Effect of omega-3 supplementation on lipid profile in children and adolescents: a systematic review and meta-analysis of randomized clinical trials

The combined effects of omega-3 polyunsaturated fatty acid supplementation and exercise training on body composition and cardiometabolic health in adults: A systematic review and meta-analysis

INTRODUCTION

We performed a systematic review and meta-analysis to investigate the effects of combining omega-3 polyunsaturated fatty acids (n-3 PUFAs) supplementation with exercise training, as compared to exercise training alone, on body composition measures including body weight, body mass index (BMI), fat mass, body fat percentage, and lean body mass. Additionally, we determined the effects on cardiometabolic health outcomes including lipid profiles, blood pressure, glycemic markers, and inflammatory markers.

METHOD

Three primary electronic databases including PubMed, Web of Science, and Scopus were searched from inception to April 5th, 2023 to identify original articles comparing n-3 PUFA supplementation plus exercise training versus exercise training alone, that investigated at least one of the following outcomes: fat mass, body fat percentage, lean body mass, triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), systolic (SBP) and diastolic (DBP) blood pressures, fasting glucose and insulin, interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α). Standardized mean differences (SMD) or weighted mean differences (WMD), and 95 % confidence intervals (CIs) were calculated using random-effects models.

RESULTS

A total of 21 studies involving 673 participants with BMIs ranging from 24 to 37 kg.m2 and ages ranging from 30 to 70 years were included in the meta-analysis. Overall, the results indicated that as compared with exercise training alone, adding omega-3 supplementation to exercise training decreased fat mass [WMD: -1.05 kg (95 % CI: -1.88 to -0.22), p = 0.01], TG [WMD: -0.10 mmol/L (95 % CI: -0.19 to -0.02)], SBP [WMD: -4.09 mmHg (95 % CI: -7.79 to -2.16), p = 0.03], DBP [WMD: -4.26 mmHg (95 % CI: -6.46 to -2.07), p = 0.001], and TNF-α [SMD: -0.35 (95 % CI: -0.70 to -0.00), p = 0.04], and increased LDL [WMD: 0.14 mmol/L (95 % CI: 0.02 to 0.26), p = 0.01] and lower-body muscular strength [SMD: 0.42 (95 % CI: 0.01 to 0.84), p = 0.04]. However, omega-3 supplementation with exercise training had no additional effects compared with training alone, for other body composition or cardiometabolic outcomes.

CONCLUSION

This systematic review and meta-analyses suggestes that adding omega-3 supplementation to exercise training may augment some effects of exercise training on body composition and cardiometabolic health in adults, although such effects appear to be modest.

Modeling of enzymatic transesterification for omega-3 fatty acids enrichment in fish oil

Mathematical models of transesterification commonly assume that oil is a mixture of triacylglycerols, where each component has only one type of acid attached. This article aims to show how a different assumption on acid distribution affects the results of acylglycerols fraction composition. Experiments of fish oil ethanolysis have been performed at different enzyme loadings and ethanol concentrations, leading to enrichments from 35 % to 52 % of ω3 mass fraction in acylglycerols, by losing 12.1 % of ω3 as ethyl esters. A kinetic model is developed assuming both all acids of the same type on each acylglycerol and all acids randomly distributed on the available positions. The two different assumptions showed strong discrepancies on the acylglycerols fraction compositions predictions, demonstrating how the initial fatty acids distribution is important when an accurate description of the acylglycerols fraction is desired.

Effect of the consumption of cashew nut (Anacardium occidentale l.) flour-based biscuits in overweight children: a pilot randomized clinical trial

BACKGROUND

cashew nut is an almond known for its cardiovascular benefits in adults and weight gain effects in malnourished children, as supported by research. However, its impact on overweight children remains unexplored.

OBJECTIVE

to analyze the effect of consuming biscuits made with cashew nut flour on the blood glucose and serum triglyceride levels of children with overweight/obesity over four weeks.

METHODS

a pilot, randomized, open-label clinical study was conducted with 19 overweight children (11 in intervention group 1 [G1] and 8 in group 2 [G2], aged between 7 and 15 years. Over four consecutive weeks, they consumed, daily, three biscuits with 50 % cashew nut flour composition (G1) and six biscuits with 50 % cashew nut flour composition (G2). The biomarkers analyzed were glycated hemoglobin (HbA1c), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and total cholesterol (TC) at baseline and seven days post-biscuit consumption.

RESULTS

post-experiment, the TG (p = 0.153), HDL-C (p = 0.895), and TC (p = 0.122) biomarkers showed no significant changes. LDL-C levels experienced a slight but statistically significant increase of 0.52 % across all participants (p = 0.031). In contrast, non-HDL cholesterol levels saw a minor yet significant reduction of -1.7 % in serum concentration (p = 0.014). Independent of group allocation, the participants' HbA1c and average blood glucose levels significantly decreased by 12.1 % (p < 0.001) and 17.9 % (p < 0.001), respectively (Cohen's Δ = 1, in both instances).

CONCLUSION

consumption of biscuits containing cashew nut flour by overweight/obese children positively affected the reduction of blood glucose and non-HDL cholesterol biomarkers in both groups, regardless of the formulations used.

The adjuvant treatment role of ω-3 fatty acids by regulating gut microbiota positively in the acne vulgaris

Objectives:We aimed to explore the potential role of omega-3 (ω-3) fatty acids on acne vulgaris by modulating gut microbiota.Materials and Methods:We randomly divided the untreated acne patients into two groups with or without ω-3 fatty acids intervention for 12 weeks. The Sprague Dawley (SD) rats with acne model were given isotretinoin, ω-3 fatty acids or their combination respectively. Then the colonic contents samples of the drug intervention SD rats were transferred to the pseudo sterile rats with acne model. The severity of the disease was assessed by the Global Acne Grading System (GAGS) score of the patients, and the swelling rate of auricle and the pathological section of the rat with acne model. The 16S rDNA gene sequencing was performed to detect the alteration of the gut microbiota.Results:ω-3 fatty acids could increase the diversity of the gut microbiota and regulate the flora structure positively both in the patients and rats, increase the abundance of butyric acid producing bacteria and GAGS score in the patients, and alleviate the inflammation and comedones of rats.Conclusion:Supplementation of ω-3 fatty acids could alleviate the inflammation of acne vulgaris by increasing the abundance of butyric acid producing bacteria.

Effectiveness of Omega-3 Polyunsaturated Fatty Acids in Non-alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis

Non-alcoholic fatty liver disease (NAFLD) is a prevalent liver disorder characterized by excessive hepatic fat accumulation without alcohol intake. It can progress to non-alcoholic steatohepatitis, increasing the risk of cirrhosis and liver failure. This study aims to evaluate the efficacy of omega-3 polyunsaturated fatty acids (n-3 PUFAs) in treating NAFLD. A systematic review and meta-analysis was conducted including studies published from January 2018 to June 2023. Databases searched included PubMed, Embase, Cochrane Library, and ClinicalTrials.gov. Inclusion criteria comprised randomized controlled trials and cohort studies involving human subjects or animal models with NAFLD. Data were extracted and analyzed to assess the impact of omega-3 PUFAs on liver fat, hepatic enzymes, and serum lipid profiles using RevMan 5.4. A total of 15 studies met the inclusion criteria. Omega-3 supplementation significantly decreased alanine aminotransferase (ALT) (mean difference = -2.12, 95% confidence interval (CI) = -3.36, -0.87) and aspartate aminotransferase (AST) (mean difference = -1.50, 95% CI = -2.59, -0.42). Gamma-glutamyl transferase levels showed a trend toward reduction (mean difference = -0.82, 95% CI = -1.66, 0.02). Serum lipid profiles improved significantly with reductions in triglycerides, low-density lipoprotein, and total cholesterol along with significant reductions in AST, ALT, and alkaline phosphatase in animal models. Omega-3 PUFAs appear to offer beneficial effects on liver enzymes, serum lipid profiles, and anthropometric indices in NAFLD patients. While their impact on liver fat content remains uncertain, omega-3 supplementation could serve as a valuable adjunct treatment for enhancing metabolic profiles and liver function in NAFLD patients.

Long-term clinical outcomes and management of hypertriglyceridemia in children with Apo-CII deficiency

BACKGROUND AND AIM

APO CII, one of several cofactors which regulate lipoprotein lipase enzyme activity, plays an essential role in lipid metabolism. Deficiency of APO CII is an ultra-rare autosomal recessive cause of familial chylomicronemia syndrome. We present the long-term clinical outcomes of 12 children with APO CII deficiency.

METHODS AND RESULTS

The data of children with genetically confirmed APO CII deficiency were evaluated retrospectively. Twelve children (8 females) with a mean follow-up of 10.1 years (±3.9) were included. At diagnosis, the median age was 60 days (13 days-10 years). Initial clinical findings included lipemic serum (41.6%), abdominal pain (41.6%), and vomiting (16.6%). At presentation, the median triglyceride (TG) value was 4341 mg/dL (range 1277-14,110). All patients were treated with a restricted fat diet, medium-chain triglyceride (MCT), and omega-3-fatty acids. In addition, seven patients (58.3%) received fibrate. Fibrate was discontinued in two patients due to rhabdomyolysis and in one patient because of cholelithiasis. Seven (58.3%) patients experienced pancreatitis during the follow-up period. One female experienced recurrent pancreatitis and was treated with fresh frozen plasma (FFP).

CONCLUSIONS

Apo CII deficiency is an ultra-rare autosomal recessive condition of hypertriglyceridemia associated with significant morbidity and mortality. Low-fat diet and MCT supplementation are the mainstays of therapy, while the benefit of TG-lowering agents are less well-defined.

Fish consumption and its lipid modifying effects - A review of intervention studies

Fish is an important source of nutrients, particularly the long chain n-3 polyunsaturated fatty acids (n-3 PUFAs). The incorporation of fish into the diet has been shown to have several health benefits, including lowering the risk of cardiovascular disease (CVD). Elevated plasma lipids are one of the main modifiable risk factors contributing to CVD and may be partly mediated by n-3 PUFAs. Although n-3 PUFAs in the form of supplementation have been shown to exert lipid modifying effects, the effects of fish consumption on the lipid profile have not been well summarised to date. Therefore, the aim of the present review is to discuss the current evidence from intervention studies investigating the effect of fish consumption on the lipid profile in both apparently healthy and non-healthy populations. Existing evidence appears to support the role of fish in promoting a shift towards a less inflammatory lipid profile through raising n-3 PUFAs and potentially lowering n-6 PUFA and triglyceride concentrations in both healthy and non-healthy populations. Fish consumption has a negligible effect on cholesterol concentrations; however, fish consumption may promote a small increase in high density lipoprotein (HDL) cholesterol amongst people with lower HDL at baseline. Limited studies have shown fish consumption to result in shifts in phospholipid and sphingolipid species and structure, albeit it is not yet clear whether these alterations have any meaningful impact on CVD risk. Future well-designed studies that utilise NMR and/or lipidomics analysis are warranted to explore the effects of these shifts in lipid content and structure in the context of disease development. Public health guidance should emphasise the cardioprotective benefits of fish and encourage consumption particularly in the Global North where fish consumption remains low.