Early-life high-dose omega-3 polyunsaturated fatty acid supplementation reduces risk of childhood asthma/wheezing: A meta-analysis of randomized controlled trials.
Asthma, a chronic inflammatory airway disease characterized by wheezing, imposes a substantial global health burden on children. Given the potential of early-life omega-3 polyunsaturated fatty acid (omega-3 PUFA) supplementation as an anti-inflammatory intervention to prevent childhood asthma and wheezing, this meta-analysis aims to clarify its efficacy and investigate dose-dependency.
This systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three reviewers independently evaluated the studies, extracted data, and assessed bias using the Jadad scale. The outcomes included the risk of asthma/wheezing: pooled odds ratios (ORs) were calculated using fixed-effects models, along with sensitivity/subgroup analyses and dose-response meta-regression.
Twelve randomized controlled trials (RCTs) involving 4,156 participants showed no overall association between omega-3 PUFA and a reduced risk of asthma/wheezing (odds ratio [OR]: 1.00; 95% confidence interval [CI]: 0.84-1.18). However, high-dose supplementation (≥1,200 mg/day) significantly decreased the risk (OR: 0.66; 95% CI: 0.46-0.94). Similarly, high-dose eicosapentaenoic acid (EPA≥1,000 mg/day) also significantly reduced the risk (OR: 0.67; 95% CI: 0.46-0.97). Dose-response analysis confirmed a linear relationship (p=0.002), indicating a 26.6% reduction in risk for every 1,000 mg/day increase in dose (OR: 0.734; 95% CI: 0.602-0.896). Subgroup analyses revealed no heterogeneity with respect to study location, allergy risk, or follow-up duration.
Early-life omega-3 PUFA supplementation reduces childhood asthma/wheezing risk in a dose-dependent manner. High-dose regimens, particularly those involving EPA, provide substantial protection, suggesting a potential clinical strategy for prevention, although further validation is required.
This systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three reviewers independently evaluated the studies, extracted data, and assessed bias using the Jadad scale. The outcomes included the risk of asthma/wheezing: pooled odds ratios (ORs) were calculated using fixed-effects models, along with sensitivity/subgroup analyses and dose-response meta-regression.
Twelve randomized controlled trials (RCTs) involving 4,156 participants showed no overall association between omega-3 PUFA and a reduced risk of asthma/wheezing (odds ratio [OR]: 1.00; 95% confidence interval [CI]: 0.84-1.18). However, high-dose supplementation (≥1,200 mg/day) significantly decreased the risk (OR: 0.66; 95% CI: 0.46-0.94). Similarly, high-dose eicosapentaenoic acid (EPA≥1,000 mg/day) also significantly reduced the risk (OR: 0.67; 95% CI: 0.46-0.97). Dose-response analysis confirmed a linear relationship (p=0.002), indicating a 26.6% reduction in risk for every 1,000 mg/day increase in dose (OR: 0.734; 95% CI: 0.602-0.896). Subgroup analyses revealed no heterogeneity with respect to study location, allergy risk, or follow-up duration.
Early-life omega-3 PUFA supplementation reduces childhood asthma/wheezing risk in a dose-dependent manner. High-dose regimens, particularly those involving EPA, provide substantial protection, suggesting a potential clinical strategy for prevention, although further validation is required.
Authors
Cai Cai, Ji Ji, He He, Zhou Zhou, Ge Ge, Gu Gu, Shang Shang, Wang Wang, Yu Yu, Ren Ren, Zhou Zhou, Zhang Zhang
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