Blackmores Institute

Published in the journal, Nutrients, the review investigated the potential effect of omega-3s on metabolic disorders and skeletal muscle abnormalities in the context of rheumatoid arthritis (RA).
 
 “Omega-3 supplementation may reduce lipotoxicity-induced muscle metabolism disorders, improving muscle protein turnover and counteracting the loss of skeletal muscle related to lipotoxicity.”
 
 According to the review, rheumatoid arthritis is characterised by systemic and local inflammation in the synovial membrane of joints and this increased inflammation could be implicated in RA-related cardiovascular risk in RA patients. The review also highlighted that body fat is increased in people with RA with normal body mass index which led to the sarcopenic obesity phenotype being defined as a decrease in lean mass while fat mass may be preserved or even increased regardless of changes in total body weight. 
 
 “These abnormalities contribute to the alteration of muscle performances, including frailty and disability in RA patients which in turn, exacerbate muscle loss and fat deposition. In addition, sarcopenia, characterised by several muscle metabolic changes that occur within a lifetime, lead to the alteration of muscle strength, mass and quality.
 
 “The pathogenesis of sarcopenia is complex and involves inflammation, insulin resistance, ectopic lipid accumulation in skeletal muscle and altered mitochondrial functions. Consequently, as RA is associated with sarcopenia, it could be hypothesised that these abnormalities observed during ageing and obesity also occur in RA patients and contribute to the consequences of RA on patient’s mobility and quality of life,” the authors explained.
 
 The review highlighted that reports of excessive consumption of saturated fatty acid (SFA) and a deficit in the intake of polyunsaturated fatty acids (PUFA), notably of the omega 3 family is characteristic of the Western diet and as such, the pro-inflammatory nature of SFA increases CVD risk and mortality, whereas other fatty acids, such as omega 3 FA are anti-inflammatory.
 
 “RA patients have a greater cardiovascular risk, more metabolic disorders such as insulin resistance and sarcopenia associated with increased intramuscular fat in comparison to healthy subjects. Supplementation with omega 3 fatty acids could improve muscle protein turnover and counteract the loss of skeletal muscle related to lipotoxicity.”
 
 “Some reports showed that omega 3s could have a beneficial effect on RA severity and its related comorbidities. One study has shown that supplementation of RA patients with omega 3s reduced circulating autoantibodies, which are closely related to the progression of the disorder.
 
 “These study results and other studies suggest omega 3s have a favourable effect on inflammation and pain in RA, that can be, at least partially, explained by the generation of omega 3 derived lipid mediators counteracting inflammation and pain by omega 3 supplementation or intake could improve mobility, and thus muscle health of RA patients,” the authors said.
 
 “RA is associated with an increased morbi-mortality, mainly due to comorbidities and cardio-metabolic disorders, such as sarcopenic obesity and CVD. Alterations in lipid homeostasis and in the quality of dietary lipids are potential causative elements of these abnormalities which share common physiopathological mechanisms. Thereby, a nutritional approach including supplementation with omega 3 should be proposed to alleviate lipotoxicity in the context of ageing, obesity and chronic inflammatory diseases such as RA,” the authors concluded.
 
 Source:
 Nutrients, 2020. DOI:<a href="https://www.mdpi.com/2072-6643/12/1/223">10.3390/nu12010223</a>

A recent review suggests that omega-3 supplementation could be of benefit in managing rheumatoid arthritis – particularly in relation to muscle health.

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