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Omega-3 PUFAs might help with anxiety, at least for some people

The first meta-analysis examining omega-3 PUFAs' effect on anxiety found a small, but significant, impact on anxiety overall.

Study under review: Association of Use of Omega-3 Polyunsaturated Fatty Acids With Changes in Severity of Anxiety Symptoms: A Systematic Review and Meta-analysis

Introduction

Anxiety[1] is a psychological state characterized by lasting, exaggerated, and/or inexplicable worry or fear that interferes with the everyday life of an individual. Up to one-third[2] of the population experiences anxiety in their lifetime and many go for more than two years[3] before obtaining diagnosis or treatment. Often co-occurring[4] with depression and associated with lower quality of life[5], anxiety calls for safe and evidence-based treatment.

Psychological and pharmacological treatment for anxiety is available and effective[6], but both have some limitations[7]. For instance, there are adverse effects[8] from pharmacological treatment, such as sedation or dependence, which can deter people. Psychological treatment, on the other hand, may be considered as too time consuming, costly, or have limited availability. In addition, the specific techniques and/or components of different behavioral therapies that are responsible for beneficial outcomes[9] are not completely understood.

Omega-3 polyunsaturated fatty acids (PUFAs) have demonstrated therapeutic potential as a part of an emerging relationship[10] between nutrition and mental health. Evidence suggests that omega-3 PUFAs[11] modulate neurochemical activity, immunomodulation, anti-inflammation, and maybe even neuroplasticity — all mechanisms which overlap with some effective pharmacological treatments as shown in Figure 1, and supporting omega-3 PUFAs’ potential role for mood and anxiety disorder[12] treatments.

These mechanistic reasons for thinking that omega-3 PUFAs may impact anxiety are supported by some clinical evidence as well. For instance, an RCT of participants with substance abuse reported significant decreases in anger and anxiety[13] in people supplementing with omega-3 PUFAs eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), when compared to placebo. Another RCT[14] found reduced inflammatory markers and anxiety symptoms in healthy individuals supplemented with omega-3 PUFAs. However, one study[15] found no difference in anxiety symptoms of obsessive compulsive participants following EPA supplementation for six weeks in a placebo-controlled crossover trial.

One common theme between these three trials is that they’re all fairly small. The low power may explain the contradictory results to some degree. Given the low sample sizes of the individual RCTs, their conflicting results, and the low-risk nature of treatment, strong theoretical rationale[16] for omega-3 PUFAs’ possible efficacy for anxiety, the authors of the systematic review and meta-analysis under review aimed to distill results from studies that evaluated the influence of omega-3 PUFAs on anxiety symptoms.

Anxiety is a psychological state characterized by exaggerated fear that interferes with everyday life. While psychological and pharmacological treatments appear effective, lack of time or fear of side effects can deter people. Omega-3 PUFAs have emerged as a potential therapeutic agent for mental disorders, including anxiety. The study under review is a systematic review and meta-analysis of existing interventions to evaluate the influence of omega-3 PUFAs on anxiety symptoms.

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