Omega-3 Fatty Acid Supplementation Effects on Weight and Appetite in Patients with Alzheimer's Disease: The Omega-3 Alzheimer's Disease Study

To study the effects of omega (Omega)-3 fatty acid (FA) supplements on weight and appetite in patients with mild to moderate Alzheimer's disease (AD) in relation to inflammatory biomarkers and apolipoprotein E epsilon 4 (APOE epsilon 4). Randomized, double-blind, placebo-controlled trial. Specialist memory clinics in the Stockholm catchment area. Two hundred four patients (aged 73 +/- 9, 52% women) with mild to moderate AD. Patients with AD received 1.7 g of docosahexaenoic acid (DHA) and 0.6 g of eicosapentaenoic acid (EPA) (Omega-3/Omega-3 group; n=89, aged 73 +/- 9, 57% women) or placebo 0.6 g of linoleic acid per day (placebo/Omega-3 group; n=85, aged 73 +/- 9, 46% women) for 6 months. After 6 months, all patients received DHA and EPA for another 6 months. Anthropometry, biochemical nutritional and inflammatory markers, and appetite assessed by caregiver. Mean weight and body mass index (kg/m(2)) at baseline were 70.0 +/- 11.8 kg and 24.3 +/- 3.0 kg/m(2), respectively. At 6- and 12-month follow-up, weight had increased 0.7 +/- 2.5 kg (P=.02) and 1.4 +/- 2.9 kg (P <.001) in the Omega-3/Omega-3 group. In the placebo group, weight was unchanged at 6 months but had increased (P=.01) at 12 months follow-up after Omega-3 supplementation was initiated. Appetite improved in the Omega-3/Omega-3 group over the treatment period (P=.01). In logistic regression analyses, not carrying the APOE epsilon 4 allele and high plasma DHA concentrations were independently related to weight gain in the combined group of patients at 6 months follow-up. A DHA-enriched Omega-3 FA supplement may positively affect weight and appetite in patients with mild to moderate AD. Not carrying the APOE epsilon 4 allele and high DHA were independently associated with weight gain.