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The potential cardiometabolic effects of long-chain ω-3 polyunsaturated fatty acids: recent updates and controversies

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Bae, Jae Hyun, Lim, Hyunjung, Lim, Soo·2023·Advances in Nutrition
DOI 10.1016/j.advnut.2023.03.014PMC PMC10334139
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Abstract

Various health-related effects of long-chain (LC) ω-3 PUFAs, EPA, and DHA have been suggested. LC ω-3 PUFAs reduce TG concentrations and have anti-inflammatory, immunomodulatory, antiplatelet, and vascular protective effects. Controversially, they might help in restoring glucose homeostasis via the gut microbiota. However, previous studies have not shown the clear benefits of LC ω-3 PUFAs for CVDs. REDUCE-IT and STRENGTH-representative randomized controlled trials (RCTs) that examined whether LC ω-3 PUFAs would prevent major adverse cardiovascular (CV) events (MACE)-showed conflicting results with differences in the types, doses, or comparators of LC ω-3 PUFAs and study populations. Therefore, we performed a meta-analysis using major RCTs to address this inconsistency and assess the clinical and biological effects of LC ω-3 PUFAs. We included RCTs that involved ≥500 participants with ≥1 y follow-up. Of 17 studies involving 143,410 people, LC ω-3 PUFA supplementation showed beneficial effects on CV death (RR: 0.94; 95% CI: 0.88, 0.99; P = 0.029) and fatal or nonfatal MI (RR: 0.83; 95% CI: 0.72, 0.95; P = 0.010). RCTs on EPA alone showed better results for 3-point MACE, CV death, and fatal or nonfatal MI. However, the benefits were not found for fatal or nonfatal stroke, all-cause mortality, and hospitalization for heart failure. Of note, studies of both the EPA/DHA combination and EPA alone showed a significant increase in risk of new-onset atrial fibrillation. Thus, well-designed studies are needed to investigate the underlying mechanisms involved in the distinct effects of EPA compared with DHA on cardiometabolic diseases. This review discusses the potential benefits and safety of LC ω-3 PUFAs from a cardiometabolic perspective focusing on recent updates and controversies.

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Cited by

Sorted by citations

Authors
Bae, J. H., Lim, H., & Lim, S.
Affiliations
  • Korea University Anam Hospital (KR)
  • Kyung Hee University (KR)
  • Seoul National University (KR)
Corresponding author
Lim, Soo
ORCID
Venue
Advances in Nutrition
Publisher
Elsevier BV
Published
2023-07
Volume
14
Issue
4
Pages
612-628
ISSN
  • 2156-5376 (ISSN-L)
  • 2161-8313
DOI
10.1016/j.advnut.2023.03.014
PMC
PMC10334139
OpenAlex
W4362696252
Cited by
78
References
24
Citations by year
2026: 22 · 2025: 26 · 2024: 25 · 2023: 5
FWCI
2.82
Type
journal article
Language
en
Update notices
erratum (2024-01-01)
Open access
Licence
Locations
  • Advances in Nutrition (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Life Sciences › Agricultural and Biological Sciences › Aquatic Science › Aquaculture Nutrition and Growth
Keywords
n-3 long-chain polyunsaturated fatty acids, eicosapentaenoic acid, docosahexaenoic acid, cardiometabolic effects, major adverse cardiovascular events, cardiovascular mortality, myocardial infarction, atrial fibrillation, REDUCE-IT trial, cardiovascular disease prevention, anti-inflammatory activity, antiplatelet activity, glucose homeostasis, gut microbiota
MeSH terms
Cardiovascular Diseases, Docosahexaenoic Acids, Humans, Eicosapentaenoic Acid, Fatty Acids, Omega-3, Stroke

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