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Omega 3 Fatty Acid Supplementation Reduces Anxiety: A Meta-Analysis

1/30/2019 12:31:32 PM
Omega-3 polyunsaturated fatty acids, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), accumulate in neuronal cell membranes of the brain. Preclinical and clinical trials suggest that these essential fatty acids might influence behavior and mood. The first systematic review and meta-analysis to assess the anxiolytic potential of omega-3 fatty acids was published in JAMA Network Open in 2018.
The meta-analysis included 19 clinical trials and 2240 participants. The participants had a wide variety of physical and psychiatric health conditions. Most of the studies compared omega-3 fatty acid supplementation to placebo, but 3 were not placebo-controlled. Dosages of omega-3 fatty acids ranged from 225 mg to 4074 mg per day. Study durations ranged from 3 to 26 weeks. 
Pooled analysis of all 19 studies showed that omega-3 fatty acids significantly reduced anxiety symptoms (p = .01). The studies had significant heterogeneity but no significant publication bias. Subgroup analysis revealed that the effect was significantly greater in subjects with defined clinical conditions than in subclinical populations. Also, daily dosages of 2000 mg or more showed significantly greater effects that daily dosages less than 2000 mg.  
A surprising result from subgroup analysis was that supplements containing less than 60% EPA showed a significant effect but not those containing 60% or more EPA. This is opposite from what has been found for depression, where EPA-enriched formulas have been shown to be more effective. The mechanism to explain this difference is not known.
Although there was significant heterogeneity among the studies in this meta-analysis, the main result would not change after removing any of the included studies. Overall, the results suggest that omega-3 fatty acids, at dosages of 2000 mg or more per day, might reduce anxiety in patients with clinical conditions.
Su K, Tseng P, Lin P, et al. Association of Use of Omega-3 Polyunsaturated Fatty Acids With Changes in Severity of Anxiety SymptomsA Systematic Review and Meta-analysis. JAMA Netw Open.2018;1(5).

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