Skip to main content
Review

Can omega-3 fatty acids and vitamin E co-supplementation affect obesity indices?

A meta-analysis

Published Online:https://doi.org/10.1024/0300-9831/a000757

Abstract:Background: Studies have shown that vitamin E as an antioxidant protects omega-3 fatty acids (FAs) from oxidation. Several studies have evaluated the effect of omega-3 FAs and vitamin E co-supplementation on obesity indices; however, the results are inconsistent. The present systematic review and meta-analysis was conducted to address the role of omega-3 FAs plus vitamin E on obesity indices. Methods: Cochrane Library, PubMed, Scopus, Embase, and Web of Science databases were searched up to February 2022. Among all of the qualified studies, 10 articles were selected. The effect size was presented as weighted mean difference (WMD) and 95% confidence interval (CI). Fixed-effects model was employed to perform meta-analysis. Subgroup analysis and publication bias assessment were carried out. Results: Ten eligible randomized controlled trials comprising 558 participants were included. The average dose of omega-3 FAs and vitamin E co-supplementation in studies was 1000–4000 mg/day and 400 IU, respectively. Intervention duration varied from 6 to 16 weeks. There was no significant effect of omega-3 and vitamin E co-supplementation on body weight (BW) (WMD=0.14 kg; 95% CI: −0.13 to 0.42; p=0.297), and body mass index (BMI) (WMD=0.08, 95% CI: −0.01 to 0.16, p=0.073). However, subgroup analysis showed that it might increase BMI in women over 50 years and if the intervention lasted more than 8 weeks. Conclusion: There was no significant impact of combined omega-3 FAs and vitamin E supplementation on BW and BMI; however, it should be noted that the intervention has an increasing impact when supplementation duration was >8 weeks and in individuals with type 2 diabetes mellitus, >50 years old, and BMI>25 kg/m2.

References

  • 1 Collaborators GO. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med. 2017;377(1):13–27. First citation in articleCrossref MedlineGoogle Scholar

  • 2 Amugsi DA, Dimbuene ZT, Mberu B, Muthuri S, Ezeh AC. Prevalence and time trends in overweight and obesity among urban women: an analysis of demographic and health surveys data from 24 African countries, 1991–2014. BMJ Open. 2017;7(10):e017344. First citation in articleCrossref MedlineGoogle Scholar

  • 3 Newton S, Braithwaite D, Akinyemiju TF. Socio-economic status over the life course and obesity: Systematic review and meta-analysis. PloS One. 2017;12(5):e0177151. First citation in articleCrossref MedlineGoogle Scholar

  • 4 Denova-Gutiérrez E, Vargas-Chanes D, Hernández S, Muñoz-Aguirre P, Napier D, Barquera S. Linking socioeconomic inequalities and type 2 diabetes through obesity and lifestyle factors among Mexican adults: a structural equations modeling approach. Salud Publica Mex. 2020;62(2):192–202. First citation in articleCrossref MedlineGoogle Scholar

  • 5 Gouda M, Matsukawa M, Iijima H. Associations between eating habits and glycemic control and obesity in Japanese workers with type 2 diabetes mellitus. Diabetes Metab Syndr Obes. 2018;11:647. First citation in articleCrossref MedlineGoogle Scholar

  • 6 Sun M, Feng W, Wang F, Li P, Li Z, Li M, et al. Meta-analysis on shift work and risks of specific obesity types. Obes Rev. 2018;19(1):28–40. First citation in articleCrossref MedlineGoogle Scholar

  • 7 Qureshi NK, Hossain T, Hassan MI, Akter N, Rahman MM, Sultana MM, et al. Neck circumference as a marker of overweight and obesity and cutoff values for bangladeshi adults. Indian J Endocrinol Metab. 2017;21(6):803. First citation in articleCrossref MedlineGoogle Scholar

  • 8 Gawrys W, Zyska A, Ślęzak A. Anthropometric indicators and their applications for assessing population’s health condition. Hygeia. 2017;52(1):41–7. First citation in articleGoogle Scholar

  • 9 Sarna A, Porwal A, Acharya R, Ashraf S, Ramesh S, Khan N, et al. Waist circumference, waist-to-height ratio and BMI percentiles in children aged 5 to 19 years in India: A population-based study. Obes Sci Pract. 2021;7(4):392–404. First citation in articleCrossref MedlineGoogle Scholar

  • 10 Tomas Ž, Škarić-Jurić T, Zajc Petranović M, Jalšovec M, Rajić Šikanjić P, Smolej Narančić N. Waist to height ratio is the anthropometric index that most appropriately mirrors the lifestyle and psychological risk factors of obesity. Nutr Diet. 2019;76(5):539–45. First citation in articleCrossref MedlineGoogle Scholar

  • 11 Batueva A, Erlikh V, Pashnina A. Influence of different types of circuit training on the functional status and anthropometric parameters in young women with obesity. Minerva Ortop Traumatol. 2018;69(Suppl 1):86–9. First citation in articleGoogle Scholar

  • 12 Friedenreich CM, Ryder-Burbidge C, McNeil J. Physical activity, obesity and sedentary behavior in cancer etiology: epidemiologic evidence and biologic mechanisms. Mol Oncology. 2021;15(3):790–800. First citation in articleCrossref MedlineGoogle Scholar

  • 13 Pharr JR, Coughenour CA, Bungum TJ. An assessment of the relationship of physical activity, obesity, and chronic diseases/conditions between active/obese and sedentary/normal weight American women in a national sample. Public Health. 2018;156:117–23. First citation in articleCrossref MedlineGoogle Scholar

  • 14 Bray G, Kim K, Wilding J, Federation WO. Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation. Obes Rev. 2017;18(7):715–23. First citation in articleCrossref MedlineGoogle Scholar

  • 15 Chia CW, Egan JM. Incretins in obesity and diabetes. Ann N Y Acad Sci. 2020;1461(1):104–26. First citation in articleCrossref MedlineGoogle Scholar

  • 16 Koliaki C, Liatis S, Kokkinos A. Obesity and cardiovascular disease: revisiting an old relationship. Metabolism. 2019;92:98–107. First citation in articleCrossref MedlineGoogle Scholar

  • 17 Cohen JB. Hypertension in obesity and the impact of weight loss. Curr Cardiol Reps. 2017;19(10):1–8. First citation in articleMedlineGoogle Scholar

  • 18 Yang MH, Kang SY, Lee JA, Kim YS, Sung EJ, Lee K-Y, et al. The effect of lifestyle changes on blood pressure control among hypertensive patients. Korean J Fam Med. 2017;38(4):173. First citation in articleCrossref MedlineGoogle Scholar

  • 19 Tebar WR, Ritti-Dias RM, Farah BQ, Zanuto EF, Vanderlei LCM, Christofaro DGD. High blood pressure and its relationship to adiposity in a school-aged population: body mass index vs waist circumference. Hypertens Res. 2018;41(2):135–40. First citation in articleCrossref MedlineGoogle Scholar

  • 20 Wei J, Liu X, Xue H, Wang Y, Shi Z. Comparisons of visceral adiposity index, body shape index, body mass index and waist circumference and their associations with diabetes mellitus in adults. Nutrients. 2019;11(7):1580. First citation in articleCrossref MedlineGoogle Scholar

  • 21 Tigbe WW, Granat MH, Sattar N, Lean ME. Time spent in sedentary posture is associated with waist circumference and cardiovascular risk. Int J Obes. 2017;41(5):689–96. First citation in articleCrossrefGoogle Scholar

  • 22 Engin A. The pathogenesis of obesity-associated adipose tissue inflammation. Adv Exp Med Biol. 2017;221–45. First citation in articleCrossrefGoogle Scholar

  • 23 Rocha VZ, Folco EJ. Inflammatory concepts of obesity. Int J Inflam. 2011;2011:529061. First citation in articleMedlineGoogle Scholar

  • 24 Goossens GH. The role of adipose tissue dysfunction in the pathogenesis of obesity-related insulin resistance. Physiol Behav. 2008;94(2):206–18. First citation in articleCrossref MedlineGoogle Scholar

  • 25 Li G, Wu H-k, Wu X-w, Cao Z, Tu Y-c, Ma Y, et al. The feasibility of two anthropometric indices to identify metabolic syndrome, insulin resistance and inflammatory factors in obese and overweight adults. Nutrition. 2019;57:194–201. First citation in articleCrossref MedlineGoogle Scholar

  • 26 Bian AL, Hu HY, Rong YD, Wang J, Wang JX, Zhou XZ. A study on relationship between elderly sarcopenia and inflammatory factors IL-6 and TNF-α. Eur J Med Res. 2017;22(1):25. First citation in articleCrossref MedlineGoogle Scholar

  • 27 Yang M, Zhou X, Xu J, Yang B, Yu J, Gong Q, et al. Association of serum chemerin and inflammatory factors with type 2 diabetes macroangiopathy and waist-to-stature ratio. Bosnian journal of basic medical sciences. 2019;19(4):328–35. First citation in articleMedlineGoogle Scholar

  • 28 Sadeghi F, Alavi-Naeini A, Mardanian F, Ghazvini MR, Mahaki B. Omega-3 and vitamin E co-supplementation can improve antioxidant markers in obese/overweight women with polycystic ovary syndrome. Int J Vitam Nutr Res. 2020;90(5–6):477–83. First citation in articleLinkGoogle Scholar

  • 29 Raederstorff D, Wyss A, Calder PC, Weber P, Eggersdorfer M. Vitamin E function and requirements in relation to PUFA. Br J Nutr. 2015;114(8):1113–22. First citation in articleCrossref MedlineGoogle Scholar

  • 30 Allard JP, Kurian R, Aghdassi E, Muggli R, Royall D. Lipid peroxidation during n-3 fatty acid and vitamin E supplementation in humans. Lipids. 1997;32(5):535–41. First citation in articleCrossref MedlineGoogle Scholar

  • 31 Meydani M, Natiello F, Goldin B, Free N, Woods M, Schaefer E, et al. Effect of long-term fish oil supplementation on vitamin E status and lipid peroxidation in women. J nutr. 1991;121(4):484–91. First citation in articleCrossref MedlineGoogle Scholar

  • 32 Moher D, Schulz KF, Simera I, Altman DG, Guidance for developers of health research reporting guidelines. PLoS medicine. 2010;7(2):e1000217. First citation in articleCrossref MedlineGoogle Scholar

  • 33 Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21(11):1539–58. First citation in articleCrossref MedlineGoogle Scholar

  • 34 Asemi Z, Soleimani A, Bahmani F, Shakeri H, Mazroii N, Abedi F, et al. Effect of the omega-3 fatty acid plus vitamin E supplementation on subjective global assessment score, glucose metabolism, and lipid concentrations in chronic hemodialysis patients. Mol Nutr Food Res. 2016;60(2):390–8. First citation in articleCrossref MedlineGoogle Scholar

  • 35 Ebrahimi FA, Samimi M, Foroozanfard F, Jamilian M, Akbari H, Rahmani E, et al. The effects of omega-3 fatty acids and vitamin E co-supplementation on indices of insulin resistance and hormonal parameters in patients with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. Exp Clin Endocrinol Diabetes. 2017;125(06):353–9. First citation in articleCrossref MedlineGoogle Scholar

  • 36 Jamilian M, Shojaei A, Samimi M, Ebrahimi FA, Aghadavod E, Karamali M, et al. The effects of omega-3 and vitamin E co-supplementation on parameters of mental health and gene expression related to insulin and inflammation in subjects with polycystic ovary syndrome. J Affect Disord. 2018;229:41–7. First citation in articleCrossref MedlineGoogle Scholar

  • 37 Rahmani E, Samimi M, Ebrahimi FA, Foroozanfard F, Ahmadi S, Rahimi M, et al. The effects of omega-3 fatty acids and vitamin E co-supplementation on gene expression of lipoprotein (a) and oxidized low-density lipoprotein, lipid profiles and biomarkers of oxidative stress in patients with polycystic ovary syndrome. Mol Cell Endocrinol. 2017;439:247–55. First citation in articleCrossref MedlineGoogle Scholar

  • 38 Jamilian M, Dizaji SH, Bahmani F, Taghizadeh M, Memarzadeh MR, Karamali M, et al. A randomized controlled clinical trial investigating the effects of omega-3 fatty acids and vitamin E co-supplementation on biomarkers of oxidative stress, inflammation and pregnancy outcomes in gestational diabetes. Can J Diabetes. 2017;41(2):143–9. First citation in articleCrossref MedlineGoogle Scholar

  • 39 Taghizadeh M, Jamilian M, Mazloomi M, Sanami M, Asemi Z. A randomized-controlled clinical trial investigating the effect of omega-3 fatty acids and vitamin E co-supplementation on markers of insulin metabolism and lipid profiles in gestational diabetes. J Clin Lipidol. 2016;10(2):386–93. First citation in articleCrossref MedlineGoogle Scholar

  • 40 Mahmoodi MR, Kimiagar M, Mehrabi Y. The effects of omega-3 plus vitamin E and zinc plus vitamin C supplementation on cardiovascular risk markers in postmenopausal women with type 2 diabetes. Ther Adv Endocrinol Metab. 2014;5(4):67–76. First citation in articleCrossref MedlineGoogle Scholar

  • 41 Mirhashemi SM, Sahmani M, Salehi B, Reza JZ, Taghizadeh M, Moussavi N, et al. Metabolic response to omega-3 fatty acids and vitamin E Co-supplementation in patients with fibrocystic breast disease: a randomized, double-blind, placebo-controlled trial. Arch Iran Med. 2017;20(8):466–73. First citation in articleMedlineGoogle Scholar

  • 42 Ramezani A, Djalali M. Effects of administration of omega-3 fatty acids with or without vitamin E on body composition in patients with coronary artery disease: a clinical trial. J Maz Univ Med Sci. 2016;25(133):25–36. First citation in articleGoogle Scholar

  • 43 Taghizadeh M, Tamtaji OR, Dadgostar E, Kakhaki RD, Bahmani F, Abolhassani J, et al. The effects of omega-3 fatty acids and vitamin E co-supplementation on clinical and metabolic status in patients with Parkinson’s disease: A randomized, double-blind, placebo-controlled trial. Neurochem Int. 2017;108:183–9. First citation in articleCrossref MedlineGoogle Scholar

  • 44 Shen HH, Peterson SJ, Bellner L, Choudhary A, Levy L, Gancz L, et al. Cold-pressed Nigella Sativa oil standardized to 3% thymoquinone potentiates omega-3 protection against obesity-induced oxidative stress, inflammation, and markers of insulin resistance accompanied with conversion of white to beige fat in mice. Antioxidants (Basel, Switzerland). 2020;9(6):489. First citation in articleMedlineGoogle Scholar

  • 45 Radler U, Stangl H, Lechner S, Lienbacher G, Krepp R, Zeller E, et al. A combination of (ω-3) polyunsaturated fatty acids, polyphenols and L-carnitine reduces the plasma lipid levels and increases the expression of genes involved in fatty acid oxidation in human peripheral blood mononuclear cells and HepG2 cells. Ann Nutr Metab. 2011;58(2):133–40. First citation in articleCrossref MedlineGoogle Scholar

  • 46 Buckley JD, Howe P. Anti-obesity effects of long-chain omega-3 polyunsaturated fatty acids. Obes Rev. 2009;10(6):648–59. First citation in articleCrossref MedlineGoogle Scholar

  • 47 Buckley JD, Howe PR. Long-chain omega-3 polyunsaturated fatty acids may be beneficial for reducing obesity – a review. Nutrients. 2010;2(12):1212–30. First citation in articleCrossref MedlineGoogle Scholar

  • 48 Yang B, Brown KK, Chen L, Carrick KM, Clifton LG, McNulty JA, et al. Serum adiponectin as a biomarker for in vivo PPARgamma activation and PPARgamma agonist-induced efficacy on insulin sensitization/lipid lowering in rats. BMC pharmacol. 2004;4(1):1–9. First citation in articleCrossref MedlineGoogle Scholar

  • 49 Belalcazar LM, Lang W, Haffner SM, Hoogeveen RC, Pi-Sunyer FX, Schwenke DC, et al. Adiponectin and the mediation of HDL-cholesterol change with improved lifestyle: the Look AHEAD Study. J Lipid Res. 2012;53(12):2726–33. First citation in articleCrossref MedlineGoogle Scholar

  • 50 Nijhawan P, Behl T, Arora S. Role of protein kinase C in obesity. Obes Med. 2020;18:100207. First citation in articleCrossrefGoogle Scholar

  • 51 Ricciarelli R, Tasinato A, Clément S, Ozer NK, Boscoboinik D, Azzi A. α-Tocopherol specifically inactivates cellular protein kinase C α by changing its phosphorylation state. Biochem J. 1998;334(1):243–9. First citation in articleCrossref MedlineGoogle Scholar

  • 52 Jiang Q. Natural forms of vitamin E: metabolism, antioxidant, and anti-inflammatory activities and their role in disease prevention and therapy. Free Radic Biol Med. 2014;72:76–90. First citation in articleCrossref MedlineGoogle Scholar

  • 53 Lewis ED, Meydani SN, Wu D. Regulatory role of vitamin E in the immune system and inflammation. IUBMB life. 2019;71(4):487–94. First citation in articleCrossref MedlineGoogle Scholar

  • 54 Taherkhani S, Suzuki K, Ruhee RT. A brief overview of oxidative stress in adipose tissue with a therapeutic approach to taking antioxidant supplements. Antioxidants. 2021;10(4):594. First citation in articleCrossref MedlineGoogle Scholar

  • 55 Huang YJ, Nan GX. Oxidative stress-induced angiogenesis. J Clin Neurosci. 2019;63:13–6. First citation in articleCrossref MedlineGoogle Scholar

  • 56 Samimi M, Pourhanifeh MH, Mehdizadehkashi A, Eftekhar T, Asemi Z. The role of inflammation, oxidative stress, angiogenesis, and apoptosis in the pathophysiology of endometriosis: Basic science and new insights based on gene expression. J Cell Physiol. 2019;234(11):19384–92. First citation in articleCrossref MedlineGoogle Scholar

  • 57 Yamamoto T. Autoimmune mechanisms of scleroderma and a role of oxidative stress. Self Nonself. 2011;2(1):4–10. First citation in articleCrossref MedlineGoogle Scholar

  • 58 Cuadrado GA, de Andrade MFC, Ariga SK, de Lima TM, Souza HP. Inflammation precedes fat deposition in an experimental model of lymphedema. Lymphat Res Biol. 2021;19(2):116–25. First citation in articleCrossref MedlineGoogle Scholar

  • 59 Zhao P, Wong KI, Sun X, Reilly SM, Uhm M, Liao Z, et al. TBK1 at the crossroads of inflammation and energy homeostasis in adipose tissue. Cell. 2018;172(4):731–43.e12. First citation in articleCrossref MedlineGoogle Scholar

  • 60 Zhang Y, Liu W, Zhao T, Tian H. Efficacy of omega-3 polyunsaturated fatty acids supplementation in managing overweight and obesity: A meta-analysis of randomized clinical trials. J Nutr Health Aging. 2017;21(2):187–92. First citation in articleCrossref MedlineGoogle Scholar

  • 61 Emami MR, Jamshidi S, Zarezadeh M, Khorshidi M, Olang B, Hezaveh ZS, et al. Can vitamin E supplementation affect obesity indices? A systematic review and meta-analysis of twenty-four randomized controlled trials. Clin Nutr. 2021;40(5):3201–9. First citation in articleCrossref MedlineGoogle Scholar