Fish Oil Saves Babies

 Dear All, 

If I had to pick one nutrient to tell you about, I’d probably start with fish oil and omega-3 fatty acids: get yourself a good bottle, or eat some flaxseeds, or wild deep sea fish!  Now.

But before I go on, you should know that I’m heavily biased.  Right now, I’m in a pediatric surgery lab at the Children’s Hospital of Boston, and the team here has seen firsthand how fish oil can save babies with short gut.  Plus, Dr. Bruce Bistrian, an esteemed professor of medicine and clinical nutrition, has been very kind to take about three hours explaining to me how fish oil works biochemically.  So, I guess you could expect that I’d be excited about fish oil.   But I am also aware that when people get excited, they can get incredibly carried away, like some authors of “superfoods” or “miraculous detox” books that you bump into at a bookstore. 

That said,  special things do happen, and I wanted to tell you a short story about it.  But I hope I don’t get carried away, and I hope can be objective…  

Prior to 2005, children with short gut, or more formally, “short bowel syndrome,” had a very difficult life.  Many of them couldn’t eat because their guts were too short, due to birth defects or injury.   Because their intestines weren’t functioning, nutrients had to be given intravenously through a process called “parenteral nutrition.”  Everyday, the children had to live with needles stuck into their veins in order to receive liquidized food formula – it was highly unpleasant.

The hope was that, while on parenteral nutrition, the babies’ guts could get healthy enough to start absorbing food.   Ever so often, however, the gut just never recovered, at which point the baby would have to rely on parenteral nutrition for an indefinite period of time.

When that happens, the outlook immediately dims.  Patients on long-term parenteral nutrition often develop serious liver problems that lead to death from liver failure.  The only option at that point would be a liver transplant.  It’s an option, but not a cure, and waiting on the transplantation list can be excruciating for parents.  If the babies did not get the transplant, they would die; this was the conventional wisdom for decades. 

But when 2005 came around, a medical team here in Boston with an inclination for fish decided they were going to give babies none other than…fish oil.  You might be wondering, where in the world did they get that idea?  And if it’s such a great idea, why did it take so long to figure out?  The team did previously test the idea on mouse models, which showed promise.  But perhaps more importantly, when faced with an emergency, you find new avenues of inspiration? 

I’m not sure what was the catalyst, but what I do know was that the fish oil worked.  Once the medical team started pumping omega-3 fatty acids into the babies’ veins, their livers started to heal — so much so that even extremely ill patients who were waiting for liver transplantations no longer needed transplants! 

All of the above that I said is true, and, at least for me, it’s exciting to learn about.  But I did want to take a step back and point out that more research needs to be done — randomized controlled trials, larger studies.  And I think it’s important to point out that patients with short gut — even if they are on fish oil and are doing much better than anyone could ever expect — still have to fight courageously.  Their families still have to be very supportive, and sadly, some patients, regardless of their omega-3 fatty acid status, will pass away from other health complications related to their short gut problems.  

Nevertheless, things are encouraging.  It’s not often that you’ll find a serious article, published in a serious medical journal, begin with the word “reversal” when describing the effectiveness of a treatment.  Typically, treatments don’t “reverse” disease.  They “ameliorate,” or “improve outcomes.”  Editors are usually careful to save lofty words for only the most dramatic encounters.   In this case, when it came time to submit the report of fish oil for publication, this was the title: “reversal of parenteral nutrition–associated liver disease.” 

And without any changes, the editors accepted it.