Long-chain n -3 polyunsaturated fatty acids for the management of age- and disease-related declines in skeletal muscle mass, strength and physical function.

PURPOSE OF REVIEW: This review uses the hierarchy of evidence as a framework to critically evaluate the effect of long chain n -3 polyunsaturated fatty acid (LC n -3 PUFA) ingestion alone, or as an adjunctive intervention to resistance training, on muscle health-related outcomes in healthy and clinical older adult populations. RECENT FINDINGS: Systematic reviews and meta-analyses of randomized controlled trials consistently report small, but clinically-relevant, effects of LC n -3 PUFA ingestion on strength outcomes, whereas mixed findings have been reported regarding changes in muscle mass and physical function. Cohort studies indicate an association between higher dietary LC n -3 PUFA intake and reduced likelihood of a sarcopenia diagnosis. Acute metabolic studies provide limited evidence for an effect of LC n -3 PUFA ingestion alone, or in combination with resistance training, on free-living integrated rates of MPS, static markers of muscle protein breakdown, or satellite cell activation in healthy older adults. SUMMARY: Recent data supports the efficacy of LCn-3 PUFA ingestion to facilitate small, but clinically relevant, improvements in muscle strength in healthy and clinical older adult populations. The mechanism(s) that underpin the action of LC n -3 PUFA in promoting strength outcomes remain unknown, but likely relate to neuromuscular function.

The Effect of Long Chain n-3 Fatty Acid Supplementation on Muscle Strength in Older Adults: A Systematic Review and Meta-Analysis.

The main objective of the current study was to perform a systematic literature review with the purpose of exploring the impact of long-chain n-3 polyunsaturated fatty acid (LCn-3 PUFA) relative to control oil supplementation on muscle strength, with secondary outcomes of muscle mass and physical function in older individuals under conditions of habitual physical activity/exercise. The review protocol was registered with PROSPERO (CRD42021267011) and followed the guidelines outlined in the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. The search for relevant studies was performed utilizing databases such as PubMed, EMBASE, CINAHL, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) up to June 2023. Randomized controlled trials (RCTs) in older adults comparing the effects of LCn-3 PUFA with a control oil supplement on muscle strength were included. Five studies involving a total of 488 participants (348 females and 140 males) were identified that met the specified inclusion criteria and were included. Upon analyzing the collective data from these studies, it was observed that supplementation with LCn-3 PUFA did not have a significant impact on grip strength (standardized mean difference (SMD) 0.61, 95% confidence interval [-0.05, 1.27]; p = 0.07) in comparison to the control group. However, there was a considerable level of heterogeneity among the studies (I2 = 90%; p < 0.001). As secondary outcomes were only measured in a few studies, with significant heterogeneity in methods, meta-analyses of muscle mass and functional abilities were not performed. Papers with measures of knee extensor muscle mass as an outcome (n = 3) found increases with LCn-3 PUFA supplementation, but studies measuring whole body lean/muscle mass (n = 2) and functional abilities (n = 4) reported mixed results. With a limited number of studies, our data indicate that LCn-3 PUFA supplementation has no effect on muscle strength or functional abilities in older adults but may increase muscle mass, although, with only a few studies and considerable heterogeneity, further work is needed to confirm these findings.

Protocol for a randomised controlled trial to investigate the effects of vitamin K2 on recovery from muscle-damaging resistance exercise in young and older adults-the TAKEOVER study.

BACKGROUND: Regular participation in resistance exercise is known to have broad-ranging health benefits and for this reason is prominent in the current physical activity guidelines. Recovery after such exercise is important for several populations across the age range and nutritional strategies to enhance recovery and modulate post-exercise physiological processes are widely studied, yet effective strategies remain elusive. Vitamin K2 supplementation has emerged as a potential candidate, and the aim of the current study, therefore, is to test the hypothesis that vitamin K2 supplementation can accelerate recovery, via modulation of the underlying physiological processes, following a bout of resistance exercise in young and older adults. METHODS: The current study is a two-arm randomised controlled trial which will be conducted in 80 (40 young (≤40 years) and 40 older (≥65 years)) adults to compare post-exercise recovery in those supplemented with vitamin K2 or placebo for a 12-week period. The primary outcome is muscle strength with secondary outcomes including pain-free range of motion, functional abilities, surface electromyography (sEMG) and markers of inflammation and oxidative stress. DISCUSSION: Ethical approval has been granted by the College of Medical Veterinary and Life Sciences Ethical Committee at the University of Glasgow (Project No 200190189) and recruitment is ongoing. Study findings will be disseminated through a presentation at scientific conferences and in scientific journals. TRIAL REGISTRATION: ClinicialTrials.gov NCT04676958. Prospectively registered on 21 December 2020.

Long-chain n-3 fatty acids as an essential link between musculoskeletal and cardio-metabolic health in older adults.

This narrative review aims to critically evaluate scientific evidence exploring the therapeutic role(s) of long-chain n-3 PUFA in the context of ageing, and specifically, sarcopenia. We highlight that beyond impairments in physical function and a lack of independence, the age-related decline in muscle mass has ramifications for cardio-metabolic health. Specifically, skeletal muscle is crucial in regulating blood glucose homeostasis (and by extension reducing type 2 diabetes mellitus risk) and providing gluconeogenic precursors that are critical for survival during muscle wasting conditions (i.e. AIDS). Recent interest in the potential anabolic action of n-3 PUFA is based on findings from experimental studies that measured acute changes in the stimulation of muscle protein synthesis (MPS) and/or chronic changes in muscle mass and strength in response to fish oil-derived n-3 PUFA supplementation. Key findings include a potentiated response of MPS to amino acid provision or resistance-based exercise with n-3 PUFA in healthy older adults that extrapolated to longer-term changes in muscle mass and strength. The key mechanism(s) underpinning this enhanced response of MPS remains to be fully elucidated, but is likely driven by the incorporation of exogenous n-3 PUFA into the muscle phospholipid membrane and subsequent up-regulation of cell signalling proteins known to control MPS. In conclusion, multiple lines of evidence suggest that dietary n-3 PUFA provide an essential link between musculoskeletal and cardio-metabolic health in older adults. Given that western diets are typically meagre in n-3 PUFA content, nutritional recommendations for maintaining muscle health with advancing age should place greater emphasis on dietary n-3 PUFA intake.

Effects of dietary supplementation with krill meal on serum pro-inflammatory markers after the Iditarod sled dog race.

A seafood-based supplement from krill, rich in omega-3 phospholipids and proteins was tested on a group of dogs competing in the 2016 Iditarod dog sled race to investigate the effects of krill meal on exercise-induced inflammation and muscle damage in comparison to a control group. A single team of 16 dogs received 8% krill meal for 5 weeks prior to the start of race, while another team of 16 dogs received no supplementation. Ten dogs of the treatment and 11 dogs of the control group finished the race and their blood was analyzed for omega-3 index, inflammation (CRP) and muscle damage (CK). The omega-3 index of the krill meal-fed dogs was significantly higher at the beginning of the race (mean 6.2% in the supplemented vs 5.2% in the control group, p < .001). CRP concentrations increased from 7.05 ±â€¯2.27 to 37.04 ±â€¯9.16 µg/ml in the control and from 4.26 ±â€¯0.69 to 16.56 ±â€¯3.03 µg/ml in the treatment group, with a significant difference between the groups (p < .001). CK activity was increased from 90.75 ±â€¯8.15 IU/l to 715.90 ±â€¯218.9 IU/l in the control group and from 99.55 ±â€¯12.15 to 515.69 ±â€¯98.98 in the supplemented group, but there were no differences between groups (p = .266). The results showed that krill meal supplementation led to significantly higher omega-3 index, which correlated with lower inflammation and a tendency for reduced muscle damage after this long-distance sled dog competition. However, these results need to be confirmed by more controlled studies, since it was a field study and effects of race speed or other performance-related factors such as fitness and musher skill on the results cannot be excluded.

Fish oil-derived n-3 polyunsaturated fatty acids for the prevention and treatment of sarcopenia.

PURPOSE OF REVIEW: Muscle mass and function decline progressively starting in middle age, which can result in sarcopenia and affect people's mobility and independence later in life. Exercise training and increased protein intake are typically recommended to counteract the age-associated decline in muscle mass and function. However, few people comply with exercise recommendations and the effectiveness of high-protein intake to halt the decline in muscle mass and function has not been proven. This review aims to explore recent developments in the potential for fish-oil derived n-3 polyunsaturated fatty acids (n-3 PUFA) to improve muscle mass and function in older people. RECENT FINDINGS: The results from several recent studies demonstrate that dietary supplementation with fish oil-derived n-3 PUFA stimulates muscle protein synthesis and improves muscle mass and function in sedentary older adults and augments the resistance exercise training-induced increase in muscle strength in older adults. The exact mechanisms by which fish oil-derived n-3 PUFAs exert their beneficial effects on muscle mass and function remain to be elucidated. SUMMARY: Fish-oil supplementation has antisarcopenic effects and should be considered in the clinical care of older adults.

Sex differences in the effect of fish-oil supplementation on the adaptive response to resistance exercise training in older people: a randomized controlled trial.

BACKGROUND: Resistance exercise increases muscle mass and function in older adults, but responses are attenuated compared with younger people. Data suggest that long-chain n-3 polyunsaturated fatty acids (PUFAs) may enhance adaptations to resistance exercise in older women. To our knowledge, this possibility has not been investigated in men. OBJECTIVE: We sought to determine the effects of long-chain n-3 PUFA supplementation on resistance exercise training-induced increases in muscle mass and function and whether these effects differ between older men and women. DESIGN: Fifty men and women [men: n = 27, mean ± SD age: 70.6 ± 4.5 y, mean ± SD body mass index (BMI; in kg/m2): 25.6 ± 4.2; women: n = 23, mean ± SD age: 70.7 ± 3.3 y, mean ± SD BMI: 25.3 ± 4.7] were randomly assigned to either long-chain n-3 PUFA (n = 23; 3 g fish oil/d) or placebo (n = 27; 3 g safflower oil/d) and participated in lower-limb resistance exercise training twice weekly for 18 wk. Muscle size, strength, and quality (strength per unit muscle area), functional abilities, and circulating metabolic and inflammatory markers were measured before and after the intervention. RESULTS: Maximal isometric torque increased after exercise training to a greater (P < 0.05) extent in the long-chain n-3 PUFA group than in the placebo group in women, with no differences (P > 0.05) between groups in men. In both sexes, the effect of exercise training on maximal isokinetic torque at 30, 90, and 240° s-1, 4-m walk time, chair-rise time, muscle anatomic cross-sectional area, and muscle fat did not differ (P > 0.05) between groups. There was a greater (P < 0.05) increase in muscle quality in women after exercise training in the long-chain n-3 PUFA group than in the placebo group, with no such differences in men (P > 0.05). Long-chain n-3 PUFAs resulted in a greater decrease (P < 0.05) than the placebo in plasma triglyceride concentrations in both sexes, with no differences (P > 0.05) in glucose, insulin, or inflammatory markers. CONCLUSION: Long-chain n-3 PUFA supplementation augments increases in muscle function and quality in older women but not in older men after resistance exercise training. This trial was registered at clinicaltrials.gov as NCT02843009.

Fit with good fat? The role of n-3 polyunsaturated fatty acids on exercise performance.

N-3 PUFA (n-3) polyunsaturated fatty acids (PUFA) are a family of fatty acids mainly found in oily fish and fish oil supplements. The effects of n-3 PUFA on health are mainly derived from its anti-inflammatory proprieties and its influence on immune function. Lately an increased interest in n-3 PUFA supplementation has reached the world of sport nutrition, where the majority of athletes rely on nutrition strategies to improve their training and performance. A vast amount of attention is paid in increasing metabolic capacity, delaying the onset of fatigue, and improving muscle hypertrophy and neuromuscular function. Nutritional strategies are also frequently considered for enhancing recovery, improving immune function and decreasing oxidative stress. The current review of the literature shows that data regarding the effects of n-3PUFA supplementation are conflicting and we conclude that there is, therefore, not enough evidence supporting a beneficial role on the aforementioned aspects of exercise performance.

Fish oil supplementation reduces markers of oxidative stress but not muscle soreness after eccentric exercise.

Due to the potential anti-inflammatory properties of fish-derived long chain n-3 fatty acids, it has been suggested that athletes should regularly consume fish oils-although evidence in support of this recommendation is not clear. While fish oils can positively modulate immune function, it remains possible that, due to their high number of double bonds, there may be concurrent increases in lipid peroxidation. The current study aims to investigate the effect of fish oil supplementation on exercise-induced markers of oxidative stress and muscle damage. Twenty males underwent a 6-week double-blind randomized placebo-controlled supplementation trial involving two groups (fish oil or placebo). After supplementation, participants undertook 200 repetitions of eccentric knee contractions. Blood samples were taken presupplementation, postsupplementation, immediately, 24, 48, and 72 hr postexercise and muscle soreness/maximal voluntary contraction (MVC) assessed. There were no differences in creatine kinase, protein carbonyls, endogenous DNA damage, muscle soreness or MVC between groups. Plasma thiobarbituric acid reactive substances (TBARS) were lower (p < .05) at 48 and 72 hr post exercise and H2O2 stimulated DNA damage was lower (p < .05) immediately postexercise in the fish oil, compared with the control group. The current study demonstrates that fish oil supplementation reduces selected markers of oxidative stress after a single bout of eccentric exercise.

Fish oil positively regulates anabolic signalling alongside an increase in whole-body gluconeogenesis in ageing skeletal muscle.

PURPOSE: Fish oil, containing mainly long-chain n-3 polyunsaturated fatty acids (LCn-3PUFA), has been found to acutely stimulate protein synthesis and insulin-mediated glucose metabolism. However, the underlying mechanism and more prolonged effect of fish oil during ageing remain to be determined. METHODS: Fish oil (EPAX6000; 49.6 % eicosapentaenoic acid, 50.4 % docosahexaenoic acid) or control oil (60 % olive, 40 % soy) supplementation was delivered, via chocolate-derived sweets, to rats for 8 weeks. Throughout the study, food intake and body weight were recorded and body composition was investigated using EchoMRI. During the last 40 min of a 6 h infusion, with labelled dextrose ([U-(13)C]glucose) and amino acids ([1-(13)C]phenylalanine), blood samples were collected to assess glucose and phenylalanine kinetics. Soleus and longissimus dorsi muscles were extracted for protein and mRNA analyses. RESULTS: Fish oil had no effect on food intake or body composition. An increased whole-body glucose turnover, mainly accounted for via an increase in endogenous glucose production, was observed with fish oil feeding. No effects on whole-body phenylalanine turnover were observed. In longissimus dorsi, fish oil augmented the phosphorylation of phosphoinositide 3-kinase (PI3K)([Tyr458]) (P = 0.04) and 70 kDa ribosomal protein S6 kinase (p70s6k)([Thr389]) (P = 0.04). There were no differences in protein kinase B (Akt)([Ser473]), mammalian target of rapamycin (mTOR)([Ser2448]), protein phosphatase 2A (PP2A) 56 kDa regulatory B subunit γ (PP2A-B56-γ), forkhead box containing proteins O-subclass 3a (FOX03a)([Ser253]) or inflammatory markers (Interleukin-6, Interleukin-1 ß, tumour necrosis factor-α, and cyclooxygenase-2). CONCLUSIONS: Our data suggest that the fish oil may stimulate endogenous glucose production and increase anabolic signalling in ageing rats.

Fish oil supplementation augments post-exercise immune function in young males.

PURPOSE: Fish oils and related fatty acid components have anti-inflammatory properties, with beneficial effects against various disorders such as cardiovascular disease. A single bout of exercise can alter immune function. However, the effects of fish oil on immune function after a single bout of exercise are currently unknown. This study investigated the effect of supplementation with fish oil on the immune response to an acute bout of endurance exercise. METHODS: Sixteen male subjects underwent a six week double blind randomised placebo controlled supplementation trial involving two groups (fish oil or placebo oil, 3g/day). They attended for two visits, the first involving a maximal exercise test and the second involving a 1-h bout of endurance exercise on a cycle ergometer at 70% (V)O(2peak). Blood samples were taken pre-supplementation, pre-exercise (post-supplementation), immediately, 1 and 3h post-exercise. Samples were analysed for plasma IL-6, eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and cortisol; peripheral blood mononuclear cell (PBMC) IL-2, IL-4 and IFN-γ production; neutrophil phagocytosis/oxidative burst; and natural killer (NK) cell cytotoxic activity. RESULTS: Post-supplementation EPA concentration was increased (P=0.0127) in the fish oil group. At 3h post-exercise PBMC IL-2 (P=0.0067) and NK cell activity (P=0.0163) was greater in the fish oil compared with the control group. However, PBMC IL-4 and IFN-γ productions, plasma IL-6 and cortisol concentrations, as well as neutrophil activity were unaffected by fish oil supplementation. CONCLUSION: The current study demonstrates that fish oil supplementation reduces increases PBMC IL-2 production and NK cell cytotoxic activity in the recovery period after exercise.