancer arising in the part of the liver that carries bile. Both studies involved treating the cancer cells with either Omega 3 (EPA and DHA) or Omega 6 fatty acid (AA) for a period of 12 to 48 hours.
The findings of both these studies were that Omega 3 treatment inhibited cell growth and that it was dose-dependent whereas the Omega 6 had no effect. Dr Tong Wu and colleagues thought that the Omega 3 effect was most likely due to the introduction of apoptosis or programmed death of the cells.
Omega 3 and Fatty Liver
A fatty liver is one where more than 10% of the liver is composed of fat. This build up of fat can occur for a number of reasons including alcohol abuse, obesity, hyperlipidemia (too much cholesterol and triglycerides in the blood), diabetes, and poisoning. The two major types of fatty liver can be divided into alcoholic and non-alcoholic types but both are precursors of serious liver disease including hepatitis and cirrhosis.
The simplest form of fatty liver is known as steatosis and is a result of an accumulation of fat in the liver but doesn't appear to cause liver damage. However, steatohepatitis is a more serious form of fatty liver and is associated with inflammation and liver damage possibly leading to permanent scarring and cancer. Why a liver becomes fatty in the first place is not well understood but is thought to be linked to a number of factors including increased absorption of fat from the intestines and a decreased ability to remove the fat from the liver. Those most at risk of non-alcoholic fatty liver disease are people who are overweight, those with diabetes and those who have high cholesterol and triglyceride levels.
It is already known that long chain polyunsaturated fatty acids found in fish oil have anti-inflammatory properties and can lower LDL (low-density lipoprotein) cholesterol and lower triglycerides, and that they have a blood-thinning effect. Studies also indicate that they can reduce the fatty droplet deposits to the liver as well as improve insulin resistance and general liver function.
A long term pilot study conducted by researchers Capanni and colleagues at the Department of Clinical Pathophysiology in Florence, Italy suggests that long chain polyunsaturated Omega 3 fatty acids could have a role in improving non-alcoholic fatty liver disease. 42 patients with non-alcoholic fatty liver disease were given Omega 3 for a year, 14 participants acted as the controls. Those on Omega 3 had decreased levels of aspartate transaminase (AST) and alanine transaminase (ALT) as well as lower levels of gamma-glutamyl transpeptidase and fasting glucose when compared with controls. High levels of AST are an indication of liver disease. The ratio of Omega 6 to Omega 3 was also reduced and an ultrasound scan showed improvements to the liver.
Research
One interesting area of research is developing involving Omega 3 fatty acids and parenteral nutrition. This is where patients who cannot eat normally are fed intravenously and it is known that prolonged feeding in this way can lead to serious liver damage, particularly in babies and small children. Researchers at the Childrens Hospital in Boston and published in the July 2006 issue of Paediatrics, discovered that if the type of intra-venous fluid is changed from the usual Omega 6 base to Omega 3, the liver doesn't appear to get damaged.
Conclusion
The early indications are that fish oil supplementation has the potential to offer therapeutic benefits as well as preventative measures for liver disease and although more research is required the future does look promising. In the meantime fish oil supplementation can offer a number of positive health benefits but it is important when choosing a supplement not to opt for cod liver oil due to its vitamin A content, which can put extra pressure on the liver. It is also advisable not to take one of the standard grade fish oils as the quantity of Omega 3 fatty acids they contain can vary and they can also contain impurities. Fish oil that is highly concentrated and of a pharmaceutical grade is the best way to ensure you get the maximum health benefits from a fish oil.
