Enhancing Athletes’ Health and Performance: A Systematic Review of Omega-3 Fatty Acid Supplementation

Author(s): Ioannis S. Vasios, Konstantinos G. Makiev, Antigoni Gkoudina, Paraskevas Georgoulas, Efthymios Iliopoulos, Konstantinos Tilkeridis, Athanasios Ververidis

Background: Participation in sports has increased globally, leading to a rise in sports-related musculoskeletal injuries. Omega-3 fatty acids, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have been proposed to reduce inflammation, support joint health, and enhance muscle recovery, potentially reducing injury risk. However, the efficacy of omega-3 supplementation in athletic performance and recovery remains unclear.

Objectives: To systematically review the literature on the effects of omega-3 fatty acid supplementation in athletes, focusing on exercise performance, muscle recovery, inflammation, and related physiological adaptations.

Materials & Methods: A systematic review was conducted following PRISMA guidelines using PubMed/MEDLINE, including studies examining omega-3 supplementation (≤4 g/day) in athletes. Risk of bias was assessed using the Cochrane RoB 2.0 tool, and evidence certainty was evaluated using the GRADE framework.

Results: Ten randomized controlled trials involving 256 athletes (aged 18.6–36.0 years) were included. Omega-3 supplementation was associated with reduced inflammatory markers (IL-1β, IL-6, TNF-α), decreased muscle damage indicators (CK, LDH-5), and improvements in pulmonary function and cardiovascular markers, including running economy and VO2max. However, effects on exercise performance and muscle strength recovery were inconsistent across studies, often demonstrating benefits in subjective recovery and soreness but not in objective strength restoration, particularly in elite athletes.

Conclusion: Omega-3 fatty acid supplementation, especially EPA and DHA, exhibits beneficial effects on inflammation, muscle soreness, cardiovascular and pulmonary adaptations, predominantly in amateur athletes. However, its impact on overall performance and strength recovery remains inconclusive due to heterogeneity in supplementation protocols, study designs, and populations. Future studies should focus on optimizing dosing strategies, clarifying molecular mechanisms, and identifying responders to enable targeted supplementation recommendations in sports performance and recovery contexts.