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Objective <p>This study aimed to evaluate the effects of different types of omega-3 polyunsaturated fatty acid (ω-3 PUFA) supplements (EPA alone vs. DHA&amp;EPA combined) on body weight, body mass index (BMI), and lean body mass (LBM) in cancer patients through a network meta-analysis and to assess confidence in the results using the CINeMA (Confidence in Network Meta-Analysis) framework.</p> Methods <p>A systematic search was conducted in Web of Science, PubMed, Embase, Cochrane Library, and Clinical Trials databases. A total of 1995 studies were initially identified, and 26 randomized controlled trials (RCTs) involving 1892 cancer patients were ultimately included. The quality of the included studies was assessed using the Cochrane risk of bias tool. A random-effects model was used to perform the network meta-analysis. The confidence in the evidence was evaluated using the CINeMA tool, considering within-study bias, reporting bias, indirectness, imprecision, heterogeneity, and incoherence.</p> Results <p>The network meta-analysis included 25 studies on body weight, 15 studies on BMI, and 6 studies on LBM. Among 25 studies assessing body weight, the DHA&amp;EPA supplementation group showed statistically significant improvements compared to the control group (standardized mean difference [SMD] = 1.29, 95% confidence interval [CI]: 0.40–2.16, <i>P</i> &lt; 0.05), with a surface under the cumulative ranking (SUCRA) score of 48, suggesting modest superiority among compared interventions. CINeMA analysis for body weight demonstrated moderate confidence in the evidence, with concerns related to the heterogeneity and incoherence. For BMI, based on 15 studies, the DHA&amp;EPA group also showed significant improvements compared to the control group (SMD = 0.53, 95% CI: 0.04–0.92, <i>P</i> &lt; 0.05), with a SUCRA score of 74. CINeMA evaluation for BMI indicated high confidence in the evidence, with minimal concerns in most domains. For LBM, no significant effects were observed for either EPA alone or DHA&amp;EPA supplementation across six studies. The CINeMA analysis for LBM indicated moderate confidence in the evidence, primarily due to imprecision and incoherence. Funnel plot analysis and Egger’s regression test showed no evidence of significant publication bias across all outcomes.</p> Conclusion <p>Omega-3 PUFA supplementation, particularly the combination of DHA&amp;EPA, may improve body weight and BMI in cancer patients, with moderate to high confidence in the evidence. However, no significant effects were observed on LBM, and the confidence in the result was moderate. Further high-quality RCTs are required to validate these findings, address heterogeneity, and determine the optimal type and dosage of supplements for nutritional interventions in cancer patients.</p>

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Comparison of EPA and DHA&EPA on body weight, BMI, and lean body mass in cancer patients: a network meta-analysis

  • 期刊论文

  • 发表日期：

    2025年11月25日

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  • Hanlin Lu,
  • Zhihua Zhang,
  • Fengxia Liu

摘要

Objective

This study aimed to evaluate the effects of different types of omega-3 polyunsaturated fatty acid (ω-3 PUFA) supplements (EPA alone vs. DHA&EPA combined) on body weight, body mass index (BMI), and lean body mass (LBM) in cancer patients through a network meta-analysis and to assess confidence in the results using the CINeMA (Confidence in Network Meta-Analysis) framework.

Methods

A systematic search was conducted in Web of Science, PubMed, Embase, Cochrane Library, and Clinical Trials databases. A total of 1995 studies were initially identified, and 26 randomized controlled trials (RCTs) involving 1892 cancer patients were ultimately included. The quality of the included studies was assessed using the Cochrane risk of bias tool. A random-effects model was used to perform the network meta-analysis. The confidence in the evidence was evaluated using the CINeMA tool, considering within-study bias, reporting bias, indirectness, imprecision, heterogeneity, and incoherence.

Results

The network meta-analysis included 25 studies on body weight, 15 studies on BMI, and 6 studies on LBM. Among 25 studies assessing body weight, the DHA&EPA supplementation group showed statistically significant improvements compared to the control group (standardized mean difference [SMD] = 1.29, 95% confidence interval [CI]: 0.40–2.16, P < 0.05), with a surface under the cumulative ranking (SUCRA) score of 48, suggesting modest superiority among compared interventions. CINeMA analysis for body weight demonstrated moderate confidence in the evidence, with concerns related to the heterogeneity and incoherence. For BMI, based on 15 studies, the DHA&EPA group also showed significant improvements compared to the control group (SMD = 0.53, 95% CI: 0.04–0.92, P < 0.05), with a SUCRA score of 74. CINeMA evaluation for BMI indicated high confidence in the evidence, with minimal concerns in most domains. For LBM, no significant effects were observed for either EPA alone or DHA&EPA supplementation across six studies. The CINeMA analysis for LBM indicated moderate confidence in the evidence, primarily due to imprecision and incoherence. Funnel plot analysis and Egger’s regression test showed no evidence of significant publication bias across all outcomes.

Conclusion

Omega-3 PUFA supplementation, particularly the combination of DHA&EPA, may improve body weight and BMI in cancer patients, with moderate to high confidence in the evidence. However, no significant effects were observed on LBM, and the confidence in the result was moderate. Further high-quality RCTs are required to validate these findings, address heterogeneity, and determine the optimal type and dosage of supplements for nutritional interventions in cancer patients.