Long-term effects of increasing omega-3, omega-6 and total polyunsaturated fats on inflammatory bowel disease and marker
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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 Sarah M. Ajabnoor1,2 · Gabrielle Thorpe3 · Asmaa Abdelhamid1 · Lee Hooper1 Received: 6 March 2020 / Accepted: 6 October 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract 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 μg/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. Keywords Inflammatory bowel diseases · Dietary fats, unsaturated · Fatty acids, omega-3 · Fatty acids, omega-6 · C-reactive protein · Alpha-linolenic acid · Meta-analysis
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00394-020-02413-y) contains supplementary material, which is available to authorized users. * Sarah M. Ajabnoor [email protected] 1
Norwich Medical School, University of East Anglia, Norwich, UK
2
Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80324, Jeddah 21589, Saudi Arabia
3
School of Health Sciences, University of East Anglia, Norwich, UK
Crohn’s Disease (CD) and ulcerative colitis (UC), collectively ‘inflammatory bowel disease’ (IBD), are inflammatory conditions of the gastrointestinal tract. While CD and UC share relapsing–remitting progression and chronic mucosal inflammation,
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