omega-3 poly-unsaturated fatty acid supplementation in overweight and obese women: a pilot RCT to improve inflammation, insulin sensitivity and decrease fetal adiposity

We previously reported (ADA 2013) that ω-3 Poly-Unsaturated Fatty Acid (EPA/DHA, PUFA) supplementation decreases inflammation in placenta and adipose tissue of overweight/obese pregnant women (O/O). We now determine if ω-3 PUFA supplementation improved insulin sensitivity, inflammatory profile and decreases fetal adiposity. We performed a double blind RCT in O/O randomly assigned ω-3 PUFA (800 mg DHA/1200 mg EPA, n=25) or placebo (wheat germ oil, n=24). Inflammatory markers, lipids, OGTT, body composition, diet and activity measures at 8-16 (V1) and 34-36 weeks (V2). Insulin sensitivity was measured using HOMA and ISogtt. Maternal and neonatal body composition was performed using anthropometry and air densitometry. Outcomes between groups were compared and changes from V1 to V2 were analyzed as the difference (Δ) between groups with adjustments for significant co-variables. There were no significant differences in maternal age, parity, race, BMI, fat mass and gestational age at V1. Maternal weight (89.9±19.9 vs.79.9±10.6 kg, p=0.03) and lean mass (51.3±7.8 vs.46.9±4.8 kg, p=0.02) were higher in the ω-3 PUFA vs. placebo at V1. There were no significant differences in diet, activity, insulin sensitivity, plasma lipids, ω-3 PUFA and cytokine levels between groups at V1. The ω-3 PUFA concentrations (EPA 1.00±0.13 vs.0.2±0.02, p=0.001), (DHA 3.50±0.20 vs.2.40±0.10, p =0.001) and ω6/ω3 ratio (0.14±0.05 vs.0.07±0.01, p=0.003) were higher in the ω-3 PUFA vs. placebo group at V2. Differences (V2-V1) in plasma cytokines, insulin sensitivity and neonatal body composition are shown (Table). When adjusted for gestational age, gender, GDM, maternal lean and fat mass, there was no significant difference in neonatal body composition between groups. Despite significant decreases in maternal plasma CRP, treatment of O/O with ω-3 PUFA did not modify maternal insulin sensitivity or neonatal body composition. (ARRA HD057236.)