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Pilot Randomized Controlled Trial of Krill Oil Supplementation for Chronic Musculoskeletal Pain in Older Adults

Tamargo JA, Carvajal E, Simic K, Przkora R, Anton SD, Cruz-Almeida Y

The Journal of nutrition, 2026

Abstract

Background: Chronic musculoskeletal (MSK) pain is highly prevalent in older adults and the leading cause of disability. Long-chain omega-3 (ω-3) polyunsaturated fatty acids have anti-inflammatory and analgesic properties, yet intake and circulating levels are low in older US adults. Krill oil, a phospholipid-bound source of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) that also contains astaxanthin and choline, may represent a feasible nutrition-based intervention for chronic MSK pain.

Objectives: To evaluate the feasibility and acceptability of krill oil supplementation in older adults with chronic MSK pain and to characterize changes in ω-3 status and exploratory pain outcomes.

Methods: A 12-wk, randomized, double-blind, placebo-controlled pilot trial in 40 community-dwelling adults aged ≥60 y with moderate chronic MSK pain. Participants were stratified by sex and randomly assigned 1:1 to krill oil (4 g/d; 1288 mg EPA+DHA) or placebo. Primary outcomes were feasibility metrics (recruitment, retention, adherence, and acceptability). Secondary outcomes included biomarkers of ω-3 status and inflammation. Exploratory outcomes included pain intensity, pain interference, pain distribution, and global improvement.

Results: Recruitment targets were met within 8 mo; retention was 95%, adherence exceeded prespecified thresholds (>70%) in both groups, and overall acceptability was rated 7.7 ± 2.3 of 10. Krill oil supplementation increased the ω-3 index from 4.3% to 7.4%,…

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Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.

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