Background & aims: n-3 Polyunsaturated fatty acids may improve cardiovascular outcomes in elderly. The aim of this study was to determine the effect of feeding elderly patients exclusively with an n-3 polyunsaturated fatty acid-enriched diet specifically designed for enteral nutrition for 6 months, evaluating modifications in plasma fatty acid profile and some biomarkers of insulin resistance (IR). Methods: Thirty-two patients >65 years were fed a new enteral formula (T-Diet Plus (R)) containing 75 mg/l of eicosapentaenoic acid (EPA) and 35 mg/l of docosahexaenoic acid (DHA) and 33 were fed an enteral diet intended for elderly (Jevity (R)). Blood samples were drawn at the beginning and after 3 and 6 months of feeding. Plasma lipids, total plasma and lipid fraction fatty acid profiles, and some IR-associated adipokines were analysed. Results: Feeding on T-Diet Plus (R) allowed EPA and DHA incorporation into plasma lipids and normalised blood triacylglycerols (TAG) levels after 3 months without major changes in IR, leptin and adiponectin. Conclusions: Feeding the elderly exclusively with an enteral formula enriched with EPA and DHA improves their plasma lipid fatty acid profile and lowers TAG, a well known cardiovascular risk biomarker, without affecting IR. (C) 2009 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.