Omega-3 Fatty Acids Supplementation and Neuroprotection, Inflammation, Fatigue, and Physical Activity in Multiple Sclerosis: A Randomized Controlled Trial.

Omega-3 fatty acids have neuroprotective properties. The present study aimed to evaluate the influence of omega-3 fatty acids supplementation on the serum levels of brain-derived neurotrophic factor (BDNF), high-sensitivity C-reactive protein (hs-CRP), physical activity, and chronic fatigue in patients with multiple sclerosis (MS). In a double-blind, placebo-controlled trial, 68 MS patients were randomly assigned to the intervention group receiving omega-3 fatty acids soft gels (1000 mg) twice a day for 12 weeks and the placebo group similarly taking paraffin soft gels. Serum concentrations of BDNF and hs-CRP were assessed before and after the intervention. Chronic fatigue, physical activity, and dietary intake of omega-3 fatty acids were evaluated. Initial comparisons between the intervention and control groups showed no significant differences for BDNF and hs-CRP levels (p = 0.321 and p = 0.996, respectively). Following the intervention, both groups showed a significant increase in their BDNF levels (p < 0.001). However, there were no significant differences in post-intervention levels of BDNF and hs-CRP serum levels between groups (p = 0.427, p = 0.695, respectively). This finding was further supported by the Quade nonparametric analysis of covariance, adjusted for baseline values, which indicated that omega-3 fatty acid supplementation had no significant effect on BDNF or hs-CRP levels in patients with MS (p = 0.644 and p = 0.533, respectively). After the intervention, hs-CRP changes were 1.5 folds greater in female patients than in male patients (p = 0.005). Additionally, no significant differences were observed between the intervention and control groups in baseline or post-intervention physical activity levels or chronic fatigue (p > 0.05), suggesting that omega-3 fatty acid supplementation did not influence physical activity or fatigue. Omega-3 fatty acids supplementation has no significant effect on BDNF and hs-CRP serum levels, fatigue, or physical activity capacity among MS patients. However, gender-specific differential hs-CRP response suggests a possible sex-related anti-inflammatory effect, which deserves further investigation.