{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T15:19:25Z","timestamp":1772205565458,"version":"3.50.1"},"reference-count":37,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"unspecified","delay-in-days":26,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"the National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82304114"],"award-info":[{"award-number":["82304114"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,2,12]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Sarcopenia imposes a substantial burden on society, while omega-3 polyunsaturated fatty acid (n-3 PUFA) supplementation holds the potential for preventing and treating this condition. This study aims to investigate the efficacy of three different n-3 PUFA supplementation regimens compared with each other and to corn oil placebo intervention on muscle health in community-dwelling older adults at high risk of sarcopenia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>A total of 400 community-dwelling older adults aged 60 years or older, with handgrip strength &lt;28\u2009kg (men) or &lt;18\u2009kg (women), will be recruited for this multicentre, randomised, double-blind, placebo-controlled trial. Participants will be randomly allocated (1:1:1:1) to one of four groups for 6 months: (1) the high eicosapentaenoic acid (EPA) group, (2) the high docosahexaenoic acid (DHA) group, (3) the high sn2-DHA group, (4) the corn oil control group. All intervention products will be packaged as capsules and administered at a daily dose of 2.5\u2009g. The primary outcome is the change in handgrip strength. Secondary outcomes include changes in skeletal muscle mass, physical function, inflammation- and metabolism-related blood biomarkers and gut microbiota diversity.A<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This study was approved by the Ruijin Hospital Ethics Committee. Trial findings will be disseminated via publications in international peer-reviewed journals and presentations at relevant academic conferences. Study results will be made available to participants and the public on study completion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>ChiCTR2500110506.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-113455","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T14:40:51Z","timestamp":1772203251000},"page":"e113455","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Omega-3 polyunsaturated fatty acid supplementation for muscle health in community-dwelling older adults at high risk of sarcopenia: protocol for a multicentre, randomised, double-blind, placebo-controlled trial"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3533-0995","authenticated-orcid":false,"given":"Zechen","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Geriatrics, Medical Center on Aging of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"},{"name":"College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yifan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Medical Center on Aging of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"},{"name":"College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Songyue","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Medical Center on Aging of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"},{"name":"College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Medical Center on Aging of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dongsheng","family":"Bian","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Medical Center on Aging of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"},{"name":"College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China"},{"name":"Department of Clinical Nutrition, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"2026022706404400000_16.2.e113455.1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afy169"},{"key":"2026022706404400000_16.2.e113455.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2014.11.013"},{"key":"2026022706404400000_16.2.e113455.3","unstructured":"Available: https:\/\/www.stats.gov.cn\/"},{"key":"2026022706404400000_16.2.e113455.4","doi-asserted-by":"crossref","first-page":"1415398","DOI":"10.3389\/fpubh.2024.1415398","article-title":"The prevalence of sarcopenia and risk factors in the older adult in China: a systematic review and meta-analysis","volume":"12","author":"Meng","year":"2024","journal-title":"Front Public Health"},{"key":"2026022706404400000_16.2.e113455.5","doi-asserted-by":"crossref","first-page":"102014","DOI":"10.1016\/j.arr.2023.102014","article-title":"Omega-3 polyunsaturated fatty acids in sarcopenia management: A network meta-analysis of randomized controlled trials","volume":"90","author":"Tseng","year":"2023","journal-title":"Ageing Res Rev"},{"key":"2026022706404400000_16.2.e113455.6","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1007\/s00223-019-00584-3","article-title":"The Relationship Between Omega-3, Omega-6 and Total Polyunsaturated Fat and Musculoskeletal Health and Functional Status in Adults: A Systematic Review and Meta-analysis of RCTs","volume":"105","author":"Abdelhamid","year":"2019","journal-title":"Calcif Tissue Int"},{"key":"2026022706404400000_16.2.e113455.7","doi-asserted-by":"crossref","DOI":"10.3390\/nu12123739","article-title":"Effects of Omega-3 Fatty Acids on Muscle Mass, Muscle Strength and Muscle Performance among the Elderly: A Meta-Analysis","volume":"12","author":"Huang","year":"2020","journal-title":"Nutrients"},{"key":"2026022706404400000_16.2.e113455.8","doi-asserted-by":"crossref","first-page":"102249","DOI":"10.1016\/j.plefa.2021.102249","article-title":"Effect of n-3 polyunsaturated fatty acid supplementation on muscle mass and function with aging: A meta-analysis of randomized controlled trials\u2730","volume":"165","author":"Ma","year":"2021","journal-title":"Prostaglandins Leukot Essent Fatty Acids"},{"key":"2026022706404400000_16.2.e113455.9","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.clnesp.2021.10.011","article-title":"The effect of long chain omega-3 polyunsaturated fatty acids on muscle mass and function in sarcopenia: A scoping systematic review and meta-analysis","volume":"46","author":"Bird","year":"2021","journal-title":"Clin Nutr ESPEN"},{"key":"2026022706404400000_16.2.e113455.10","doi-asserted-by":"crossref","DOI":"10.3390\/nu14112221","article-title":"Effects of Omega-3 Supplementation Alone and Combined with Resistance Exercise on Skeletal Muscle in Older Adults: A Systematic Review and Meta-Analysis","volume":"14","author":"Cornish","year":"2022","journal-title":"Nutrients"},{"key":"2026022706404400000_16.2.e113455.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2019.12.012"},{"key":"2026022706404400000_16.2.e113455.12","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.2000.89.2.465"},{"key":"2026022706404400000_16.2.e113455.13","doi-asserted-by":"crossref","first-page":"1579","DOI":"10.1111\/ggi.13538","article-title":"Can bioelectrical impedance analysis using a home-use device properly estimate sarcopenia in community-dwelling older adults?","volume":"18","author":"Tanaka","year":"2018","journal-title":"Geriatr Gerontol Int"},{"key":"2026022706404400000_16.2.e113455.14","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1038\/s41392-023-01502-8","article-title":"Inflammation and aging: signaling pathways and intervention therapies","volume":"8","author":"Li","year":"2023","journal-title":"Sig Transduct Target Ther"},{"key":"2026022706404400000_16.2.e113455.15","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-018-0064-2"},{"key":"2026022706404400000_16.2.e113455.16","doi-asserted-by":"crossref","first-page":"111931","DOI":"10.1016\/j.exger.2022.111931","article-title":"Inflammaging: The ground for sarcopenia?","volume":"168","author":"Liang","year":"2022","journal-title":"Exp Gerontol"},{"key":"2026022706404400000_16.2.e113455.17","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/59.3.M242"},{"key":"2026022706404400000_16.2.e113455.18","doi-asserted-by":"publisher","DOI":"10.1111\/j.1582-4934.2009.00733.x"},{"key":"2026022706404400000_16.2.e113455.19","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1007\/s11357-020-00247-4","article-title":"Association of inflammatory mediators with frailty status in older adults: results from a systematic review and meta-analysis","volume":"42","author":"Marcos-P\u00e9rez","year":"2020","journal-title":"Geroscience"},{"key":"2026022706404400000_16.2.e113455.20","doi-asserted-by":"crossref","DOI":"10.1080\/07853890.2024.2384664","article-title":"Association of interleukin-6 with sarcopenia and its components in older adults: a systematic review and meta-analysis of cross-sectional studies","volume":"56","author":"Ding","year":"2024","journal-title":"Ann Med"},{"key":"2026022706404400000_16.2.e113455.21","doi-asserted-by":"crossref","DOI":"10.1093\/gerona\/glae173","article-title":"Causal Relationship Between Gut Microbiota, Metabolites, and Sarcopenia: A Mendelian Randomization Study","volume":"79","author":"Zhang","year":"2024","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"2026022706404400000_16.2.e113455.22","doi-asserted-by":"crossref","first-page":"1480293","DOI":"10.3389\/fcimb.2025.1480293","article-title":"Comparison of the gut microbiota in older people with and without sarcopenia: a systematic review and meta-analysis","volume":"15","author":"Ren","year":"2025","journal-title":"Front Cell Infect Microbiol"},{"key":"2026022706404400000_16.2.e113455.23","doi-asserted-by":"crossref","first-page":"110639","DOI":"10.1016\/j.exger.2019.110639","article-title":"Gut microbiota and physical frailty through the mediation of sarcopenia","volume":"124","author":"Casati","year":"2019","journal-title":"Exp Gerontol"},{"key":"2026022706404400000_16.2.e113455.24","doi-asserted-by":"crossref","DOI":"10.3390\/nu13062045","article-title":"The Effects of Lifestyle and Diet on Gut Microbiota Composition, Inflammation and Muscle Performance in Our Aging Society","volume":"13","author":"Strasser","year":"2021","journal-title":"Nutrients"},{"key":"2026022706404400000_16.2.e113455.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.jada.2004.01.007"},{"key":"2026022706404400000_16.2.e113455.26","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.clnu.2017.12.020","article-title":"A high whey protein, vitamin D and E supplement preserves muscle mass, strength, and quality of life in sarcopenic older adults: A double-blind randomized controlled trial","volume":"38","author":"Bo","year":"2019","journal-title":"Clin Nutr"},{"key":"2026022706404400000_16.2.e113455.27","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.114.105833"},{"key":"2026022706404400000_16.2.e113455.28","doi-asserted-by":"publisher","DOI":"10.4103\/2229-3485.83221"},{"key":"2026022706404400000_16.2.e113455.29","doi-asserted-by":"crossref","DOI":"10.1186\/s12877-016-0228-z","article-title":"Case finding for sarcopenia in geriatric inpatients: performance of bioimpedance analysis in comparison to dual X-ray absorptiometry","volume":"16","author":"Reiss","year":"2016","journal-title":"BMC Geriatr"},{"key":"2026022706404400000_16.2.e113455.30","doi-asserted-by":"crossref","DOI":"10.3390\/diagnostics14090899","article-title":"Reliability and Agreement Assessment of Sarcopenia Diagnosis through Comparison of Bioelectrical Impedance Analysis and Dual-Energy X-ray Absorptiometry","volume":"14","author":"Lee","year":"2024","journal-title":"Diagnostics (Basel)"},{"key":"2026022706404400000_16.2.e113455.31","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.clnesp.2024.06.040","article-title":"Comparison of body composition measures assessed by bioelectrical impedance analysis versus dual-energy X-ray absorptiometry in the United Kingdom Biobank","volume":"63","author":"Feng","year":"2024","journal-title":"Clin Nutr ESPEN"},{"key":"2026022706404400000_16.2.e113455.32","doi-asserted-by":"crossref","first-page":"1700","DOI":"10.1111\/jgs.15994","article-title":"Association of 3-Year Multidomain Intervention and Omega-3 Supplementation with Frailty Incidence","volume":"67","author":"Guerville","year":"2019","journal-title":"J Am Geriatr Soc"},{"key":"2026022706404400000_16.2.e113455.33","doi-asserted-by":"crossref","DOI":"10.1093\/ageing\/afac274","article-title":"Effects of fish oil-derived n-3 polyunsaturated fatty acid on body composition, muscle strength and physical performance in older people: a secondary analysis of a randomised, double-blind, placebo-controlled trial","volume":"51","author":"Xu","year":"2022","journal-title":"Age Ageing"},{"key":"2026022706404400000_16.2.e113455.34","doi-asserted-by":"crossref","DOI":"10.3390\/nu11081931","article-title":"Effect of Long-Term Omega 3 Polyunsaturated Fatty Acid Supplementation with or without Multidomain Lifestyle Intervention on Muscle Strength in Older Adults: Secondary Analysis of the Multidomain Alzheimer Preventive Trial (MAPT)","volume":"11","author":"Rolland","year":"2019","journal-title":"Nutrients"},{"key":"2026022706404400000_16.2.e113455.35","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1093\/ajcn\/nqaa449","article-title":"Does supplementation with leucine-enriched protein alone and in combination with fish-oil-derived n-3 PUFA affect muscle mass, strength, physical performance, and muscle protein synthesis in well-nourished older adults? A randomized, double-blind, placebo-controlled trial","volume":"113","author":"Murphy","year":"2021","journal-title":"Am J Clin Nutr"},{"key":"2026022706404400000_16.2.e113455.36","doi-asserted-by":"crossref","DOI":"10.3390\/nu15163579","article-title":"The Effect of Long Chain n-3 Fatty Acid Supplementation on Muscle Strength in Older Adults: A Systematic Review and Meta-Analysis","volume":"15","author":"Timraz","year":"2023","journal-title":"Nutrients"},{"key":"2026022706404400000_16.2.e113455.37","doi-asserted-by":"crossref","first-page":"304","DOI":"10.7762\/cnr.2023.12.4.304","article-title":"Effects of Omega-3 Fatty Acid Supplementation on Skeletal Muscle Mass and Strength in Adults: A Systematic Review","volume":"12","author":"Moon","year":"2023","journal-title":"Clin Nutr Res"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-113455","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T14:40:55Z","timestamp":1772203255000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-113455"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":37,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,27]]},"published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1136\/bmjopen-2025-113455"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-113455","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]}}}