Subgroup analysis revealed that increasing dietary ALA tends to elevate CRP concentration  in healthy subjects .
However , the null effect of ALA supplementation on other inflammatory markers was not changed in various subgroups , indicating that the results are stable .
Meta-regression results revealed a negative relationship between the effect size on CRP and its baseline concentration .
No significant publication bias was observed for all inflammatory markers as suggested by funnel plot and Begg ’s test .
Conclusion Our meta- analysis did not find any beneficial effect of ALA supplementation  on reducing inflammatory markers including TNF , IL-6 , CRP , sICAM-1 , and sVCAM-1 .
However , in healthy subjects  , ALA supplementation might increase CRP concentration
Purpose The aim of the current meta- analysis was to investigate the effect of increasing dietary ALA intake on the blood concentration of inflammatory markers including tumor necrosis factor ( TNF ) , interleukin 6 ( IL-6 ) , C-reactive protein ( CRP ) , soluble intercellular adhesion molecule-1 ( sICAM-1 ) , and soluble vascular cell adhesion molecule-1 ( sVCAM-1 )  in adults .
Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial
BACKGROUND There is conflicting evidence on the benefits of foods rich in vitamin E ( alpha-tocopherol ) , n-3 polyunsaturated fatty acids ( PUFA ) , and their pharmacological substitutes . We investigated the effects of these substances as supplements in patients who had myocardial infa rct ion . METHODS From October , 1993 , to September , 1995 , 11,324 patients surviving recent ( < or = 3 months ) myocardial infa rct ion were r and omly assigned supplements of n-3 PUFA ( 1 g daily , n=2836 ) , vitamin E ( 300 mg daily , n=2830 ) , both ( n=2830 ) , or none ( control , n=2828 ) for 3.5 years . The primary combined efficacy endpoint was death , non-fatal myocardial infa rct ion , and stroke . Intention-to-treat analyses were done according to a factorial design ( two-way ) and by treatment group ( four-way ) . FINDINGS Treatment with n-3 PUFA , but not vitamin E , significantly lowered the risk of the primary endpoint ( relative-risk decrease 10 % [ 95 % CI 1 - 18 ] by two-way analysis , 15 % [ 2 - 26 ] by four-way analysis ) . Benefit was attributable to a decrease in the risk of death ( 14 % [ 3 - 24 ] two-way , 20 % [ 6 - 33 ] four-way ) and cardiovascular death ( 17 % [ 3 - 29 ] two-way , 30 % [ 13 - 44 ] four-way ) . The effect of the combined treatment was similar to that for n-3 PUFA for the primary endpoint ( 14 % [ 1 - 26 ] ) and for fatal events ( 20 % [ 5 - 33 ] ) . INTERPRETATION Dietary supplementation with n-3 PUFA led to a clinical ly important and statistically significant benefit . Vitamin E had no benefit . Its effects on fatal cardiovascular events require further exploration
Subgroup analysis revealed that increasing dietary ALA tends to elevate CRP concentration  in healthy subjects .
However , the null effect of ALA supplementation on other inflammatory markers was not changed in various subgroups , indicating that the results are stable .
Meta-regression results revealed a negative relationship between the effect size on CRP and its baseline concentration .
No significant publication bias was observed for all inflammatory markers as suggested by funnel plot and Begg ’s test .
Conclusion Our meta- analysis did not find any beneficial effect of ALA supplementation  on reducing inflammatory markers including TNF , IL-6 , CRP , sICAM-1 , and sVCAM-1 .
However , in healthy subjects  , ALA supplementation might increase CRP concentration
Purpose The aim of the current meta- analysis was to investigate the effect of increasing dietary ALA intake on the blood concentration of inflammatory markers including tumor necrosis factor ( TNF ) , interleukin 6 ( IL-6 ) , C-reactive protein ( CRP ) , soluble intercellular adhesion molecule-1 ( sICAM-1 ) , and soluble vascular cell adhesion molecule-1 ( sVCAM-1 )  in adults .