Nutritional Optimization for Brain Health in Contact Sports: A Systematic Review and Meta-Analysis on Long-Chain ω-3 Fatty Acids and Neurofilament Light.
Level 1 - systematic review of randomized trials
Systematic review and individual participant-level meta-analysis of controlled trials
PubMed 39429508 · doi:10.1016/j.cdnut.2024.104454
What was done
A systematic review and one-stage individual participant-level data meta-analysis evaluated the effect of long-chain omega-3 polyunsaturated fatty acid (LC ω-3 PUFA) supplementation on serum neurofilament-light (Nf-L) concentrations in athletes exposed to repetitive subconcussive head impacts. Databases (PubMed, CINAHL) were searched through January 2024. Changes from baseline to midseason (MS) and postseason (PS) were compared between LC ω-3 PUFA and control/placebo groups using least square means (±SE) and contrast t-tests.
What was found
Out of 460 identified records, 3 studies in collegiate American football players (total n = 179; LC ω-3 PUFA = 105, placebo = 71) were analyzed. Compared with placebo, the change in Nf-L was not statistically different at midseason (mean difference [MD] = -1.66 ± 0.82 pg·mL⁻¹, adjusted P = 0.09) but was significantly lower at postseason (MD = -2.23 ± 0.83 pg·mL⁻¹, adjusted P = 0.02) in athletes receiving LC ω-3 PUFA.
Why it matters
This review provides preliminary evidence that prophylactic omega-3 fatty acid supplementation may attenuate neuroaxonal injury markers associated with repetitive subconcussive impacts across a competitive athletic season.
Limits
The total evidence base is small, comprising only 3 studies and 179 participants. All participants were collegiate American football players, limiting generalizability to female athletes, other contact sports, and other age groups. Optimal dosing, formulation differences, adherence rates, and clinical neurocognitive outcomes were not reported in the abstract.