Omega-3 polyunsaturated fatty acids in sarcopenia management: A network meta-analysis of randomized controlled trials

Ping-Tao Tseng; Bing-Yan Zeng; Bing-Syuan Zeng; Yu-Chi Liao; Brendon Stubbs; John S Kuo; Cheuk-Kwan Sun; Yu-Shian Cheng; Yen-Wen Chen; Tien-Yu Chen; Yu-Kang Tu; Pao-Yen Lin; Chih-Wei Hsu; Dian-Jeng Li; Chih-Sung Liang; Mein-Woei Suen; Yi-Cheng Wu; Yow-Ling Shiue; Kuan-Pin Su

doi:10.1016/j.arr.2023.102014

Omega-3 polyunsaturated fatty acids in sarcopenia management: A network meta-analysis of randomized controlled trials

Ageing Res Rev. 2023 Sep:90:102014. doi: 10.1016/j.arr.2023.102014. Epub 2023 Jul 11.

Authors

Ping-Tao Tseng¹, Bing-Yan Zeng², Bing-Syuan Zeng³, Yu-Chi Liao⁴, Brendon Stubbs⁵, John S Kuo⁶, Cheuk-Kwan Sun⁷, Yu-Shian Cheng⁸, Yen-Wen Chen⁹, Tien-Yu Chen¹⁰, Yu-Kang Tu¹¹, Pao-Yen Lin¹², Chih-Wei Hsu¹³, Dian-Jeng Li¹⁴, Chih-Sung Liang¹⁵, Mein-Woei Suen¹⁶, Yi-Cheng Wu¹⁷, Yow-Ling Shiue¹⁸, Kuan-Pin Su¹⁹

Affiliations

¹ Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan; Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan; Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung, Taiwan; Institute of Precision Medicine, National Sun Yat-sen University, Kaohsiung City, Taiwan.
² Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan; Department of Internal Medicine, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan.
³ Department of Internal Medicine, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan; Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan.
⁴ Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan; Clinical Psychology Center, Asia University Hospital, Taichung, Taiwan; Center for Prevention and Treatment of Internet Addiction, Asia University, Taichung, Taiwan.
⁵ Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK; Faculty of Health, Social Care Medicine and Education, Anglia Ruskin University, Chelmsford, UK.
⁶ Neuroscience and Brain Disease Center, China Medical University,Taichung, Taiwan; Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan.
⁷ Department of Emergency Medicine, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan; School of Medicine for International Students, I-Shou University, Kaohsiung, Taiwan.
⁸ Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan; Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai's Home, Taiwan.
⁹ Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung, Taiwan.
¹⁰ School of Medicine, National Defense Medical Center, Taipei, Taiwan; Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei 112, Taiwan.
¹¹ Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan.
¹² Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
¹³ Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
¹⁴ Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan.
¹⁵ School of Medicine, National Defense Medical Center, Taipei, Taiwan; Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan.
¹⁶ Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan; Gender Equality Education and Research Center, Asia University, Taichung, Taiwan; Department of Medical Research, Asia University Hospital, Asia University, Taichung, Taiwan; Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan.
¹⁷ Department of Sports Medicine, Landseed International Hospital, Taoyuan, Taiwan. Electronic address: Keanu.firefox@gmail.com.
¹⁸ Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan; Institute of Precision Medicine, National Sun Yat-sen University, Kaohsiung City, Taiwan. Electronic address: shirley@imst.nsysu.edu.tw.
¹⁹ Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan; An-Nan Hospital, China Medical University, Tainan, Taiwan. Electronic address: cobolsu@gmail.com.

PMID: 37442370
DOI: 10.1016/j.arr.2023.102014

Abstract

Sarcopenia frequently occurs with aging and leads to major adverse impacts on activities of daily living and quality of life in elderly individuals. Omega-3 polyunsaturated fatty acid (omega-3 PUFAs) supplements are considered promising therapeutic agents for sarcopenia management; however, the evidence remains inconsistent. We reviewed randomized controlled trials (RCTs) about omega-3 PUFA supplementation in patients with sarcopenia or in those at high risk for sarcopenia. Network meta-analysis (NMA) procedures were conducted using a frequentist model. The primary outcomes were (1) upper-extremity muscle strength and (2) lower-extremity physical function. The NMA of 16 RCTs showed that the high-dose (more than 2.5 g/day omega-3 PUFAs) group yielded the greatest improvement in both upper-extremity muscle strength and lower-extremity physical function [compared to placebo/standard care groups, standardized mean difference (SMD)= 1.68, 95% confidence interval (95%CI)= 0.03-3.33, and SMD= 0.73, 95%CI= 0.16-1.30, respectively], and the effects were reaffirmed in subgroup analyses of placebo-controlled RCTs or those excluding concurrent resistance training programs. None of the investigated omega-3 PUFAs supplementation was associated with significantly increased skeletal muscle mass, fat mass, or overall body weight. Our findings provide a basis for future large-scale RCTs to investigate the dose effects and clinical application of omega-3 PUFA supplementation in sarcopenia management. TRIAL REGISTRATION: The current study was approved by the Institutional Review Board of the Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (TSGHIRB No. B-109-29) and registered in PROSPERO (CRD42022347161).

Keywords: Frailty; Network meta-analysis; Omega-3 fatty acid; Polyunsaturated fatty acid; Sarcopenia.

Publication types

Meta-Analysis
Review
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Dietary Supplements
Fatty Acids, Omega-3*
Humans
Network Meta-Analysis
Randomized Controlled Trials as Topic
Sarcopenia* / drug therapy

Substances

Fatty Acids, Omega-3