A recently published meta-analysis reports that fatty acid supplementation, particularly omega-3, may significantly reduce severity, duration and frequency of migraine in patients – although the researchers suggested further randomised controlled trials may be necessary to confirm these results.
The analysis included six randomised controlled trials comprising 407 participants with chronic migraine, assessing the effects of fatty acid supplementation over eight to 16 weeks.
The overall risk of bias across studies was assessed as low, and the pooled data showed significant reductions in headache intensity (standardised mean difference [SMD] = -1.77; 95% CI, -3.32 to -0.21; P = .03), headache duration (SMD = -0.77; 95% CI, -1.05 to -0.50; P < .00001), headache frequency (SMD = -1.91; 95% CI, -2.61 to -1.21; P < .00001), and Headache Impact Test-6 (HIT-6) scores (SMD = -2.44; 95% CI, -4.13 to -0.76; P = .004).
“Migraines are a prevalent neurological condition that significantly impacts the quality of life. Although narrative reviews and clinical trials suggest the potential effects of fatty acid supplementation as a promising approach for migraine prophylaxis, the findings remain inconsistent,” wrote co-authors Guillermo García Pérez de Sevilla, PhD, professor of physical activity and sports sciences, and Ángel González de la Flor, PhD, professor of physiotherapy, both from at the European University of Madrid.
The researchers performed the systematic review and meta-analysis using Medline, Scopus, Web of Science, and CINAHL databases up to 7 October 2024: only randomised controlled trials that included adults with migraine receiving fatty acid supplementation were selected.
The study, published in Nutrition Reviews, had methodological quality and risk of bias independently assessed by two reviewers using the Cochrane Risk of Bias 2 tool.
All told, reports Neurology Live, the interventions varied across studies, with most focusing on omega-3 supplementation, sometimes paired with omega-6 restriction, and one trial investigating the effects of alpha-lipoic acid. Investigators noted that the use of a random-effects model accounted for heterogeneity among studies, with SMDs interpreted as small, moderate, or large effects.
Despite these encouraging results, the researchers emphasised that additional high-quality randomised controlled trials may be needed to confirm the efficacy of fatty acid supplementation for migraine, particularly for alpha-lipoic acid, which showed promising but preliminary outcomes.
The study builds on earlier findings where in a separate meta-analysis, results showed that although omega-3 fatty acids might not have affected migraine frequency or severity, they significantly shorted migraine attack duration.
The analysis included 13 randomsed controlled trials, of which 5, 2, and 3 trials met eligibility criteria to assess omega-3’s impact on migraine frequency, duration, and severity, respectively.
Results indicated no significant effect on migraine frequency (weighted mean difference [WMD] = -0.20; 95% CI, -0.67 to 0.27; P = 0.401) or severity (SMD = -0.59; 95% CI, -1.85 to 0.66; P = 0.35), but a notable reduction in the duration of migraine attacks by approximately 3.44 hours (WMD = -3.44; 95% CI, -5.70 to -1.19; P = 0.003).
Meta-regression analyses also explored potential sources of heterogeneity. Low heterogeneity was observed for migraine frequency (I² = 4.6%; P = 0.380) and duration (I² = 0.0%; P = 0.926), whereas high heterogeneity was seen for severity outcomes (I² = 88.8%; P = 0.000).
Despite the mixed findings, the prior analysis supports that omega-3 supplementation could significantly reduce the duration of migraine attacks. However, researchers noted that further randomised controlled trials with robust methodological design and larger sample sizes may be necessary to confirm these results.
Study details
Impact of Fatty Acid Supplementation on Migraine Outcomes: A Systematic Review and Meta-analysis
Guillermo García-Pérez-de-Sevilla, Ángel González-de-la-Flor.
Published in Nutrition Reviews 17 January 2025
Abstract
Context
Migraines are a prevalent neurological condition that significantly impacts the quality of life. Although narrative reviews and clinical trials suggest the potential effects of fatty acid supplementation as a promising approach for migraine prophylaxis, the findings remain inconsistent.
Objective
The aim was to evaluate the efficacy of fatty acid supplementation on migraine clinical outcomes through a systematic review and meta-analysis.
Data sources
This systematic review and meta-analysis was conducted using electronic databases including Medline, Scopus, Web of Science, and CINAHL from their inception up to October 7, 2024.
Data extraction
Studies meeting the PICOS criteria were included: adults diagnosed with migraine, dietary supplementation with fatty acids, assessing migraine clinical outcomes, and only randomised controlled trials. Methodological quality and risk of bias were assessed independently by two reviewers using the Cochrane Risk of Bias 2 tool.
Data analysis
Meta-analyses were conducted using Review Manager software. A random-effects model was applied to account for heterogeneity among studies. A standardised mean difference (SMD) of 0.2, 0.5, and 0.8 was interpreted as small, moderate, and large effects, respectively. Six randomised controlled trials, including 407 participants with chronic migraines, were analysed. Interventions varied, including omega-3 supplementation with or without omega-6 restriction, lasting from eight to 16 weeks, and one trial assessing alpha-lipoic acid. The overall risk of bias was assessed as low. The pooled analysis demonstrated significant reductions in headache intensity (SMD = -1.77; 95% CI: -3.32 to -0.21; P = .03), headache duration (SMD = -0.77; 95% CI: -1.05 to -0.50; P < .00001), headache frequency (SMD = -1.91; 95% CI: -2.61 to -1.21; P < .00001), and HIT-6 score (SMD = -2.44; 95% CI: -4.13 to -0.76; P = .004).
Conclusion
This meta-analysis provides moderate evidence that fatty acid supplementation, particularly omega-3, improves migraine clinical outcomes. Additional high-quality, randomised controlled trials are needed to confirm these findings, particularly for the promising effects of alpha-lipoic acid.
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