4.5 Review

Long-term effects of increasing omega-3, omega-6 and total polyunsaturated fats on inflammatory bowel disease and markers of inflammation: a systematic review and meta-analysis of randomized controlled trials

期刊

EUROPEAN JOURNAL OF NUTRITION
卷 60, 期 5, 页码 2293-2316

出版社

SPRINGER HEIDELBERG
DOI: 10.1007/s00394-020-02413-y

关键词

Inflammatory bowel diseases; Dietary fats; unsaturated; Fatty acids; omega-3; Fatty acids; omega-6; C-reactive protein; Alpha-linolenic acid; Meta-analysis

资金

  1. University of East Anglia from the World Health Organization (WHO)

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The comprehensive meta-analysis of 83 RCTs on the long-term effects of omega-3, omega-6, and total PUFA on IBD and inflammatory markers suggests that increasing LCn3 intake may reduce the risk of IBD relapse and worsening. However, supplementation with PUFAs shows little to no effect on the prevention or treatment of IBD and provides limited support for modifying long-term inflammatory status.
Background and aim Effects of long-chain omega-3 (LCn3) and omega-6 fatty acids on prevention and treatment of inflammatory bowel diseases (IBD, including Crohn's Disease, CD and ulcerative colitis, UC), and inflammation are unclear. We systematically reviewed long-term effects of omega-3, omega-6 and total polyunsaturated fats (PUFA) on IBD diagnosis, relapse, severity, pharmacotherapy, quality of life and key inflammatory markers. Methods We searched Medline, Embase, Cochrane CENTRAL, and trials registries, including RCTs in adults with or without IBD comparing higher with lower omega-3, omega-6 and/or total PUFA intake for >= 24 weeks that assessed IBD-specific outcomes or inflammatory biomarkers. Results We included 83 RCTs (41,751 participants), of which 13 recruited participants with IBD. Increasing LCn3 may reduce risk of IBD relapse (RR 0.85, 95% CI 0.72-1.01) and IBD worsening (RR 0.85, 95% CI 0.71-1.03), and reduce erythrocyte sedimentation rate (ESR, SMD - 0.23, 95% CI - 0.44 to - 0.01), but may increase IBD diagnosis risk (RR 1.10, 95% CI 0.63-1.92), and faecal calprotectin, a specific inflammatory marker for IBD (MD 16.1 mu g/g, 95% CI - 37.6 to 69.8, all low-quality evidence). Outcomes for alpha-linolenic acid, omega-6 and total PUFA were sparse, but suggested little or no effect where data were available. Conclusion This is the most comprehensive meta-analysis of RCTs investigating long-term effects of omega-3, omega-6 and total PUFA on IBD and inflammatory markers. Our findings suggest that supplementation with PUFAs has little or no effect on prevention or treatment of IBD and provides little support for modification of long-term inflammatory status.

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