Effect of Omega-3 Fatty Acids on Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
What this study found
Compared with placebo, Omega-3 supplementation was associated with weight gain (mean difference 0.25, 95% CI 0.02 to 0.48; P=0.03), higher LDL (0.70, 95% CI 0.30 to 1.10; P<0.001), and reduced IL-6 (−0.32, 95% CI −0.60 to −0.05; P=0.02). No significant differences were found for lung function, 6-minute walk distance, or quality of life. Interpret with caution due to limited and heterogeneous evidence; overall effects on COPD outcomes are not clearly favorable.
- Study & population
- Eight randomized controlled trials in COPD patients (n=418; mean age 67.3 years, SD 10.2).
- Intervention
- Omega-3 fatty acids delivered via oral or enteral nutritional supplements (ONS/ENS).
- Key limitation
- Small number of trials with diverse regimens and populations; variable outcome reporting; short durations and incomplete reporting of key measures; potential risk of bias due to allocation concealment and possible industry funding; inability to draw firm conclusions about long-term clinical benefits.
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Open PDFOriginal abstract
Purpose Omega-3 fatty acid is an emerging hotspot on anti-inflammation and chronic obstructive pulmonary disease (COPD) is known as a chronic inflammatory disease. The effect of Omega-3 fatty acid supplement on patients with COPD remains mixed for insufficient evidence. This systematic review and meta-analysis is based on neat randomized controlled trials trying to give a clearer impression on the effect of Omega-3 on patients with COPD. Methods This systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) statements. Randomized clinical trials (RCTs) published in electronic databases including Medline, Embase, Cochrane Library, ClinicalTrials.gov and China National Knowledge Infrastructure (CNKI) by May 10, 2021 were searched. Data extracted from 6 predetermined domains (nutritional condition, lipid composition, inflammatory biomarker, lung function, physical endurance and quality of life [QoL]) were reviewed and analyzed. Results A total of 8 RCTs evaluating 418 patients (age, mean [SD] = 67.3 [10.2] years) were included. Statistical differences were found in 3 parameters of 3 domains – weight (Wt) (0.25 [95% CI, 0.02 to 0.48], P = 0.03) in nutritional condition, low-density lipoprotein (LDL) (0.70 [95% CI, 0.30 to 1.10], P = 0.00) in lipid composition and interleukin-6 (IL-6) level (−0.32 [95% CI, −0.60 to −0.05], P = 0.02) in inflammatory biomarker – while no significant difference was found in lung function, physical endurance or QoL. Conclusion Comparing with placebo, Omega-3 intake was associated with more weight-gaining, LDL increase and IL-6 reduction. These results should be interpreted cautiously for the quality and quantity of available evidence are limited.