Parenteral Fat Emulsions Based on Olive and Soybean Oils: A Randomized Clinical Trial in Preterm Infants

Abstract

ABSTRACTObjectiveTo evaluate in premature infants a new parenteral lipid emulsion based on olive and soybean oils (ratio 4:1), with less polyunsaturated fatty acids (PUFA) and more α‐tocopherol than standard soybean oil emulsion.Study designPremature infants (gestational age, 28–<37 weeks) were randomized to receive one of the two emulsions within the first 72 hours of life. The triglyceride dose was increased to 2 g/kg/day within 3 days. Plasma phospholipid fatty acids, α‐tocopherol/lipid ratio, and urinary malondialdehyde (MDA) excretion were determined at baseline and after 7 days.ResultsOf 45 recruited infants, 33 completed the study per protocol (15 soybean oil, 18 olive oil emulsion). At study end, groups did not differ in plasma phospholipid arachidonic acid, total n‐6 and n‐3 metabolites, but the olive oil group showed higher values of the PUFA intermediates C18:3n‐6 (0.19% ± 0.01% vs. 0.13% ± 0.02%, P < 0.05) and C20:3n‐6 (2.92% ± 0.12% vs. 2.21% ± 0.17%, P = 0.005). The plasma α‐tocopherol/total lipd ratio was higher in the olive oil group (2.45 ± 0.27 μmol/mmol vs. 1.90 ± 0.08 μmol/mmol, P = 0.001), whereas urinary MDA excretion did not differ.ConclusionThe lower PUFA supply with the olive/soybean oil emulsion appears to enhance linoleic acid conversion. The reduced PUFA content, combined with a higher antioxidant intake in the olive oil group, results in an improved vitamin E status. The olive oil‐based emulsion is a valuable alternative for parenteral feeding of preterm infants who are often exposed to oxidative stress, while their antioxidative defense is weak.