Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
Department of Health and Human Performance, University of Houston, Houston, TX, USA.
BMC Psychiatry. 2024 Jun 18;24(1):455. doi: 10.1186/s12888-024-05881-2.
BACKGROUND/OBJECTIVES: There is uncertainty about the optimum dose of omega-3 fatty acids for anxiety symptoms. We aimed to find the dose-dependent effect of omega-3 supplementation on anxiety symptoms.
We systematically reviewed PubMed, Scopus, and Web of Science until December 2022 to find randomized trials that assessed the effects of omega-3 fatty acids supplementation on anxiety symptoms in adults. Investigators performed the literature search and screened the titles/abstracts and full-texts and between-reviewer agreement was assessed as Cohen's kappa coefficient. We conducted a random-effects dose-response meta-analysis to estimate standardized mean differences (SMD) and 95% confidence intervals (CIs) and assessed the certainty of evidence using the GRADE framework.
A total of 23 trials with 2189 participants were included. Each 1 gram per day supplementation with omega-3 fatty acids resulted in a moderate decrease in anxiety symptoms (SMD: -0.70, 95%CI: -1.17, -0.22; GRADE = low). The non-linear dose-response analysis indicated the greatest improvement at 2 g/d (SMD: -0.93, 95%CI: -1.85, -0.01), and that supplementation in a dose lower than 2 g/d did not affect anxiety symptoms. Omega-3 fatty acids did not increase adverse events (odds ratio: 1.20, 95%CI: 0.89, 1.61; GRADE = moderate).
The present dose-response meta-analysis suggested evidence of very low certainty that supplementation with omega-3 fatty acids may significantly improve anxiety symptoms, with the greatest improvements at 2 g/d. More trials with better methodological quality are needed to reach more robust evidence.
PROSPERO (CRD42022309636).
背景/目的：对于治疗焦虑症状的最佳 ω-3 脂肪酸剂量存在不确定性。我们旨在确定 ω-3 补充剂对焦虑症状的剂量依赖性影响。
我们系统地检索了 PubMed、Scopus 和 Web of Science，检索时间截至 2022 年 12 月，以查找评估 ω-3 脂肪酸补充剂对成年人焦虑症状影响的随机试验。研究者进行文献检索，并筛选标题/摘要和全文，评估两位审稿人之间的一致性采用 Cohen's kappa 系数。我们进行了随机效应剂量-反应荟萃分析，以估计标准化均数差（SMD）和 95%置信区间（CI），并使用 GRADE 框架评估证据的确定性。
共纳入 23 项试验，共计 2189 名参与者。每天补充 1 克 ω-3 脂肪酸可使焦虑症状适度减轻（SMD：-0.70，95%CI：-1.17，-0.22；GRADE=低）。非线性剂量-反应分析表明，每天补充 2 克时改善效果最佳（SMD：-0.93，95%CI：-1.85，-0.01），而每天补充剂量低于 2 克时对焦虑症状没有影响。ω-3 脂肪酸不会增加不良反应（比值比：1.20，95%CI：0.89，1.61；GRADE=中）。
本剂量-反应荟萃分析结果提示，补充 ω-3 脂肪酸可能显著改善焦虑症状，但证据确定性非常低，每天补充 2 克时效果最佳。需要更多高质量方法学试验来获得更稳健的证据。
PROSPERO（CRD42022309636）。
