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"Spend your money on something more useful," said a British researcher who reviewed evidence on omega-3 fatty acids and type 2 diabetes.
The increase in the number of omega-3 fatty acids in the diet has "little or no effect" on the prevention or treatment of type 2 diabetes, according to an important report from evidence done by a team from the Norwich Medical School of the University of East Anglia (UEA).
The researchers undertook to analyze how omega-3, omega-6 and total polyunsaturated fatty acids (PUFAs) affected glucose metabolism and the diagnosis of diabetes.
The study, which would be the most comprehensive study to date, was commissioned by the World Health Organization and its findings are published online today by the Commission. BMJ .
Does fish oil fight diabetes?
Previous research has been mixed on omega-3 and type 2 diabetes, with data showing both positive and negative effects.
Many countries recommend increasing the intake of polyunsaturated and omega-3 fatty acids as part of a healthy and balanced diet. In the UK, this translates into recommendations recommending eating two servings of fish a week, including a fat one. In the UK, no specific recommendations for omega-3 supplementation. Despite this, fish oil supplements are one of the best-selling supplements in the UK.
The UEA team evaluated data from 83 randomized controlled trials lasting at least 24 weeks, involving 121,070 people with and without type 2 diabetes. Some previously unpublished data were included.
Good quality evidence has been found for long-chain omega-3 fatty acids (LCn3) from fish oils. The LCn3 increase of 2 g per day over a mean test duration of 33 months did not have a significant impact on the diagnosis of diabetes or glucose metabolism. The review also found that there was no change with a longer testing period.
Results that a dose of more than 4.4 g per day could have negative effects on the risk of diabetes and glucose metabolism should be interpreted with caution, they said.
There was less evidence of good quality for the effects of alpha-linolenic acid (ALA, another omega-3), omega-6, and total PUFAs on the diagnosis of diabetes.
However, a meta-analysis again suggested that glucose metabolism was little or not affected. The increase in ALA could increase insulin fasting by about 7%, they discovered.
The researchers found that data was missing in some studies and others had a risk of bias.
Relieved, rather than surprised
Were the researchers surprised by their discoveries? "We were really relieved because we had suspected before starting the examination that omega-3s could have negative effects on diabetes – both the risk of diabetes and the control of diabetes," Lee Hooper, Reader in Research Synthesis, Nutrition and Hydration, Narrated Medscape News UK.
"But we did not find any negative effects," she said. We were very relieved. We did not find any benefit either. We have a huge mass of evidence here. It looks like the effects are completely neutral, it does not go positive, it does not go negative – very little effect.
"The exception to this rule is that when we come up with fairly high doses of long-chain omega-3, on 4.4 mg a day, it seems that glucose metabolism may be slightly more At this point, even though very high doses may be negative, most never take such high doses, so this is probably not a problem for many people. "
No convincing evidence
The researchers concluded, "There is no convincing evidence to suggest that altering our intake of LCn3, ALA, Omega-6 or total PUFAs impairs glucose metabolism or the risk of diabetes."
They also said that supplementation "should not be encouraged for the prevention or treatment of diabetes".
They stated that future evidence from longer, high quality trials, with a duration of at least 12 months, would be useful.
Reacting to the study in a statement, Douglas Twenefour, Deputy Head of Healthcare at Diabetes UK, said: "Although omega-3 fatty acids are essential to our overall health, it is generally best for people with type 2 diabetes to ingest at least two servings of fatty fish a week, taking supplements. "
Doctor, should I take omega-3 supplements?
This was part of a series of examinations conducted by the UEA team. "The World Health Organization asked us about the health effects of omega-3, omega-6 and total polyunsaturated fat on a range of health effects," Lee Hooper told us. .
"We have already published our work on the effects of cardiovascular disease, heart disease and stroke, as well as body weight, and again, it seems that omega-3s are also very neutral in this regard.
"Add diabetes to that, and it's not a problem, it's great."
So what should the doctors say if patients were asking questions about omega-3 supplements?
"What we should be saying is," Spend your money for something more useful. Devote it to a great physical activity that you really like. Or use it for foods you really like. Healthy fruits or superb fish.
She continued, "Do not spend it on supplements, choose things that will make a profit and please you."
BMJ 2019; 366: l4697 http://dx.doi.org/10.1136/bmj.l4697
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