In short Article

Omega-3 fatty acids not better than placebo

Recent studies have concluded that omega-3 fatty acid supplementation offers no added value for the prevention of premature birth, the treatment of keratoconjunctivitis sicca (‘dry eye syndrome’) or the prevention of kidney damage in type 2 diabetes mellitus. These findings are consistent with the conclusions of an extensive  series of systematic reviews which consistently did not recommend omega-3 fatty acid supplementation. Evidence of any added value of this supplementation is lacking or is usually of moderate to poor quality.

  • Omega-3 fatty acid supplementation offers no added value for the prevention of premature birth, the treatment of keratoconjunctivitis sicca or the prevention of kidney damage in type 2 diabetes mellitus.

  1. Makrides M, Best K, Yelland L, et al. A Randomized Trial of Prenatal n-3 Fatty Acid Supplementation and Preterm Delivery. N Engl J Med. 2019;381(11):1035-1045. doi:10.1056/NEJMoa1816832
  2. Dry Eye Assessment and Management Study Research Group, Asbell PA, Maguire MG, et al. n-3 Fatty Acid Supplementation for the Treatment of Dry Eye Disease. N Engl J Med. 2018;378(18):1681-1690. doi:10.1056/NEJMoa1709691
  3. de Boer IH, Zelnick LR, Ruzinski J, et al. Effect of Vitamin D and Omega-3 Fatty Acid Supplementation on Kidney Function in Patients With Type 2 Diabetes: A Randomized Clinical Trial [published online ahead of print, 2019 Nov 8]. JAMA. 2019;322(19):1899-1909. doi:10.1001/jama.2019.17380
  4. Middleton P, Gomersall JC, Gould JF, Shepherd E, Olsen SF, Makrides M. Omega-3 fatty acid addition during pregnancy. Cochrane Database Syst Rev. 2018;11(11):CD003402. Published 2018 Nov 15. doi:10.1002/14651858.CD003402.pub3
  5. Downie LE, Ng SM, Lindsley KB, Akpek EK. Omega-3 and omega-6 polyunsaturated fatty acids for dry eye disease. Cochrane Database Syst Rev. 2019;12(12):CD011016. Published 2019 Dec 18. doi:10.1002/14651858.CD011016.pub2
  6. Hornstra G. Visoliesupplementen. Gebu. 1999;33(4):37-42.
  7. Kerst AJFA. Beschermt visolie tegen levensbedreigende hartritmestoornissen? Gebu. 2005;39(12):137.
  8. Kerst AJFA. Werken B-vitaminen en omega-3-vetzuren gunstig bij cardiovasculaire aandoeningen? Gebu. 2011;45(8):94-95.
  9. Kerst AJFA. Visolievetzuren en cardiovasculaire incidenten. Gebu. 2013;47(2):24-25.
  10. Nieuwhof MAE. Gebu. 2014;48(6):69-70.
  11. van der Heijden S, Janssens HJEM . Suppletie omega-3-vetzuren geen cardiovasculair nut. Gebu. 2019;53(2):17-19.
  12. Nederlands Huisartsen Genootschap. Bolsius EJ, De Jongh E, Larsen-Bakker IM, et al. NHG-Standaard Rood oog en oogtrauma. Versie 2.0 december 2017. Via: Geraadpleegd op 27 mei 2020.
  13. Miller KL, Walt JG, Mink DR, et al. Minimal clinically important difference for the ocular surface disease index. Arch Ophthalmol. 2010;128(1):94-101. doi:10.1001/archophthalmol.2009.356
  14. Lee CC, Sharp SJ, Wexler DJ, Adler AI. Dietary intake of eicosapentaenoic and docosahexaenoic acid and diabetic nephropathy: cohort analysis of the diabetes control and complications trial. Diabetes Care. 2010;33(7):1454-1456. doi:10.2337/dc09-2245
  15. No authors listed 1986. The Diabetes Control and Complications Trial (DCCT). Design and methodologic considerations for the feasibility phase. The DCCT Research Group. Diabetes. 1986;35(5):530-545.
  16. Cárdenas C, Bordiu E, Bagazgoitia J, Calle-Pascual AL; Diabetes and Nutrition Study Group, Spanish Diabetes Association. Polyunsaturated fatty acid consumption may play a role in the onset and regression of microalbuminuria in well-controlled type 1 and type 2 diabetic people: a 7-year, prospective, population-based, observational multicenter study. Diabetes Care. 2004;27(6):1454-1457. doi:10.2337/diacare.27.6.1454
  17. Chewcharat A, Chewcharat P, Rutirapong A, Papatheodorou S. The effects of omega-3 fatty acids on diabetic nephropathy: A meta-analysis of randomized controlled trials. PLoS One. 2020;15(2):e0228315. Published 2020 Feb 11. doi:10.1371/journal.pone.0228315
  18. Shimizu H, Ohtani K, Tanaka Y, Sato N, Mori M, Shimomura Y. Long-term effect of eicosapentaenoic acid ethyl (EPA-E) on albuminuria of non-insulin dependent diabetic patients. Diabetes Res Clin Pract. 1995;28(1):35-40. doi:10.1016/0168-8227(95)01056-j
  19. Shapiro H, Theilla M, Attal-Singer J, Singer P. Effects of polyunsaturated fatty acid consumption in diabetic nephropathy. Nat Rev Nephrol. 2011;7(2):110-121. doi:10.1038/nrneph.2010.156
  20. Patel FA, Challis JRG. Prostaglandins and uterine activity. In: Smith R, ed. The endocrinology of parturition: basic science and clinical application. Basel, Switzerland: Karger, 2001: 31-56.
  21. Serhan CN, Chiang N, Van Dyke TE. Resolving inflammation: dual anti-inflammatory and pro-resolution lipid mediators. Nat Rev Immunol. 2008;8(5):349-361. doi:10.1038/nri2294
  22. College ter Beoordeling van Geneesmiddelen. Geneesmiddeleninformatiebank. Productinformatie Omacor. Via: Geraadpleegd op 18 mei 2020.
  23. Brown SA, Brown CA, Crowell WA, et al. Effects of dietary polyunsaturated fatty acid supplementation in early renal insufficiency in dogs. J Lab Clin Med. 2000;135(3):275-286. doi:10.1067/mlc.2000.105178
  24. Hagiwara S, Makita Y, Gu L, et al. Eicosapentaenoic acid ameliorates diabetic nephropathy of type 2 diabetic KKAy/Ta mice: involvement of MCP-1 suppression and decreased ERK1/2 and p38 phosphorylation. Nephrol Dial Transplant. 2006;21(3):605-615. doi:10.1093/ndt/gfi208
  25. Thesing CS. Fatty acids in depressive and anxiety disorders: Fishing for answers. PhD Thesis Vrije Universiteit Amsterdam 2020.


  • Sander van den Bogert, dr, pharmacist