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Open Access Highly Accessed Research article

Treating asthma with omega-3 fatty acids: where is the evidence? A systematic review

J Reisman1*, HM Schachter2, RE Dales3, K Tran4, K Kourad2, D Barnes2, M Sampson2, A Morrison4, I Gaboury2 and J Blackman5

Author affiliations

1 Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada

2 Chalmers Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada

3 The Clinical Epidemiology Unit, Ottawa Health Research Institute, Ottawa Hospital and University of Ottawa, Ottawa, ON, Canada

4 Canadian Coordinating Office for Health Technology Assessment, Ottawa, ON, Canada

5 Complementary Medicine Program, University of Maryland, Baltimore, MD, USA

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Citation and License

BMC Complementary and Alternative Medicine 2006, 6:26  doi:10.1186/1472-6882-6-26

Published: 19 July 2006

Abstract

Background

Considerable interest exists in the potential therapeutic value of dietary supplementation with the omega-3 fatty acids. Given the interplay between pro-inflammatory omega-6 fatty acids, and the less pro-inflammatory omega-3 fatty acids, it has been thought that the latter could play a key role in treating or preventing asthma. The purpose was to systematically review the scientific-medical literature in order to identify, appraise, and synthesize the evidence for possible treatment effects of omega-3 fatty acids in asthma.

Methods

Medline, Premedline, Embase, Cochrane Central Register of Controlled Trials, CAB Health, and, Dissertation Abstracts were searched to April 2003. We included randomized controlled trials (RCT's) of subjects of any age that used any foods or extracts containing omega-3 fatty acids as treatment or prevention for asthma. Data included all asthma related outcomes, potential covariates, characteristics of the study, design, population, intervention/exposure, comparators, and co interventions.

Results

Ten RCT's were found pertinent to the present report.

Conclusion

Given the largely inconsistent picture within and across respiratory outcomes, it is impossible to determine whether or not omega-3 fatty acids are an efficacious adjuvant or monotherapy for children or adults. Based on this systematic review we recommend a large randomized controlled study of the effects of high-dose encapsulated omega-3 fatty acids on ventilatory and inflammatory measures of asthma controlling diet and other asthma risk factors. This review was limited because Meta-analysis was considered inappropriate due to missing data; poorly or heterogeneously defined populations, interventions, intervention-comparator combinations, and outcomes. In addition, small sample sizes made it impossible to meaningfully assess the impact on clinical outcomes of co-variables. Last, few significant effects were found.