Supplementation of n3 Long-chain Polyunsaturated Fatty Acid Synergistically Decreases Insulin Resistance with Weight Loss of Obese Prepubertal and Pubertal Children

Background and Aims. Supplementation with n3 long-chain polyunsaturated fatty acids (n3-LCPUFA) appears to affect body weight, adipokines, and insulin resistance (IR) in obese individuals. However, it is unclear whether the effect on IR is independent of weight loss and if the same effect is observed in children. We undertook this study to analyze the effect of supplementation with n3-LCPUFA on adipokine concentration and IR of prepubertal and pubertal children, independent of weight loss. Methods. Included were 76 children, 9- to 18-years of age. Subjects were overweight and insulin resistant, but otherwise healthy. They were randomly assigned to receive 900 mg n3-LCPUFA daily (Omega III, Salmon Oil, GNLD) or placebo for 1 month. No dietary intervention was conducted. Dietary information, anthropometry, and blood samples to measure adipokines and IR were obtained at baseline. Anthropometry and measurement of biochemical parameters were repeated at the end of follow-up. For analysis, children were stratified by treatment (placebo and n3-FA) and according to changes in body weight (increase, decrease, unchanged). Results. Twenty seven children received placebo and 49 received the n3-LCPUFA. Despite no differences at baseline, only the n3-FA group decreased fasting insulin and HOMA-IR (p < 0.010). Significant differences between groups were observed for changes in TNF-alpha, leptin and adiponectin after supplementation (p < 0.050). At the end of the 1-month period, 16 children lost weight and 27 children gained weight. Multiple analysis demonstrated that supplementation with n3-LCPUFA decreased HOMA-IR by 15% after adjusting for puberty, treatment adherence, changes in adipokines, and weight loss. Interaction between supplementation and weight loss was significant (p = 0.007). Conclusions. Supplementation with n3-LCPUFA is a potential beneficial tool for obese at-risk children. (C) 2011 IMSS. Published by Elsevier Inc.