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Fighting fat with fat: omega-3s vs. NAFLD

Diet and exercise are some of the main ways to fight non-alcoholic fatty liver disease. This meta-analysis examined whether n-3 supplementation could be added to the list.

Study under review: Systematic review and meta-analysis of controlled intervention studies on the effectiveness of long-chain omega-3 fatty acids in patients with nonalcoholic fatty liver disease

Introduction

Non-alcoholic fatty liver disease (NAFLD) is a condition in which excessive fat (more than 5% of liver weight) accumulates in the liver due to causes unrelated to alcohol. Depending on the method of diagnosis, the prevalence of NAFLD in the U.S. is 21-24%[1]. The primary risk factors[2] for NAFLD are obesity, type 2 diabetes, dyslipidemia, and the metabolic syndrome.

Although NAFLD is a condition associated with adults, there has been a rise in the presence of NAFLD in children over the last several decades. The average prevalence is about 8%[3], with rates as high as 38%[4] in some groups of children. Despite the prevalence of the disease in adults, and the burgeoning issue in children, there are no therapeutic agents currently approved for managing NAFLD. This is a problem, since NAFLD can ultimately progress to non-alcoholic steatohepatitis (NASH - inflamed fatty liver not due to alcohol).

Long-chain omega-3 fatty acids, specifically EPA and DHA, have been investigated as potential therapeutics for NAFLD because they have been shown to alter expression of genes[5] related to fatty acid metabolism in the liver. Specifically, they have been shown to increase expression of genes related to fatty acid oxidation[6] and decrease expression of genes[7] related to fatty acid synthesis[8].

There have been a myriad of clinical trials investigating the effect of omega-3 supplementation in both adults and children with NAFLD. Some of these trials have been previously examined in a systematic review and meta-analysis[9]. However, the previous study did not include children and there has been additional research since its publication in 2012. Therefore, the purpose of this study was to perform a contemporary systematic review and meta-analysis on the effect of omega-3 supplementation in adults and children with NAFLD on liver-related outcomes and metabolic risk factors.

NAFLD affects roughly a quarter of the adult population in the U.S., while rates in children are growing at an alarming rate. Omega-3 fatty acids have been shown to directly modulate genes related to fatty acid metabolism in the liver. The present study is a systematic review and meta-analysis examining the effect of omega-3 supplementation in adults and children with NAFLD on liver-related outcomes and metabolic risk factors.

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Other Articles in Issue #47 (September 2018)