Comparison of Olive Versus Fish Oil Based Parenteral Nutrition and Clinical Outcomes-A Systematic Review

It is well-established that earlier generations of lipid emulsions based on soybean oil are inferior to later generations based on olive or fish oil. However, evidence directly comparing between later-generation lipid emulsions is limited. This study aims to systematically review existing literature comparing olive versus fish oil based parenteral nutrition formulations within an inpatient setting, and to evaluate clinical outcomes.

Electronic databases Medline, Embase, CINAHL and Web of Science were searched from earliest to current date. Titles, abstracts and full texts were screened for eligibility. Eligible papers were assessed for risk of bias and relevant data were extracted for a qualitative summary of results.

Six papers in total were eligible. Primary outcomes of interest reported across the six papers were related to infection, inflammation and oxidative stress. Overall, the number of studies and significant findings were limited. Based on the current evidence it is not possible to promote either fish or olive oil emulsions as superior to the other in influencing immune function, inflammation, liver function or clinical outcomes.

While previous evidence has shown the clear benefits to reducing soybean oil content, the similar benefits may be obtained by replacing this with either olive or fish oil. More high-quality research is required to further explore olive versus fish oil based parenteral nutrition to guide clinical practice.