Red palm oil supplementation in patients with chronic pancreatitis: is there any beneficial effect on serum fatty acid profile and inflammatory-oxidative status?

It is well-known that patients with chronic pancreatitis may suffer from fat malabsorption and this, on its turn, may hamper an adequate absorption of fat-soluble vitamin, namely vitamin E. We had previously shown that patients with chronic pancreatitis have an impaired monocyte burst ability which is unrelated to flare-up of the disease and to the weight loss per se. Unlike other oils, red palm oil is the richest food source of carotenoids and it is endowed by a good oxidative stability due to its peculiar abundancy of tocopherols, tocotrienols and the virtual lack of linolenic acid. The aim of the present study was to investigate the status ofthe reticulo-endothelial system, as assessed by superoxide anion generation of blood monocytes, the elythrocyte oxidability (lipid peroxidation stress test induced by addition of CumOOH) as well as the analysis of serum fatty acids and of circulating levels of cytokines in patients with chronic pancreatitis. Our study population consisted of 24 patients with chronic pancreatitis. The diagnostic criteria for chronic pancreatitis was based upon a typical history of recurrent clinical acute pancreatitis was required in addition to one or more of the following: pancreatic calcification and ductal lesions (as assessed by abdominal -x-ray, ultrasound and/or CT scan and/or chronic pancreatic duct changes at cholangyo-NMR). A dietary questionnaire was used and habitual intake of macronutrient and micronutrient was be done at the entry and re-assessed at the end of the study using the model of seven-day diet history. Patients were instructed not to consume any fish oil supplement and refrain from olive oil dietary consumption, being put on a 2-week wash out period from such use when present. Patients were then given a sample containing a specific highly-purified, non-GMO red palm oil, with the aim of using 40ml daily for 2 weeks without any flying or heating processing. Twenty-two patients fully complied with the supplementation protocol reporting good palatability of RPO and no side effect. EMI and WHR and routine biochemistry remained stable throughout the study period, being comparable to age-matched controls. As compared to baseline values, CP patients fed-RPO showed a significant improvement of the peak value of generated superoxide anion (p<0.05) and a reduced erythrocytes oxidability (p<0.01). These data were paralleled by a significant normalization (p<0.001) and the previously observed reduced level of linoleic acid and of docosa-hexaenoic-acid (p<0.05). RPO brought about also a significant decrease of TNF-α and IL-6 (p<0.05) which in these patients was constantly higher than in healthy controls (p<0.05). Taken overall, these data suggest that a dietary enrichment with RPO is able to significantly improve the oxidative-inflammatory profile in CP patients while also beneficially correcting the fundamental deficiencies in essential fatty acids. Given the multifactoriality of the disease and the subtle clinical worsening, such dietary intervention seems an amenable integrative therapeutic tool.