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Transition to a fish oil-fortified 100% whey peptide-based enteral formula is associated with increased specialized pro-resolving mediators in home enterally fed adults: An exploratory analysis of a pilot prospective cohort study

Year: 2026

Type: article

Abstract: Background and aims Chronic inflammatory diseases account for large share of modern morbidity. Nutrition-based strategies that favor resolution rather than immune-suppression are of growing interest. We evaluated whether transition to a fish oil-fortified 100% whey peptide-based enteral formula altered plasma specialized pro-resolving lipid mediators (SPMs). Methods Single-center pilot prospective cohort study where 25 adults dependent on home enteral nutrition were transitioned from standard polymeric formula to study formula for 14 days. Parent study outcomes included tolerance, biochemical markers, metabolomics, and fatty acid profiles. For this analysis, paired plasma samples underwent targeted lipid mediator metabololipidomics by liquid chromatography-tandem mass spectrometry. Global profiling was assessed using principal component analysis and partial least squares discriminant analysis, followed by PERMANOVA. Results 25 participants completed the intervention; 17 had paired fatty acid data and 18 had paired lipid mediator data. Eicosapentaenoic acid levels increased by 469.3% and docosahexaenoic acid levels increased by 143.0%, while omega-6:omega-3 polyunsaturated fatty acid (PUFA) ratio fell (10.8 ± 3.6 to 4.7 ± 2.7). Lipid mediator profiling demonstrated a significant overall shift after intervention (PERMANOVA P = 0.001; Hotelling t 2 P = 0.0025). Concentrations of n-3 docosapentaenoic acid–derived Resolvin D5 (RvD5 n-3 DPA ) and Maresin conjugate in tissue regeneration 2 (MCTR2) were increased, accompanied by an elevated ratio of SPM to potent pro-inflammatory mediator leukotriene B 4 . Conclusions Short-term transition to study formula increased omega-3 PUFA enrichment and shifted plasma lipid mediators towards a more pro-resolving profile. These findings support controlled studies to determine whether formula-driven SPM remodeling translates into clinical benefit.

Source: Clinical Nutrition Open Science

DOI: 10.1016/j.nutos.2026.100708