What is the interest of ribonucleotides, Vitamin D, Omega-3 (n3) fatty acids, and Arginine in a healthy, well-nourished patient?

From the Guidelines

There is no clear interest in supplementing ribonucleotides, Vitamin D, Omega-3 (n3) fatty acids, and Arginine in a healthy, well-nourished patient.

Key Points

• The provided evidence primarily focuses on the benefits of these supplements in malnourished patients or those undergoing major cancer surgery, with arganine, omega-3-fatty acids, and ribonucleotides being recommended for postoperative immune-nutrition in such cases 1.
• Omega-3 fatty acids have been shown to improve appetite, body weight, lean body mass, and reduce inflammatory responses in cancer patients, particularly those undergoing chemotherapy 1.
• Vitamin D is not mentioned in the provided evidence as a supplement of interest in this context.
• The evidence suggests that immune-modulating nutritional formulas may contribute to a decreased rate of postoperative complications and a decreased length of stay in general surgical patients and those with head/neck cancer surgery 1.
• Arginine, omega-3-fatty acids, and ribonucleotides are the primary immunomodulating substrates studied in the context of perioperative nutrition 1.
• The quality of evidence for these recommendations is generally considered low, and the strength of recommendation is often weak 1.

Considerations

• The benefits of these supplements are most clearly established in malnourished patients or those with specific medical conditions, such as cancer, rather than healthy, well-nourished individuals.
• Early oral feeding and oral nutritional supplements can be beneficial in the postoperative period, even for well-nourished patients, but the addition of specific immunomodulating substrates like arginine, omega-3-fatty acids, and ribonucleotides is not clearly indicated for healthy patients 1.

From the Research

Interest of Ribonucleotides, Vitamin D, Omega-3 (n3) Fatty Acids, and Arginine

• There is no direct evidence in the provided studies regarding the interest of ribonucleotides and arginine in a healthy, well-nourished patient.
• The provided studies focus on the effects of Vitamin D and Omega-3 fatty acids on various health outcomes.

Effects of Vitamin D and Omega-3 Fatty Acids

• Vitamin D supplementation has been shown to decrease serum hs-CRP levels by 19% at 2-year follow-up, but not at 4-year follow-up 2.
• Marine n-3 FAs were not significantly associated with changes in inflammatory markers at years 2 and 4 2.
• There is evidence suggesting that n-3 PUFA intake has an anti-inflammatory effect in aging, while the existing intervention studies do not support a similar activity for vitamin D and whey supplements 3.
• Supplemental vitamin D3 and/or marine omega-3 fatty acids for 2 years did not improve physical performance in a generally healthy adult population 4.
• Neither vitamin D nor n-3 FA supplementation over 1 year decreased biomarkers of inflammation in a large sample from a population-based randomized controlled trial 5.
• A combination of high-dose, supplemental vitamin D3, marine omega-3s, and a simple home exercise program showed significantly decreased odds of becoming pre-frail compared to control in robust, generally healthy and active older adults 6.