Astaxanthin (Eye Fatigue)

INTRODUCTION: This study assessed the effects of astaxanthin supplementation on chronic and acute digital eye strain in school-aged children (10-14 years) and evaluated its safety. While previous studies focused on adults, this study examined astaxanthin's effects on developing eyes. METHODS: A randomized, double-blind, placebo-controlled trial was conducted over 84 days involving 64 children engaged in ≥ 4 h of screen time daily and experiencing mild to moderate computer vision syndrome (CVS) symptoms as indicated by a CVS-Questionnaire (CVS-Q) score ≥ 8 and < 19. Participants received a daily 4-mg astaxanthin soft capsule for 84 days. Primary outcomes were measured using CVS-Q, while secondary outcomes included visual fatigue Likert scale (VFLS), visual acuity, spherical equivalence, near point of accommodation, near exophoria, dry eye intensity, pupil size, stereopsis, blinking frequency, immunity, and safety variables. RESULTS: Of the 64 participants (mean age 11.5-11.7 years), 35 were male and 29 were female. Astaxanthin supplementation significantly improved CVS-Q scores after 84 days (- 4.00 ± 4.05 arbitrary units (A.U.) from baseline, p < 0.0001) compared to placebo (- 1.72 ± 3.61 A.U., p < 0.05), a 20% between group difference. The mean VFLS scores were significantly lower in the astaxanthin group (11.55 ± 5.78 A.U.) compared to placebo (15.78 ± 7.12 A.U., p = 0.01), showing a 27% improvement after 84 days. Stereopsis improved significantly after acute visual load at 28 and 84 days (p < 0.05, p < 0.0001 vs. placebo, respectively), and pupillary light reflex improved after 84 days (p < 0.05 vs. placebo). Tear production increased after 14, 56, and 84 days (p < 0.05, p < 0.001, and p < 0.001 vs. baseline, respectively) in the astaxanthin group, with no significant intergroup difference in the Schirmer I test, visual acuity, spherical equivalence, near point of accommodation, near exphoria, immune markers, or safety variables. CONCLUSION: Astaxanthin supplementation effectively reduced chronic and acute digital eye strain, while enhancing objective measures of visual performance in school-aged children, underscoring the benefits of astaxanthin in pediatric

BACKGROUND/OBJECTIVES: Nutritional supplementation has been proposed as a potential adjunct strategy in myopia prevention and control through antioxidative, anti-inflammatory, and extracellular matrix-regulating mechanisms. This systematic review aimed to evaluate randomized controlled trial (RCT) evidence on the effects of carotenoids, anthocyanins, polyunsaturated fatty acids, and combined nutraceutical formulations on refractive outcomes, axial length, macular pigment optical density (MPOD), visual function, and symptoms of visual fatigue. METHODS: The review was registered in PROSPERO (CRD420251149727) and conducted in accordance with PRISMA 2020 and AMSTAR-2 guidelines. PubMed, Web of Science, and Scopus were searched up to 5 August 2025. Eligible studies were RCTs involving individuals with myopia or at risk of myopia, comparing nutritional supplementation with placebo or active controls. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Cochrane RoB 2 tool. RESULTS: Nine RCTs were included. Carotenoids such as crocetin, lutein, zeaxanthin, and astaxanthin produced modest benefits, including improved MPOD, reduced visual fatigue, and-in one pediatric trial-slightly less axial elongation. Anthocyanin-rich extracts improved mesopic contrast sensitivity and subjective asthenopia. A combined carotenoid-polyphenol formulation enhanced accommodative facility. However, no consistent clinically meaningful reduction in myopia progression was observed. Trials were generally small, heterogeneous, and short in duration. CONCLUSIONS: Nutritional supplementation may improve visual function and retinal antioxidant status but lacks strong evidence for slowing myopia progression. Larger, long-term RCTs are needed before recommending supplementation for routine myopia management.

Objective: Seaweed and microalgae provide antioxidants, polyunsaturated fatty acids, and bioactive compounds that may enhance exercise performance and accelerate recovery. However, evidence remains inconsistent. This systematic review and meta-analysis aimed to evaluate the effects of algae-derived supplementation on exercise performance and physiological recovery outcomes in healthy and athletic adults. Methods: This review was registered in PROSPERO (CRD420251166723) and conducted in accordance with PRISMA 2020 guidelines. PubMed, Web of Science, Embase, Cochrane Library, EBSCO, and CNKI were systematically searched for randomized controlled trials (RCTs) evaluating algae supplementation in exercise contexts. Inclusion and exclusion criteria were defined based on the PICOS framework. Primary outcomes included VO2max, Time to exhaustion (TTE), maximal power output (WRmax), Time-Trial (TT) performance, and creatine kinase (CK). Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Subgroup, sensitivity, and publication bias analyses were performed. Results: Twenty-two RCTs (n = 822) investigating Spirulina, Chlorella, brown-algal polysaccharides, or astaxanthin met inclusion criteria. Algae supplementation showed a suggestive improvement in VO2max (SMD = 0.88, 95% CI: 0.00-1.75) and significantly improved in TTE (SMD = 1.06, 95% CI: 0.16-1.96), with smaller effects on WRmax (SMD = 0.29, 95% CI: 0.03-0.55), and no significant benefit for TT performance (SMD = -0.27, 95% CI: -0.74 to 0.21). Regarding recovery, CK concentrations were significantly reduced (SMD = -0.78, 95% CI: -1.28 to -0.28). Subgroup analysis suggested greater effects for Chlorella supplementation, higher dosages, and aerobic training contexts; reductions in muscle-damage markers were more evident following resistance exercise. Sensitivity analyses supported the robustness of the main findings with minimal evidence of publication bias. Conclusions: Algae-derived supplements-particularly Spirulina and Chlorella-may modestly enhance aerobic exercise performance and attenuate exercise-induced muscle damage under certain conditions. Eff

Polycystic ovary syndrome (PCOS) is a major risk factor for ovarian hyperstimulation syndrome (OHSS) during controlled ovarian stimulation (COS). Oxidative stress and inflammation, mediated by the advanced glycation end products (AGE)-receptor for AGE (RAGE)-nuclear factor kappa-B (NFκB) pathway, contribute to OHSS development and impaired oocyte quality. Astaxanthin (AST), a potent antioxidant, may modulate this pathway. In this exploratory pilot trial using a triple‑blind, randomized, placebo‑controlled design, 44 PCOS patients at high risk for OHSS were assigned to receive AST (n = 22) or placebo (n = 22) adjunct to the COS regimen. COS was performed using a gonadotropin-releasing hormone (GnRH) antagonist protocol with individualized gonadotropin dosing. Stimulation characteristics, gonadotropin dose, and follicle distribution were comparable between groups. The mean number of retrieved oocytes was slightly higher with AST, and the oocyte maturity rate (OMR) was significantly greater. Estradiol and progesterone levels on trigger day were lower in the AST group, though not statistically significant. Molecular analyses showed reduced RAGE expression, a lower phosphorylated inhibitor of kappa-B (pIκB)/inhibitor of kappa-B (IκB) ratio in granulosa cells (GCs), and significantly decreased interleukin-6 (IL-6) in follicular fluid (FF), with vascular endothelial growth factor (VEGF) showing a downward trend. These findings suggest that AST supplementation may improve COS outcomes and favorably modulate inflammatory pathways, with potential to reduce OHSS risk in high-risk PCOS patients. However, this pilot trial was not powered enough to confirm the primary OHSS endpoint, and larger studies are required for validation.Trial registration: Registration ID: IRCT20231028059882N2; Registration date: 2024-06-15; Update date: 2025-03-16; Direct Access Link: https://irct.behdasht.gov.ir/trial/77250 . © 2026. The Author(s).

BACKGROUND AND AIMS: Carotenoids are known for their beneficial effects in improving chronic diseases through their antioxidant properties. However, there has been no meta-analysis on the effects of carotenoids on liver enzymes and the evidence is inconsistent. So, this study aimed to evaluate the effects of carotenoid supplementation on liver enzyme levels in adults. METHODS: Through November 2024, the PubMed, Scopus and Web of Science electronic databases were searched for eligible trials evaluating the carotenoid supplementation effects on the Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Alkaline phosphatase (ALP) and Gamma-glutamyl transferase (GGT). The 95% confidence intervals (CIs) and weighted mean differences (WMDs) were calculated using the random effects model. As part of standard methods, dose-response, meta-regressions, sensitivity, and publication bias analyses were performed. Evidence certainty was assessed using GRADE (Grading of Recommendations for Assessment, Development, and Evaluation). RESULTS: Of the 15 studies (20 arms; n = 757), 7 included healthy participants, while 8 involved non-healthy individuals, including 4 studies on prediabetes or diabetes. Pooled estimates indicated non-significant effects of carotenoid supplementation on all enzymes including ALT (WMD: -2.25 IU/L, 95%CI: -4.84,0.34, P = 0.089), AST (WMD: -0.46 IU/L, 95%CI: -1.25,0.34, P = 0.259), ALP (WMD: -0.34 IU/L, 95%CI: -6.89,6.21, P = 0.918) and GGT (WMD: -0.43 IU/L, 95%CI: -3.06,2.21, P = 0.751) levels non-significantly. Significant reductions in ALT levels occurred in < 12 weeks (P = 0.028), BMI ≥ 25 (P = 0.045), and among non-healthy participants (P = 0.015). AST levels were significantly reduced in non-healthy participants (P = 0.003) with ages > 50 (P = 0.003) as well as GGT levels (P = 0.011) in non-healthy participants. CONCLUSION: Carotenoid supplementation might be beneficial in reducing liver enzymes, especially in non-healthy participants and in those with a BMI ≥ 25 kg/m2. However, more trials with standard methods are required. PROSPERO REGISTERATION CODE: CRD42024612956. © 2025. The Author(s).

BACKGROUND AND AIMS: Chronic heart failure (HF) is often linked to increased oxidative stress and metabolic issues like high uric acid, which can worsen outcomes. Astaxanthin (ASX), a strong antioxidant, may help reduce these harmful effects. This study aimed to investigate the effects of ASX supplementation on oxidative stress markers as the primary outcome and clinical symptoms in patients with HF. METHODS: In this randomized, double-blind, placebo-controlled clinical trial, 80 patients with HF were enrolled and randomly assigned to receive either ASX (20 mg/day) or a placebo (20 mg/day of maltodextrin) for 8 weeks. Biomarkers including total antioxidant capacity (TAC), malondialdehyde (MDA), superoxide dismutase (SOD), serum UA, and clinical symptoms (dyspnea, fatigue, appetite) were assessed pre-and post-intervention. RESULTS: After eight weeks, compared to the placebo group, participants receiving ASX supplementation showed a significant increase in TAC (0.12 vs. -0.04 mmol/L, P = 0.002) and SOD levels (156.92 vs. 36.14 U/mL, P < 0.001). In contrast, the ASX group demonstrated significantly greater reductions in MDA (-2.19 vs. -0.68 nmol/L, P < 0.001) and serum UA levels (-1.82 vs. -0.63 mg/dl, P = 0.003) compared to placebo. Furthermore, among ASX treated patients, improvements in dyspnea and fatigue were statistically significant (P < 0.001), while the increase in appetite was only marginally significant (P = 0.071). CONCLUSION: These findings suggest that ASX supplementation may be effective in improving oxidative stress biomarkers and clinical status in patients with HF. TRIAL REGISTRATION: Iranian Registry of Clinical Trials IRCT20200429047235N3. Registered on 26 March 2024, prior to the enrollment of the first participant. http://irct.behdasht.gov.ir/trial/75913 . © 2025. The Author(s).

OBJECTIVE: To investigate the effect of krill oil (KO) supplementation during alternate-day fasting (ADF) on body composition and muscle function in healthy adults with overweight. METHODS: In a randomized trial, during the 8-week ADF, participants consumed four capsules per day containing krill oil (KO group) or vegetable oil (placebo group). Each capsule of KO contained 191 mg EPA, 94 mg DHA, 78 mg choline, and 100 mcg astaxanthin. Body mass, fat-free mass (FFM), and handgrip strength (HGS) were measured before and after the intervention. Data were analyzed using ANOVA. RESULTS: The study was completed by 41 (25 women and 16 men) participants (age: 39 ± 10 years, BMI: 31.1 ± 4.2 kg/m2). Body weight reduction was not different (p > 0.05) between groups (KO, -4.6 ± 1.4 kg; Placebo, -4.5 ± 1.9 kg). The KO group had no change (p > 0.05) in FFM (-0.2 ± 0.9 kg) or HGS (-0.2 ± 0.5 kg). The placebo group experienced a reduction (p < 0.05) in FFM (-1.2 ± 2.0 kg) and HGS (-0.9 ± 0.7 kg). Changes in FFM and HGS were different (p < 0.05) between groups. CONCLUSIONS: KO supplementation during body weight loss attenuates the decline in FFM and muscle strength. TRIAL REGISTRATION: ClinicalTrials.gov Identifier (NCT06001632). © 2025 The Author(s). Obesity published by Wiley Periodicals LLC on behalf of The Obesity Society.

Rheumatoid Arthritis (RA) is a chronic, systemic inflammatory disease that results in joint destruction and progressive disability. This study aimed to determine the effect of astaxanthin (ASX) on clinical outcomes, quality of life, and inflammatory factors in patients with RA. In this randomized, triple-blind, placebo-controlled clinical trial, 60 patients with RA were randomly allocated into two groups and given either 20 mg day-1 of ASX supplement in the intervention group (n = 30) or placebo in the control group (n = 30) for 8 weeks. Fasting blood samples were obtained from patients at the beginning and end of the intervention to measure the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and interleukin-6 (IL-6). Clinical symptoms were also measured, including the pain intensity based on the visual analogue scale (VAS), Disease Activity Score 28 (DAS-28), and Health Assessment Questionnaire (HAQ). In the intervention group compared to the control group after the intervention, DAS-28, HAQ, ESR, and CRP levels were significantly reduced (P < 0.05), and the pain intensity was marginally significantly reduced. The significant differences in DAS-28, HAQ, and ESR levels persisted even after adjusting for baseline values and other covariates. However, no significant differences in the pain intensity and CRP levels were found after controlling for confounding factors (P > 0.05). The IL-6 level did not change in either group by the end of the study, and the difference between the two groups also was not statistically significant (P > 0.05). This study demonstrated the beneficial effects of ASX on some important clinical outcomes, quality of life, and inflammatory factors in patients with RA. Including it as part of their treatment plan could significantly aid in managing their condition.

Obesity increases the risk for insulin resistance (IR) and type-2 diabetes. Lifestyle interventions (LI) and dietary supplementation can help mitigate IR. We investigated the effect of calanus oil (CO) supplementation, combined with LI, on glucose homeostasis in obese subjects. CO, a novel marine oil, contains omega-3 fatty acid wax esters as well as plant sterols and astaxanthin. In the double-blind, randomized, placebo-controlled 12-week intervention study, 266 subjects with distinct IR phenotypes were assigned to four groups: 2 g CO/day, 4 g CO/day, 2 g CO/day + LI, and placebo. The effect of CO on HOMA index reduction was influenced by the initial (t0) squared HOMA index (interaction p = 0.011). A post hoc test showed significant improvement with 2 g CO/day + LI (estimated marginal means [EMM] 95% confidence interval [CI]: -0.19 [-0.80-0.41], p = 0.021). Secondary analysis revealed that 4 g CO/day had significant effects in subjects with mild IR (HOMA index 2.5-5.0) (EMM [95% CI]: -0.76 [-1.53-0.03], p = 0.043). CO supplementation improved glucose homeostasis, with effects varying by dose, combination with LI, and IR phenotype.

RATIONALE: Firefighters are at risk for cardiovascular disease due to occupational-related inflammation, oxidative stress, and lifestyle practices. Astaxanthin (AX) possesses anti-inflammatory/antioxidant and purported ergogenic properties. This study examined the impact of supplementing the diet with 12 mg/d AX for four weeks on markers of inflammation, oxidative stress, cardiometabolic health, exercise capacity, and occupation-related performance in career firefighters. METHODS: In a randomized, double-blinded, placebo-controlled, crossover fashion, 15 male career firefighters (34.5 ± 7.4 years; 177.7 ± 7.0 cm; 95.6 ± 12.0 kg; 30.1 ± 2.9 kg/m2; 11.03 ± 6.85 years of service) ingested 12 mg/d of AX (AstaReal®, AstaReal AB, Nacka, SWE) or placebo (PLA) for four weeks while following a standardized resistance training program. After each treatment, testing sessions were completed to assess inflammatory markers, oxidative stress markers, cardiopulmonary exercise capacity, and performance to a fire ground test (FGT) consisting of nine fire suppressive activities. Data were analyzed using general linear model (GLM) analysis with repeated measures. Clinical significance was assessed via mean changes from baseline with 95% confidence intervals. RESULTS: Analysis of mean percent changes from baseline revealed that AX supplementation lessened the inflammatory response to to performing an incremental maximal exercise test and attenuated increases in interleukin-1β, cortisol, and uric acid in response to performing fire suppressive activities compared to when they ingested PLA. However, most of these effects were within groups rather than between groups. Additionally, there was evidence that AX ingestion increased the ventilatory anaerobic threshold. Four weeks of AX supplementation did not significantly affect fasting markers of oxidative stress, blood lipids, performance during the FGT, general clinical chemistry panels, or self-reported side effects. CONCLUSIONS: Results provide some evidence that AX supplementation may help mediate occupation-related inflammation in response to high-intensity, short-duration exercise in firefighters. More research is warranted to dete

OBJECTIVES: We conducted a systematic review and meta-analysis to assess the effects of carotenoid supplementation on glycemic indices, and the certainty of evidence. METHODS: A systematic literature search in PubMed, SCOPUS, ISI-Web of Science, and Cochrane Library was conducted from inception up to Jun 17, 2024. Randomized controlled trials (RCTs) investigating the effect of carotenoid supplementation on circulating glycemic parameters were included. Records were excluded when studies reported the effect of co-interventions with other nutrients, did not provide mean differences (MDs) and standard deviations (SD) for outcomes, or administered whole food rather than supplements of carotenoids. Summary mean differences (MDs) and 95% CI between intervention and control groups were estimated using a random-effects model. The risk of bias of the included studies was assessed using the Risk of Bias 2.0 (RoB 2.0) tool. RESULTS: Overall, 36 publications with 45 estimated effect sizes were included in the meta-analyses. The overall findings showed an improvement in fasting blood glucose (FBG) (MD = -4.54 mg/dl; 95% CI: -5.9, -3.2; n = 45), and hemoglobin A1C (HbA1C) (MD = -0.25% (95% CI: -0.4, -0.11; n = 22) in the intervention group in comparison with the control group. Moreover, in individuals with type 2 diabetes (T2D), interventions with astaxanthin and fucoxanthin led to a reduction in FBG by 4.36 mg/dl (95% CI: -6.13, -2.6; n = 10). The findings also showed that the intervention with crocin reduced FBG levels by 13.5 mg/dl (95% CI: -15.5, -7.8; n = 5), and HbA1C by 0.55% (95% CI: -0.77, -0.34; n = 5) in individuals with T2D. However, the certainty of evidence was very low. CONCLUSION: Carotenoid's supplementation improved glycemic parameters especially in people with T2D. However. the certainty of evidence was very low, mainly due to small sample size, and indirectness. Therefore, no specific recommendations can be provided at present and well-designed RCTs are required. REGISTRY URL: https://www.crd.york.ac.uk/PROSPERO/ REGISTRY NUMBER: CRD42021285084 REGISTRY AND REGISTRY NUMBER FOR SYSTEMATIC REVIEWS OR META-ANALYSES: PROSPERO ID: CRD42021285084. © 2024. The A

OBJECTIVE: Obesity is associated with an exacerbated metabolic condition that is mediated through impairing balance in the secretion of some adipo-myokines. Therefore, the objective of the present study was to explore the impact of astaxanthin supplementation in conjunction with a 12-week CrossFit training regimen on some selected adipo-myokines, insulin insensitivity, and serum lipid levels in obese males. MATERIAL AND METHODS: This study is a randomized control trial design; 60 obese males were randomly divided into four groups of 15, including the control group (CG), supplement group (SG), training group (TG), and combined training and supplement group (TSG). The participants were subjected to 12 weeks of astaxanthin (AST) supplementation [20 mg/d capsule, once/d] or CrossFit training or a combination of both interventions. The training regimen comprised 36 sessions of CrossFit, each lasting 60 min, conducted three times per week. The metabolic indices, body composition, anthropometrical, cardio-respiratory, and also some plasma adipo-myokine factors, including decorin (DCN), activin A, myostatin (MST), transforming growth factor (TGF)-β1, and follistatin (FST), were examined 12 and 72 h before the initiation of the main interventional protocols, and then 72 h after the final session of the training protocol. RESULTS: There was no significant difference in the baseline data between the groups (p > 0.05). There were significant interactions between group x time for DCN (η2 = 0.82), activin A (η2 = 0.50), FST (η2 = 0.92), MST (η2 = 0.75), and TGFB-1 (η2 = 0.67) (p < 0.001 for all the variables). Significantly changes showed for DCN in TSG compared to TG and SG and also TG compared to SG (p = 0.0001); for activin A in SG compared to TG (p = 0.01) and TSG (p = 0.002); for FST in SG compared to TG and TSG (p = 0.0001), also in TSG compared to TG (p = 0.0001); for MST in SG, TG, and TSG compared to CG (p = 0.0001) and also in TSG compared to SG (p = 0.0001) and TG (p = 0.001); for TGFB-1 in SG, TG, and TSG compared to CG (p = 0.0001) and also TSG compared to SG (p = 0.0001) and TG (p = 0.001). CONCLUSIONS: The 12-week CrossFit training concurrent with AST supplemen

Polycystic ovary syndrome (PCOS) is a prevalent gynecological-endocrinological disorder characterized by hyperandrogenism, menstrual irregularities, and metabolic disturbances. Recent research has highlighted the role of oxidative stress and chronic inflammation in exacerbating PCOS symptoms and impeding reproductive outcomes. Astaxanthin, a potent antioxidant found in marine organisms, has been suggested as a potential therapeutic intervention due to its ability to reduce oxidative stress and inflammation. This meta-analysis systematically reviews randomized controlled trials assessing the impact of astaxanthin supplementation on oxidative stress and reproductive outcomes in women with PCOS. Data from four trials were analyzed, focusing on markers of oxidative stress and reproductive health metrics. The meta-analysis utilized fixed and random-effects models to synthesize results, with heterogeneity assessed using Chi-square and I2 statistics. The findings indicate that while astaxanthin significantly improves markers of total antioxidant capacity (TAC) in follicular fluid, it does not show a consistent effect on other oxidative stress biomarkers such as malondialdehyde (MDA), catalase (CAT), or superoxide dismutase (SOD). Reproductive outcomes, including oocyte quality and the number of high-quality embryos, showed moderate improvements, although effects on fertilization rates and pregnancy outcomes were insignificant. The analysis highlights variability in study designs and dosing, suggesting a need for further research with standardized protocols and larger sample sizes. Future studies should focus on determining optimal dosing, exploring mechanistic pathways, and investigating the combined effects of astaxanthin with other interventions. Longitudinal studies are needed to assess long-term benefits and safety, and personalized approaches could enhance treatment efficacy for individuals with PCOS. © 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

BACKGROUND: Heart failure is a chronic and progressive disease where the heart muscle is unable to pump enough blood and oxygen to meet the body's needs. Oxidative stress and inflammation are key elements in the development and progression of heart failure. Astaxanthin, a carotenoid, has strong anti-inflammatory and antioxidant effects that may protect the cardiovascular system. A study will evaluate the effect of astaxanthin supplementation on inflammatory status, oxidative stress, lipid profile, uric acid levels, endothelial function, quality of life, and disease symptoms in people with heart failure. METHODS: The current study is a double-blind controlled randomized clinical trial for 8 weeks, in which people with heart failure were randomly assigned to two groups: intervention (one capsule containing 20 mg of astaxanthin per day, n = 40) and placebo (one capsule containing 20 mg of maltodextrin per day, n = 40) will be divided. At the beginning and end of the intervention, uric acid, lipid profile, oxidative stress indices, inflammatory markers, blood pressure, nitric oxide, and anthropometric factors will be measured, and questionnaires measuring quality of life, fatigue intensity, shortness of breath, and appetite will be completed. SPSS version 22 software will be used for statistical analysis. DISCUSSION: There is a growing global interest in natural and functional food products. This RCT contributes to the expanding body of research on the potential benefits of astaxanthin in heart failure patients, including its antioxidant, lipid-lowering, and anti-inflammatory effects. TRIAL REGISTRATION: Iranian Registry of Clinical Trials IRCT20200429047235N3. Registered on 26 March 2024. © 2024. The Author(s).

The efficacy of functional lipids with antioxidant properties in reducing cardiovascular risk has not been consistent. Randomized controlled trials (RCTs) reporting estimates for the effects of antioxidant functional lipid supplementations on cardiometabolic risk factors were searched up to 1 May 2024. Overall, antioxidant lipid supplementations, compared with placebo, had favorable effects on systolic blood pressure (lycopene: -1.95 [-3.54, -0.36] mmHg), low-density lipoprotein cholesterol (n6 fatty acid: -0.39 [-0.71, -0.06] mmol/L; astaxanthin: -0.11 [-0.21, -0.01] mmol/L), high-density lipoprotein cholesterol (n3 fatty acid: 0.20 [0.13, 0.27] mmol/L; n6 fatty acid: 0.08 [0.01, 0.14] mmol/L; astaxanthin: 0.13 [0.05, 0.21] mmol/L), total cholesterol (n6 fatty acid: -0.24 [-0.37, -0.11] mmol/L; astaxanthin: -0.22 [-0.32, -0.12] mmol/L; beta-carotene: -0.13 [-0.23, -0.04] mmol/L), triglyceride (n3 fatty acid: -0.37 [-0.47, -0.28] mmol/L; astaxanthin: -0.46 [-0.83, -0.10] mmol/L), and fasting blood insulin (astaxanthin: -2.66 [-3.98, -1.34] pmol/L). The benefits of antioxidant lipid supplementations appeared to be most evident in blood pressure and blood lipids in participants with different cardiometabolic health statuses. Notably, n9 fatty acid increased triglyceride and hemoglobin A1C in the total population, which increases CVD risk. Antioxidant lipid supplementations ameliorate cardiometabolic risk factors, while their effect may depend on type and cardiometabolic health status. Long-term RCTs are needed to corroborate risk-benefit ratios across different antioxidant functional lipid supplementation settings.