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Effects of omega-3 fatty acid supplementation on heart rate variability

Atef Abdelsattar Ibrahim H, Gouda Kamal K, Zid MKAMA, Ashraf Hamad A, Kuraishi A, Taha M

World journal of clinical pediatrics, 2026

134 participants

Abstract

Background: Obesity and overweight are major public health challenges and are associated with autonomic imbalance and decreased heart rate variability (HRV), a non-invasive indicator of cardiovascular risk. Omega-3 polyunsaturated fatty acids have shown cardioprotective effects and may modulate autonomic function. Nevertheless, the effect of omega-3 supplementation on HRV in individuals who are overweight or obese remains unclear.

Aim: To study the effect of omega-3 supplementation on HRV in overweight and obese individuals and to explore the heterogeneity across different study designs.

Methods: In accordance with PRISMA guidelines, a systematic review and meta-analysis were conducted. PubMed, Science Citation Index, and Scopus were searched for randomized controlled trials (RCTs) assessing the impact of oral omega-3 supplementation on HRV in overweight or obese participants. Primary outcomes were the impacts of omega-3 supplementation on time-domain HRV indices [root mean square of successive differences (RMSSD), standard deviation of normal-to-normal intervals (SDNN), and percentage of successive normal-to-normal intervals differing by more than 50 milliseconds (pNN50%)], and frequency-domain indices [high-frequency (HF) power, low-frequency (LF) power, and LF/HF ratio].

Results: Four RCTs (n = 134 participants) met the inclusion criteria. Two trials compared pre- vs post- omega-3 supplementation, and two compared omega-3 with placebo on HRV in overweight and obese…

How strong is the evidence?

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. Reported size: 134 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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