Shulkin M, Pimpin L, Bellinger D, et al. Effects of omega-3 supplementation during pregnancy and youth on neurodevelopment and cognition in childhood: a systematic review and meta-analysis. FASEB Journal. 2016 April30;(1): S295.5.
Long-chain omega-3 fatty acids are thought to be crucial for optimal neurodevelopment in early life.
To investigate the effect of omega-3 supplementation during pregnancy and infancy on child cognitive and developmental outcomes.
We searched PubMed, Cochrane Library, EMBASE, and PsychInfo through May 2015 without language or publication year restrictions for randomized controlled trials (RCTs) of omega-3 supplementation (>3 months) i.e. docosahexanoic acid (DHA) and eicosapentaenoic acid (EPA), and quantitative measure of neurodevelopment or cognition. Full-text inclusion decisions and data extractions were performed independently and in duplicate. Our primary outcome was the standardized mean difference in Bayley Scales of Infant Development (BSID) score between intervention groups in RCTs. Other outcomes included the Weschler Intelligence Scale for Children, Weschler Preschool and Primary Scale of Intelligence, Kaufman Brief Intelligence Test, Kaufman Assessment Battery for Children, Peabody Picture Vocabulary Test, and other standardized measures.
Among 571 abstracts, we identified 15 trials with 20 intervention arms involving 2,525 children. Trials used DHA + EPA (N=6 arms), DHA only (N=2), DHA + arachidonic acid (AA) (N=10), or DHA + EPA + AA (N=2); either prenatally (mean 20 weeks gestation; N=4 arms) or within the first few days of birth (N=16). Mean supplementation duration was 7.3 months; and age at outcome assessment, 16 months. In pooled analyses, both maternal and infant supplementation similarly improved neurodevelopment: standardized mean difference (SMD) in BSID= 0.21 (95% CI: 0.01, 0.41) and 0.24 (0.00, 0.48) respectively (Figure 1). Among BSID subscales, DHA and/or EPA raised the psychomotor developmental index (N=8 arms; SMD 0.40; 95% CI: 0.10, 0.70), while DHA + AA raised the mental developmental index (N=15 arms; SMD 0.17; 95% CI: 0.00, 0.35). Pooled findings for other outcomes will be presented.
Omega-3 supplementation during either pregnancy or infancy improves child neurodevelopment. These findings indicate the importance of sufficient polyunsaturated fatty acid intake by pregnant women and young children.
Omega-3 fatty acids from fish oil have been associated with beneficial cardiovascular effects, but their role in modifying cardiac structures and tissue characteristics in patients who have had an acute myocardial infarction while receiving current guideline-based therapy remains unknown.
In a multicenter, double-blind, placebo-controlled trial, participants presenting with an acute myocardial infarction were randomly assigned 1:1 to 6 months of high-dose omega-3 fatty acids (n=180) or placebo (n=178). Cardiac magnetic resonance imaging was used to assess cardiac structure and tissue characteristics at baseline and after study therapy. The primary study endpoint was change in left ventricular systolic volume index. Secondary endpoints included change in noninfarct myocardial fibrosis, left ventricular ejection fraction, and infarct size.
By intention-to-treat analysis, patients randomly assigned to omega-3 fatty acids experienced a significant reduction of left ventricular systolic volume index (-5.8%, P=0.017), and noninfarct myocardial fibrosis (-5.6%, P=0.026) in comparison with placebo. Per-protocol analysis revealed that those patients who achieved the highest quartile increase in red blood cell omega-3 index experienced a 13% reduction in left ventricular systolic volume index in comparison with the lowest quartile. In addition, patients in the omega-3 fatty acid arm underwent significant reductions in serum biomarkers of systemic and vascular inflammation and myocardial fibrosis. There were no adverse events associated with high-dose omega-3 fatty acid therapy.
Treatment of patients with acute myocardial infarction with high-dose omega-3 fatty acids was associated with reduction of adverse left ventricular remodeling, noninfarct myocardial fibrosis, and serum biomarkers of systemic inflammation beyond current guideline-based standard of care.
Heydari B1, Abdullah S1, Pottala JV1, Shah R1, Abbasi S1, Mandry D1, Francis SA1, Lumish H1, Ghoshhajra BB1, Hoffmann U1, Appelbaum E1, Feng JH1, Blankstein R1, Steigner M1, McConnell JP1, Harris W1, Antman EM1, Jerosch-Herold M1, Kwong RY2. Effect of Omega-3 Acid Ethyl Esters on Left Ventricular Remodeling After Acute Myocardial Infarction: The OMEGA-REMODEL Randomized Clinical Trial. Circulation. 2016 Aug 2;134(5):378-91. doi: 10.1161/CIRCULATIONAHA.115.019949.
A new paper confirming that omega-3 supplements in the Australian and New Zealand markets are within oxidation limits and contain the labeled contents of EPA and DHA has been published in Nutrients. The work was funded by the Omega-3 Centre in Australia after a paper from the Liggins Institute was published in Scientific Reports last year alleging that fish oils in the New Zealand market were over-oxidised and had as little as half of the EPA and DHA claimed on the labels.
The Liggins Institute paper caused a media uproar in New Zealand and the results seemed contradictory to what industry participants and market surveillance groups had observed. In order to determine if there was a problem in that market, GOED (Global Organisation for EPA and DHA) funded its own tests, as did the Australian Therapeutic Goods Administration and now the Omega-3 Centre. None of these groups’ results substantiated the Liggins Institute’s allegations. The Liggins researchers have said in the media that these results are not valid because they are not peer-reviewed, but now the Omega-3 Centre results have been, and GOED’s tests will be submitted for peer-reviewed publication shortly as well.
The Liggins researchers also published a subsequent study that raised additional questions about oxidised oils. GOED is funding a number of papers in the next year to investigate some of the issues raised.
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Freshness, which ensures product integrity and biological efficacy, may be the single most important quality of fish oils. Nordic Naturals‘ oxygen–free manufacturing process maintains the freshness of fish oil used in our products, with peroxide values (indicators of freshness) well below the EP (European Pharmacopoeia) Standard limits. The lower the peroxide value, the fresher the fish oil. Nordic Naturals’ third-party analysis verifies adherence to strict standards set out by leading international organisations and experts such as GOED, IFOS, WHO and EP.
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