BIOAVAILABILITY OF POLYUNSATURATED FATTY ACIDS IN FISH AND KRILL OIL: A NETWORK META-ANALYSIS

Objective: This research compared the bioavailability of polyunsaturated fatty acids in fish and krill oil at various dosages and dosage forms. Methods: This study complied with the PRISMA 2015 checklist and used the PEDro scale to assess the risk of bias. Studies published from 1993 to 2023 were collected from Embase, PubMed, ClinicalTrials, ICTRP, and Cochrane. Network meta-analysis was performed using omega-3 index (O3i) and area under the curve (AUC). Data were analyzed using R software (version 2023.12.1+402). The study’s PROSPERO ID is CRD42024532536. Results: A total of 26 RCTs were eligible for inclusion in the meta-analysis, with 8 of excellent quality (30.77%), 15 of good quality (57.69%), and the remaining studies of average quality (11.54%). A forest plot, SUCRA ranking scores, rankograms, and league tables showed that fish oil emulsion and phospholipid or free fatty acid (PL/FFA) krill oil at doses of 100 to 1900 mg (DHA + EPA) had the highest therapeutic rating in the index. AUC values indicated SUCRA rankings of 16.92% and 11.40% for fish and krill oil, respectively. The O3i showed that fish oil at all doses (100–1900, 2000–2900, and >3000 mg) and dosage forms had higher bioavailability than krill oil, for which (DHA + EPA) doses >3000 mg had the highest score (SUCRA = 14.71%). The use of krill oil generated more positive results than the use of fish oil. The reliability of the results and the absence of publication bias were determined via Egger’s test, including bias estimates, standard deviations, degrees of freedom, t value (range: –1.96–1.96), and p-value (>0.05). Conclusion: Supplementing fish oil with a content of (DHA + EPA) >3000 mg per day is the first choice in increasing O3i. The bioavailability of krill oil emulsion (PL/FFA) showed better efficacy than did the bioavailability of fish oil. Further studies are needed on the bioavailability of krill oil at high doses (>2000 mg).