Omega-3, Omega-6, and Polyunsaturated Fat for Cognition: Systematic Review and Meta-analysis of Randomized Trials |
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| Affiliation: | 1. Norwich Medical School, University of East Anglia, Norwich, United Kingdom;2. School of Health Sciences, University of East Anglia, Norwich, United Kingdom;3. Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, United Kingdom;1. Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong;2. Jockey Club Centre for Osteoporosis Care and Control, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong;3. Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong;1. GHU AP-HP.Sorbonne Université, Hôpital Saint-Antoine, Pharmacie, Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France;2. Université Paris-Saclay, Faculté de Pharmacie, Département de Pharmacie Clinique, Chatenay Malabry, France;3. Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, GHU AP-HP.Sorbonne Université, Hôpital Pitié-Salpêtrière, Service de Biostatistiques santé publique information médicale, Paris, France;1. Brain Physiology and Metabolism Section, Laboratory of Neuroscience, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA;2. Section on Nutritional Neurosciences, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA;3. Department of Physical Medicine and Rehabilitation, Program on Integrative Medicine, University of North Carolina, Chapel Hill, NC, USA;4. Nutrition Research and Metabolism Core, North Carolina Translational Clinical Sciences Institute, University of North Carolina, Chapel Hill, USA;5. Department of Neurology, Program on Integrative Medicine, University of North Carolina, Chapel Hill, NC, USA;1. University of Pittsburgh, Department of Psychology, 210S. Bouquet St, Pittsburgh, PA 15260, USA;2. Center for the Neural Basis of Cognition, Pittsburgh, PA, USA;3. University of Pittsburgh, Department of Medicine, 120 Lytton Avenue, Suite 100B, Pittsburgh, PA 15213, USA;4. Department of Psychiatry, Mt. Sinai School of Medicine, 130 West Kingsbridge Road Bronx, NY 10468, USA |
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| Abstract: | ObjectivesNeurocognitive function may be influenced by polyunsaturated fat intake. Many older adults consume omega-3 supplements hoping to prevent cognitive decline. We assessed effects of increasing omega-3, omega-6, or total polyunsaturated fats on new neurocognitive illness and cognition.Design and inclusion criteriaWe carried out a systematic review and meta-analysis of randomized controlled trials (RCTs) in adults, with duration ≥24 weeks, assessing effects of higher vs lower omega-3, omega-6, or total polyunsaturated fats and outcomes: new neurocognitive illness, newly impaired cognition, and/or continuous measures of cognition.MethodsWe searched MEDLINE, Embase, Cochrane CENTRAL, and trials registers (final update of ongoing trials December 2018). We duplicated screening, data extraction, and risk of bias assessment. Neurocognitive measures were grouped to enable random effects meta-analysis. GRADE assessment, sensitivity analyses, and subgrouping by dose, duration, type of intervention, and replacement were used to interrogate our findings.ResultsSearches generated 37,810 hits, from which we included 38 RCTs (41 comparisons, 49,757 participants). Meta-analysis suggested no or very little effect of long-chain omega-3 on new neurocognitive illness [risk ratio (RR) 0.98, 95% confidence interval (CI) 0.87-1.10, 6 RCTs, 33,496 participants, I2 36%), new cognitive impairment (RR 0.99, 95% CI 0.92-1.06, 5 RCTs, 33,296 participants, I2 0%) or global cognition assessed using the Mini-Mental State Examination (MD 0.10, 95% CI 0.03-0.16, 13 RCTs, 14,851 participants, I2 0%), all moderate-quality evidence. Effects did not differ with sensitivity analyses, and we found no differential effects by dose, duration, intervention type, or replacement. Effects of increasing α-linolenic acid, omega-6, or total PUFA were unclear.ConclusionsThis extensive trial data set enabled assessment of effects on neurocognitive illness and cognitive decline not previously adequately assessed. Long-chain omega-3 probably has little or no effect on new neurocognitive outcomes or cognitive impairment.ImplicationsLong-chain omega-3 supplements do not help older adults protect against cognitive decline. |
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| Keywords: | Fatty acids, omega-3 fatty acids, omega-6 fatty acids, unsaturated meta-analysis cognition dementia |
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