Non-alcoholic fatty liver disease (NAFLD), an important non-communicable disease (NCD), affecting around 25% of the world population and approximately 30% of western populations, represents a major challenge to public health(1; 2). Lifestyle modification to lose 7%–10% of total body weight by diet and exercise is the first-line treatment for NAFLD (3). The addition of omega-3 (n-3) fatty acids offer benefits to NAFLD biomarkers (4). However, the effects of plant-based n-3 fatty acids are yet to be determined. The aim of this systematic review and meta-analysis was to evaluate potential benefits of plant-based n-3 supplementation on NAFLD biomarkers and parameters.
The review followed the PRISMA checklist for systematic reviews and meta-analysis, used Cochrane Collaboration search strategies,(5; 6) and is registered with PROSPERO (CRD42021251980)  Searches were made using SCOPUS, PuBMeD and CINAHLwith criteria including terms relating to plant-based n-3 interventions in adults, adolescents and children diagnosed with NAFLD. Titles and abstracts were screened for relevance by two independent review authors (EM and KEL).
The searches identified 982 articles, which reduced to 60 upon abstract and title screening. Application of inclusion/exclusion criteria led to identification of six key studies (eight publications). The identified adult studies (n=3) were completed in Iran, used flaxseed n-3 sources (alpha-linolenic acid (ALA)) with study durations of twelve weeks. The child and adolescent studies (n=3) were completed in Italy, used algal oil n-3 sources (docosahexaenoic acid (DHA)) with minimum study duration of twelve weeks, maximum six months. Hypocaloric diets and/or lifestyle interventions were prescribed for all participants in intervention or control/placebo groups.
The results of the meta-analysis showed plant-based n-3 fatty acid supplementation interventions gave significant reductions in biomarkers for alanine aminotransferase (ALT), (WMD -8.04; (CI -14.70 -1.38), p = 0.02), low density lipoprotein cholesterol (WMD -8.75 (CI-17.53, 0.04); p = 0.05) and blood triglycerides (WMD-37.51; (CI -66.85, 8.17); p = 0.01), alongside body composition markers BMI, waist circumference and total weight (p < 0.05) in NAFLD patients. However, the meta-analysis showed high heterogeneity. Due to the small number of studies, it was not possible to separate the effects of ALA and DHA and the results could not be delimited for the effects of weight loss.
Further research is needed to identify the most effective plant-based n-3 supplement sources in NAFLD patient biomarkers including ALA, eicosapentaenoic acid (EPA) and DHA and to establish whether plant-based n-3 supplementation offers improvements with and without weight loss targeted lifestyle interventions.
1. Younossi ZM, Koenig AB, Abdelatif D et al. (2016) Hepatol 64, 73-84.
2. Lazarus JV, Mark HE, Anstee QM et al.(2022) Nature Reviews Gastroenterology & Hepatology 19, 60-78.
3. EASL, EASD, EASO (2016) J Hepatol 64, 1388-1402.
4. Puri P, Baillie RA, Wiest MM et al. (2007) Hepatol 46, 1081-1090.
5. Moher D, Liberati A, Tetzlaff J et al.(2009) BMJ 339, b2535.
6. Kelley GA, Kelley KS (2019) Br J Nutr 122, 1279-1294.
Conference theme: Nutrition in the treatment, management and prevention of disease.

Non-alcoholic fatty liver disease (NAFLD), an important non-communicable disease (NCD), affecting around 25% of the world population and approximately 30% of western populations, represents a major challenge to public health(1; 2). Lifestyle modification to lose 7%–10% of total body weight by diet and exercise is the first-line treatment for NAFLD (3). The addition of omega-3 (_n_-3) fatty acids offer benefits to NAFLD biomarkers (4). However, the effects of plant-based _n_-3 fatty acids are yet to be determined. The aim of this systematic review and meta-analysis was to evaluate potential benefits of plant-based _n_-3 supplementation on NAFLD biomarkers and parameters.
The review followed the PRISMA checklist for systematic reviews and meta-analysis, used Cochrane Collaboration search strategies,(5; 6) and is registered with PROSPERO (CRD42021251980)  Searches were made using SCOPUS, PuBMeD and CINAHLwith criteria including terms relating to plant-based _n_-3 interventions in adults, adolescents and children diagnosed with NAFLD. Titles and abstracts were screened for relevance by two independent review authors (EM and KEL).
The searches identified 982 articles, which reduced to 60 upon abstract and title screening. Application of inclusion/exclusion criteria led to identification of six key studies (eight publications). The identified adult studies (n=3) were completed in Iran, used flaxseed _n_-3 sources (alpha-linolenic acid (ALA)) with study durations of twelve weeks. The child and adolescent studies (n=3) were completed in Italy, used algal oil _n_-3 sources (docosahexaenoic acid (DHA)) with minimum study duration of twelve weeks, maximum six months. Hypocaloric diets and/or lifestyle interventions were prescribed for all participants in intervention or control/placebo groups.
The results of the meta-analysis showed plant-based _n_-3 fatty acid supplementation interventions gave significant reductions in biomarkers for alanine aminotransferase (ALT), (WMD -8.04; (CI -14.70 -1.38), _p_ = 0.02), low density lipoprotein cholesterol (WMD -8.75 (CI-17.53, 0.04); _p_ = 0.05) and blood triglycerides (WMD-37.51; (CI -66.85, 8.17); _p_ = 0.01), alongside body composition markers BMI, waist circumference and total weight (_p_ < 0.05) in NAFLD patients. However, the meta-analysis showed high heterogeneity. Due to the small number of studies, it was not possible to separate the effects of ALA and DHA and the results could not be delimited for the effects of weight loss.
Further research is needed to identify the most effective plant-based _n_-3 supplement sources in NAFLD patient biomarkers including ALA, eicosapentaenoic acid (EPA) and DHA and to establish whether plant-based _n_-3 supplementation offers improvements with and without weight loss targeted lifestyle interventions.
1. Younossi ZM, Koenig AB, Abdelatif D _et al._ (2016) _Hepatol_ **64**, 73-84.
2. Lazarus JV, Mark HE, Anstee QM _et al._(2022) _Nature Reviews Gastroenterology & Hepatology_ **19**, 60-78.
3. EASL, EASD, EASO (2016) _J Hepatol_ **64**, 1388-1402.
4. Puri P, Baillie RA, Wiest MM _et al._ (2007) _Hepatol_ **46**, 1081-1090.
5. Moher D, Liberati A, Tetzlaff J _et al._(2009) _BMJ_ **339**, b2535.
6. Kelley GA, Kelley KS (2019) _Br J Nutr_ **122**, 1279-1294.
Conference theme: Nutrition in the treatment, management and prevention of disease.

The effect of plant-based omega-3 fatty acids in patients with non-alcoholic fatty liver disease. A systematic review and meta-analysis.

The Nutrition Society Summer Conference 2022 is hosted in collaboration between Sheffield Hallam University, University of Sheffield and Sheffield City Council. It will be the first in-person Summer Conference since the pandemic, held at the Sheffield Hallam University city centre campus.

Sustainability is high on the agenda for individuals and for society as a whole, recent meetings such as COP 26 have highlighted the urgency of addressing climate change, of which food systems are a key factor.

The overarching theme of this conference highlights sustainability- sustainability is a large, diverse and contemporary issue consisting of environmental, societal and health perspectives which will be addressed from varying angles. 

This meeting will consider how to build ethical food systems, tackle inequalities and sustain health and wellbeing for future generations.

The Organising Committee have considered local food provision and will offer you a chance to explore Sheffield and its local produce.