CoChat
Sign Up
Cited by 353Fatty Acid Research and HealthTreatment of Major DepressionTryptophan and brain disorders

Updated systematic review and meta-analysis of the effects of n−3 long-chain polyunsaturated fatty acids on depressed mood

Open access
Appleton, Katherine M, Rogers, Peter J, Ness, Andrew R·2010·The American Journal of Clinical Nutrition
DOI 10.3945/ajcn.2009.28313
Open this paper in CoChat — free accountOpen PDF

Abstract

Background The debate over a role for n-3 long-chain polyunsaturated fatty acids (n-3 PUFAs) in depressed mood continues. Objective The objective was to update a previous systematic review and meta-analysis of published randomized controlled trials investigating the effects of n-3 PUFAs on depressed mood and to explore potential sources of heterogeneity. Design Eight databases were searched for trials that randomly assigned participants to receive n-3 PUFAs/fish, measured depressed mood, used human participants, and included a comparison group up to April 2009. Results Thirty-five randomized controlled trials were identified; 17 were not included in the previous review. The pooled standardized difference in mean outcome of the 29 trials that provided data to allow pooling (fixed-effects model) was 0.10 SD (95% CI: 0.02, 0.17) in those who received n-3 PUFAs compared with placebo, with strong evidence of heterogeneity (I(2) = 65%, P < 0.01). The presence of funnel plot asymmetry suggested that publication bias was a likely source of this heterogeneity. Depressive symptom severity and participant diagnosis also explained some of the observed heterogeneity. Greater effects of n-3 PUFAs were found in individuals with more-severe depressive symptoms. In trials that enrolled individuals with a diagnosed depressive disorder, the combined mean difference was 0.41 (95% CI: 0.26, 0.55), although evidence of heterogeneity was also found (I(2) = 71%). In trials that enrolled individuals without a depressive diagnosis, no beneficial effects of n-3 PUFAs were found (largest combined mean difference: 0.22; 95% CI: -0.01, 0.44; I(2) = 0%). Conclusions Trial evidence of the effects of n-3 PUFAs on depressed mood has increased but remains difficult to summarize because of considerable heterogeneity. The evidence available provides some support of a benefit of n-3 PUFAs in individuals with diagnosed depressive illness but no evidence of any benefit in individuals without a diagnosis of depressive illness.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.3945/ajcn.2009.28313

Cites

85 of 85 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • A meta-analytic review of 35 randomized controlled trials found that omega-3 fatty acid supplementation is associated with a 0.41-0.57 SD difference in depression severity for individuals with MDD.

    “a recent meta-analytic review of 35 randomized controlled trials found that omega-3 fatty acid supplementation is associated with a 0.41-0.57SD difference in depression severity for individuals with MDD”

    From From stress to inflammation and major depressive disorder: A social signal transduction theory of depression. (2014) · cites this paper as Appleton, Rogers, & Ness, 2010

    The Participant diagnosis section (page not provided) reports pooled differences of 0.41 SD and 0.57 SD for trials enrolling people with a depressive disorder, not specifically MDD. The Results section (page not provided) identifies 35 trials across the review but says only 29 were included in the meta-analyses; the quoted effect sizes come from the depressive-disorder subgroup. (LLM, conf=0.90)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

2 of the 87 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. Warren G, McKendrick M, Peet M. The role of essential fatty acids in chronic fatigue syndrome. Acta Neurol Scand 1999;99:112-6.
  2. Sheehan DV, Lecrubier Y, Harnett-Sheehan K, et al. The Mini In- ternational Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview. J Clin Psy- chiatry 1998;59:22-33.

Cited by

Sorted by citations

Related

Authors
Appleton, K. M., Rogers, P. J., & Ness, A. R.
Affiliations
Queen's University Belfast (GB)
Corresponding author
Appleton, Katherine M
ORCID
Venue
The American Journal of Clinical Nutrition
Publisher
Elsevier BV
Published
2010-03
Volume
91
Issue
3
Pages
757-770
ISSN
0002-9165 (ISSN-L)
DOI
10.3945/ajcn.2009.28313
OpenAlex
W2135221710
Cited by
353
References
87
Citations by year
2026: 3 · 2025: 6 · 2024: 10 · 2023: 8 · 2022: 8 · 2021: 12 · 2020: 21 · 2019: 19 · 2018: 19 · 2017: 25 · 2016: 34 · 2015: 31 · 2014: 39 · 2013: 34 · 2012: 41
FWCI
4.19
Type
journal article
Language
en
Open access
Licence
Locations
  • American Journal of Clinical Nutrition (publishedVersion)
  • PubMed (publishedVersion)
  • Explore Bristol Research (submittedVersion)
  • Research Portal (Queen's University Belfast) (submittedVersion)
Funders
McGill University
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
Keywords
n-3 long-chain polyunsaturated fatty acids, omega-3 fatty acids, fish oil supplementation, depressive mood, depression, depressive symptoms, treatment effect heterogeneity, publication bias
MeSH terms
Depression, Dietary Fats, Humans, Severity of Illness Index, Fatty Acids, Omega-3, Randomized Controlled Trials as Topic, Publication Bias

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review