Sex Differences in Omega-3 and Omega-6 PUFA Status: A Systematic Review and Meta-analysis of Cross-Sectional Comparisons

Sex hormones may regulate the biosynthesis of polyunsaturated fatty acids (PUFAs), however, the extent and consistency of sex differences in different lipid pools remain unclear. We aimed to update and synthesize evidence on sex differences in circulating and tissue omega-3 (n-3) and omega-6 (n-6) PUFA biomarkers in healthy adults with mean age ≤50 years. We systematically searched Medline, Embase and Cochrane Central Register of Controlled Trials through to February 21, 2026 for cross-sectional reports of n-3 and n-6 PUFA levels for both sexes in plasma total lipids, phospholipids, triglycerides, cholesteryl esters (CE); erythrocyte total lipids, phosphatidylcholine, phosphatidylethanolamine; or adipose tissue. Unadjusted mean differences (MD) between male and female n-3 and n-6 PUFA levels were pooled using random-effects meta-analysis. We identified 67 eligible publications including 85 comparisons from observational studies and clinical trials, yielding synthesis of 71 PUFA biomarkers. By absolute difference in percentage of total fatty acids, we observed, in males versus females, higher n-3 docosapentaenoic acid (DPAn-3) (MD=0.19%, 95% CI: 0.10, 0.27, P