Omega-3 and omega-6 polyunsaturated fatty acids and metabolic

syndrome: A systematic review and meta-analysis

Haeun Jang, Kyong Park -- Department of Food and Nutrition, Yeungnam University, 280 Daehak-Ro, Gyeongsan, Gyeongbuk, 38541, Republic of
Korea
Presented by Team B4: Kratimenou, Luster, Mastori-Kourmpani, Meneguzzo, Papadopoulos​

Background & Discussion

Aims
Metabolic syndrome:
• A cluster of metabolic disorders
• Leads directly to the increase of the risk of cardiovascular disease
Individuals with metabolic disorders have a high risk of heart disease and stroke and are also
burdened by an increased medical costs.
For prevention and management of Metabolic syndrome, the exploration of a protective
factor is extremely important.
The association between diet, nutrition and MetS has been evaluated by different studies.
More specifically n-3 and n-6 PUFAS positively impact the health.
1. Omega-3 polyunsaturated fatty acids:
• Suppress the synthesis of thromboxanes, atherosclerotic plaque and inflammation
• Have beneficial effects on the management of triglycerides, fasting blood sugar, HDL
cholesterol and insulin resistance.
n-3 PUFAs and MetS risk
Neither docosapentaenoic acid (DPA) nor eicosapentaenoic acid (EPA) levels were
significantly associated with MetS risk. However, docosahexaenoic acid (DHA) was
inversely associated with the risk of MetS. (Fig. 3)
n-6 PUFAs and MetS risk
Subgroup analysis of circulating/dietary n-6 PUFA composition showed that neither linoleic
acid (LA) nor arachidonic acid (AA) level was significantly associated with MetS risk (Fig.
6)
• Higher omega-3 PUFA levels in diets or blood were associated with a 26%
reduction in the risk of MetS, but little association found in non-Asian
population.
• EPA and DHA provide similar health benefits in humans, but DHA has shown
greater effectiveness in inhibiting vasoconstriction, controlling inflammatory
pathways, and dissolving blood lipids.
• Since studies are using differentiated approaches, a selection based on a
STOBE criteria of at least 11 was applied to remove lower-than-valid cohort
studies.
• This significantly reduced the amount of useful studies to 13.

2. Omega-6 polyunsaturated fatty acids:

• Reduce the risk of type 2 diabetes Total Individuals 36,542
• Have a positive effect of lipid management resulting inà decrease of total cholesterol,
increase of HDL- cholesterol
Case-control 2
Nevertheless, previous studies have reported conflicting evidence and have a lack in depth
Cross-sectional 9
analysis.
Nested case-control 1
This study is aimed to:
• Systematically review the association between n-3 and n-6 PUAFS and MetS Prospective Cohort 1
• Estimate the summarized results
• Discuss the heterogeneity between studies

Methods and Materials Conclusion

Fig. 3. Forest plot of the association between circulating/dietary omega-3 polyunsaturated fatty acids and metabolic
syndrome stratified by fatty acid composition. ALA, alpha-linolenic acid; AT, adipose tissue; DHA, docosahexaenoic acid;

Source & Source Selection D, dietary intake; DPA, docosapentaenoic acid; EP, erythrocyte phospholipids; EPA, eicosapentaenoic acid; ES, effect size;
M, men; PP, plasma phospholipids; TP, total plasma; W, women. a The odds ratio was calculated using the values of the The present meta-analysis indicates that higher intakes of omega-3 PUFAs, but not omega-6
• Guidelines and Standards Suggested by PRISMA.  highest quantiles of exposure in the relevant previous studies.
PUFAs, was associated with lower MetS risk; adding to the current body of evidence on the
• Literature search: PUBMED, Web of Science, and Cochrane Library. 
metabolic health effects of circulating/dietary omega-3 PUFAs.
• Publications until December 19th, 2017. 
• Keywords Used: fish oils, seafood, omega-3, n-3, PUFA, omega-6, n-
6, metabolic syndrome, metabolic syndrome X, syndrome X, insulin resistance

•
syndrome. 
Studies screened according to PICOS criteria. 
References
• 4 exclusion criteria used. 
• Quality Assessment: STROBE Checklist score <11 excluded. 
1. National Cholesterol Education Program. National cholesterol education program
• 13 Independent Articles chosen for the Meta-Analysis. 
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cross-sectional studies, 1 nested case-control study, and 1 prospective cohort study), which Cardiovasc Dis 2017;11:215e25.
included 36,542 participants Fig. 6. Forest plot of the association between circulating/dietary omega-6 polyunsaturated fatty acids and metabolic
syndrome stratified by fatty acid composition. AA, arachidonic acid; AT, adipose tissue; D, dietary intake; ES, effect size;
LA, linoleic acid; M, men; PP, plasma phospholipids; TP, total plasma; W, women. a The odds ratio was calculated using the
values of the highest quantiles of exposure in the relevant previous studies.