TY - JOUR
T1 - The Relationship Between Omega-3, Omega-6 and Total Polyunsaturated Fat and Musculoskeletal Health and Functional Status in Adults
T2 - A Systematic Review and Meta-analysis of RCTs
AU - the PUFAH Group
AU - Abdelhamid, Asmaa
AU - Hooper, Lee
AU - Sivakaran, Ruksana
AU - Hayhoe, Richard P.G.
AU - Welch, Ailsa
AU - Ajabnoor, Sarah
AU - Alabdulghafoor, Faye
AU - Alkhudairy, Lena
AU - Biswas, Priti
AU - Brainard, Julii
AU - Bridges, Charlene
AU - Brown, Tracey J.
AU - Deane, Katherine
AU - Donaldson, Daisy
AU - Hanson, Sarah
AU - Jimoh, Oluseyi Florence
AU - Hooper, Lee
AU - Martin, Nicole
AU - O’Brien, Alex
AU - Rees, Karen
AU - Alkhudairy, Lena
AU - Song, Fujian
AU - Thorpe, Gabrielle
AU - Wang, Xia
AU - Winstanley, Lauren
N1 - Publisher Copyright:
© 2019, The Author(s).
PY - 2019/10/1
Y1 - 2019/10/1
N2 - We conducted a systematic review and meta-analysis to assess the effects of increasing dietary omega-3, omega-6 and mixed polyunsaturated fatty acids (PUFA) on musculoskeletal health, functional status, sarcopenia and risk of fractures. We searched Medline, Embase, The Cochrane library, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP) databases for Randomised Controlled Trials (RCTs) of adults evaluating the effects of higher versus lower oral omega-3, omega-6 or mixed PUFA for ≥ 6 months on musculoskeletal and functional outcomes. We included 28 RCTs (7288 participants, 31 comparisons), 23 reported effects of omega-3, one of omega-6 and four of mixed total PUFA. Participants and doses were heterogeneous. Six omega-3 trials were judged at low summary risk of bias. We found low-quality evidence that increasing omega-3 increased lumbar spine BMD by 2.6% (0.03 g/cm2, 95% CI − 0.02 to 0.07, 463 participants). There was also the suggestion of an increase in femoral neck BMD (of 4.1%), but the evidence was of very low quality. There may be little or no effect of omega-3 on functional outcomes and bone mass; effects on other outcomes were unclear. Only one study reported on effects of omega-6 with very limited data. Increasing total PUFA had little or no effect on BMD or indices of fat-free (skeletal) muscle mass (low-quality evidence); no data were available on fractures, BMD or functional status and data on bone turnover markers were limited. Trials assessing effects of increasing omega-3, omega-6 and total PUFA on functional status, bone and skeletal muscle strength are limited with data lacking or of low quality. Whilst there is an indication that omega-3 may improve BMD, high-quality RCTs are needed to confirm this and effects on other musculoskeletal outcomes.
AB - We conducted a systematic review and meta-analysis to assess the effects of increasing dietary omega-3, omega-6 and mixed polyunsaturated fatty acids (PUFA) on musculoskeletal health, functional status, sarcopenia and risk of fractures. We searched Medline, Embase, The Cochrane library, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP) databases for Randomised Controlled Trials (RCTs) of adults evaluating the effects of higher versus lower oral omega-3, omega-6 or mixed PUFA for ≥ 6 months on musculoskeletal and functional outcomes. We included 28 RCTs (7288 participants, 31 comparisons), 23 reported effects of omega-3, one of omega-6 and four of mixed total PUFA. Participants and doses were heterogeneous. Six omega-3 trials were judged at low summary risk of bias. We found low-quality evidence that increasing omega-3 increased lumbar spine BMD by 2.6% (0.03 g/cm2, 95% CI − 0.02 to 0.07, 463 participants). There was also the suggestion of an increase in femoral neck BMD (of 4.1%), but the evidence was of very low quality. There may be little or no effect of omega-3 on functional outcomes and bone mass; effects on other outcomes were unclear. Only one study reported on effects of omega-6 with very limited data. Increasing total PUFA had little or no effect on BMD or indices of fat-free (skeletal) muscle mass (low-quality evidence); no data were available on fractures, BMD or functional status and data on bone turnover markers were limited. Trials assessing effects of increasing omega-3, omega-6 and total PUFA on functional status, bone and skeletal muscle strength are limited with data lacking or of low quality. Whilst there is an indication that omega-3 may improve BMD, high-quality RCTs are needed to confirm this and effects on other musculoskeletal outcomes.
KW - Aged
KW - Alpha-linolenic acid
KW - Bone density
KW - Docosahexaenoic acids
KW - Eicosapentaenoic acid
KW - Fatty acids omega-3
KW - Fatty acids omega-6
KW - Fatty acids unsaturated
KW - Meta-analysis
KW - Muscle strength
KW - Musculoskeletal physiological phenomena
KW - Randomised controlled trial
UR - https://www.scopus.com/pages/publications/85069847908
U2 - 10.1007/s00223-019-00584-3
DO - 10.1007/s00223-019-00584-3
M3 - Article
C2 - 31346665
AN - SCOPUS:85069847908
SN - 0171-967X
VL - 105
SP - 353
EP - 372
JO - Calcified Tissue International
JF - Calcified Tissue International
IS - 4
ER -