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Comparative Study
. 2000;2000(4):CD001283.
doi: 10.1002/14651858.CD001283.

Dietary marine fatty acids (fish oil) for asthma

R K Woods  1 , F C Thien, M J Abramson
Affiliations
Comparative Study

Dietary marine fatty acids (fish oil) for asthma

R K Woods et al. Cochrane Database Syst Rev. 2000.

Update in

Abstract

Background: Epidemiological studies suggest that a diet high in marine fatty acids (fish oil) may have beneficial effects on inflammatory conditions such as rheumatoid arthritis and possibly asthma.

Objectives: 1. To determine the effect of marine n-3 fatty acid (fish oil) supplementation in asthma. 2. To determine the effect of a diet high in fish oil in asthma.

Search strategy: The Cochrane Airways Review Group register was search using the terms: marine fatty acids OR diet OR nutrition OR fish oil OR eicosapentaenoic acid OR EPA. Bibliographies of retrieved trials were searched and fish oil manufacturers contacted.

Selection criteria: Randomised controlled trials in patients with asthma more than two years of age were included. The study duration had to be in excess of 4 weeks. Double blind trials were preferred, but single-blind and open trials were also reviewed for possible inclusion. Three reviewers read each paper, blind to its identity. Decisions concerning inclusion were made by simple majority. Quality assessment was performed by all three reviewers independently.

Data collection and analysis: The only comparison possible was between marine n-3 fatty acid supplementation and placebo. There were insufficient trials to examine dietary manipulation alone.

Main results: Eight randomised controlled trials conducted between 1986 and 1998 satisfied the inclusion criteria. Six were of parallel design and two were cross-over studies. Seven compared fish oil with placebo whilst one compared high dose vs low dose marine n-3 fatty acid supplementation. None of the included studies reported asthma exacerbations, health status or hospital admissions. There was no consistent effect on any of the analyzable outcomes: FEV1, peak flow rate, asthma symptoms, asthma medication use or bronchial hyper reactivity. The single study performed in children also combined dietary manipulation with fish oil supplementation and showed improved peak flow and reduced asthma medication use. There were no adverse events associated with fish oil supplements. Updated Search conducted August 2000. No new trials were found.

Reviewer's conclusions: There is little evidence to recommend that people with asthma supplement or modify their dietary intake of marine n-3 fatty acids (fish oil) in order to improve their asthma control. Equally, there is no evidence that they are at risk if they do so.

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Conflict of interest statement

One of the reviewers (FT) was the Principal Investigator in one of the included trials (Thien 1993).

Figures

1.1
1.1. Analysis
Comparison 1 n‐3 fatty acid supplementation versus placebo (parallel studies), Outcome 1 PEF ‐ end.
1.2
1.2. Analysis
Comparison 1 n‐3 fatty acid supplementation versus placebo (parallel studies), Outcome 2 PEF ‐ baseline.
1.3
1.3. Analysis
Comparison 1 n‐3 fatty acid supplementation versus placebo (parallel studies), Outcome 3 PEF ‐ change.
1.4
1.4. Analysis
Comparison 1 n‐3 fatty acid supplementation versus placebo (parallel studies), Outcome 4 FEV1.
1.5
1.5. Analysis
Comparison 1 n‐3 fatty acid supplementation versus placebo (parallel studies), Outcome 5 Asthma symptom scores.
1.6
1.6. Analysis
Comparison 1 n‐3 fatty acid supplementation versus placebo (parallel studies), Outcome 6 Asthma medication usage.
1.7
1.7. Analysis
Comparison 1 n‐3 fatty acid supplementation versus placebo (parallel studies), Outcome 7 Bronchial hyperresponsiveness (logged).
2.1
2.1. Analysis
Comparison 2 n‐3 supplementation versus placebo (cross‐over studies), Outcome 1 PEF ‐ end.
2.3
2.3. Analysis
Comparison 2 n‐3 supplementation versus placebo (cross‐over studies), Outcome 3 Asthma symptom scores.
2.4
2.4. Analysis
Comparison 2 n‐3 supplementation versus placebo (cross‐over studies), Outcome 4 Symptomatic deterioration.
3.1
3.1. Analysis
Comparison 3 adults versus children ‐ bronchial hyperresponsiveness (logged), Outcome 1 Adults versus Children.
4.1
4.1. Analysis
Comparison 4 adults versus children ‐ Asthma symptom scores, Outcome 1 Adults versus children.
See this image and copyright information in PMC

Update of

References

References to studies included in this review

Arm 1988 {published data only}
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References to studies excluded from this review

Broughton 1997 {published data only}
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Mickleborough 2003 {published data only}
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Palat 1988 {published data only}
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Payan 1986 {published data only}
    1. Payan DG, Wong MY, Chernov‐Rogan T, Valone FH, Pickett WC, Blake VA, et al. Alterations in human leukocyte function induced by ingestion of eicosapentaenoic acid. Journal of Clinical Immunology 1986;6(5):402‐10. - PubMed
Picado 1988 {published data only}
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Surette 2008 {published data only}
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Villani 1998 {published data only}
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vonSchacky 1993 {published data only}
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References to studies awaiting assessment

Ade 2011 {published data only}
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Brew 2015 {published data only}
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Gunaratne 2016 {published data only}
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Hansell 2018 {published data only}
    1. Hansell AL, Bakolis I, Cowie CT, Belousova EG, Ng K, Weber‐Chrysochoou C, et al. Childhood fish oil supplementation modifies associations between traffic related air pollution and allergic sensitisation. Environmental health: a global access science source 2018;17(1). - PMC - PubMed
Huang 2015 {published data only}
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Lang 2013 {published data only}
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Lang 2019 {published data only}
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Lee 2013 {published data only}
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Lello 2010 {published data only}
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Lello 2012 {published data only}
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Lopez‐Frias 2018 {published data only}
    1. Lopez‐Frias SB, Alcantara ST, Jesus Leija Martinez J, Rio Navarro BE, Carmen Castillo Hernandez M, et al. Effect of N‐3 polyunsaturated fatty acids on oxidative stress markers and resolvin e1 in obese asthmatic adolescents with hypertriglyceridemia. Atherosclerosis. Supplements 2018;32:133.
Nsouli 2012 {published data only}
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Pascual 2010 {published data only}
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Shu‐Chen 2012 {published data only}
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Skilton 2012 {published data only}
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Zeki 2018 {published data only}
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Zielen 2017 {published data only}
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