Harnessing algae oil as a sustainable DHA source for parenteral nutrition in vegan patients

Parenteral nutrition (PN) is a life-saving intervention for patients unable to meet their nutritional needs through oral or enteral routes. However, long-term PN therapy is often associated with complications, including intestinal failure-associated liver disease (IFALD), largely attributed, among other factors, to oxidative stress induced by pro-inflammatory unsaturated fatty acids. To mitigate the risk of developing IFALD, NEs have been optimized by increasing the content of ohm-3 fatty acids, particularly docosahexaenoic acid (DHA). This study aimed to develop a novel NE utilizing algae oil as a sustainable source of DHA, along with soybean lecithin as an emulsifier, to create a fully animal-free alternative to commercial intravenous NEs. The formulated algae oil-based NEs met pharmacopeial and physicochemical standards for intravenous administration, achieving a mean droplet diameter below 166.2 nm, a narrow polydispersity index, and a minimal percentage of fat globules larger than 5 mu m, capped at a maximum of 0.01%. They demonstrated excellent compatibility with commercial PN admixtures, biocompatibility with red blood cells, and stability over six months of storage. Among the formulations, NE P100, prepared using non-GMO soybean-derived phospholipids containing over 90% phosphatidylcholine, exhibited the most favorable properties, indicating its potential for further development. These findings highlight algae oil as a sustainable and effective source of DHA, offering a viable option for PN-dependent patients, including those following vegan diets, while reducing the risk of IFALD. Further in vitro and in vivo research is warranted to expand applications and refine this vegan alternative in PN therapy.