Fatty Acid Trip

A comprehensive review of studies on the benefits of omega-3 consumption has led scientists to recommend the establishment of a Dietary Reference Intake (DRI) for EPA and DHA to reduce the risk of heart disease.

The strength of evidence linking eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) to a reduced risk of coronary heart disease was “remarkable”, they said, prompting them to recommend a DRI of between 250 and 500mg/day.

In 2002, the US Institute of Medicine (IOM) concluded that there was insufficient evidence to define DRIs for EPA and DHA. The current review, based on a workshop organized last year by the Technical Committee on Dietary Lipids of the International Life Sciences Institute of North America, was designed to examine new data that have emerged since 2002.

The workshop aimed to examine evidence of the benefits of EPA and DHA on coronary heart disease (CHD), cancer and cognitive decline.

In a supplement published this year in The Journal of Nutrition and based on the workshop conclusions, the scientists stated that while evidence was clear for the benefits of EPA and DHA for reducing the risk of CHD, there was not enough consistent evidence on the benefits of the omega-3s for cognitive health and cancer reduction.

These findings add momentum to the drive to establish an omega-3 DRI, a move that has long been supported by the research community and the food and dietary supplement industries.

Heart disease

The scientists reviewed over 15 prospective cohort studies in generally healthy populations, a retrospective case-control study of sudden cardiac death, four large randomized controlled trials with fish or fish oil in patients with and without known heart disease, and several in vivo and animal experimental studies.

This evidence indicates that modest EPA and DHA consumption “markedly” reduces the risk of cardiac death, they said.

“The quality, strength, and concordance of this evidence are remarkable, meeting and indeed generally exceeding those for any other dietary factor for which a DRI has been set based on reducing risk for chronic disease, including saturated fat, dietary cholesterol, salt, and dietary fiber,” they wrote.

“For primary prevention of cardiac death, the leading cause of death in both men and women in the United States and nearly all other developed nations, current evidence supports a DRI for EPA1DHA between 250 and 500 mg/d.”

However, the scientists found that evidence was “more modest” for the effects of long-chain polyunsaturated fatty acids (PUFA) on other cardiovascular risks, including blood pressure, resting heart rate, triglyceride levels and heart rate variability.

Cognitive and cancer benefits

The review also included emerging data on the cognitive and cancer benefits of EPA and DHA.

The evidence for protective effects of omega-3 long chain PUFA from fish on risk of dementia is “promising but limited”, said the scientists.

Epidemiological evidence suggests positive benefits of one fish meal per week on the risk of Alzheimer’s disease, dementia, and cognitive decline. In addition, the animal evidence and biologic plausibility support a protective relation of omega-3 long-chain PUFA on neurodegeneration of the brain with aging. However, tissue DHA levels do not seem to be consistently lower in Alzheimer’s disease or any form of cognitive decline associated with aging, said the scientists.

“Several primary and secondary prevention trials are in progress in the United States and Europe that will greatly inform the field. Further research is necessary to examine the effects of different dose levels, benefits of DHA, EPA, and ALA, and the importance of relative intakes of [omega-3] vs. [omega-6] fatty acids”.

In relation to the cancer benefits of omega-3s, the researchers concluded that “there are no clear relations between dietary intakes of EPA and DHA and risk for cancer.”

Source:
Towards Establishing Dietary Reference Intakes for Eicosapentaenoic and Docosahexaenoic Acids
The Journal of Nutrition
First published online February 25, 2009; doi:10.3945/jn.108.101329.
Authors: William S. Harris, Dariush Mozaffarian, Michael Lefevre, Cheryl D. Toner, John Colombo, Stephen C. Cunnane, Joanne M. Holden, David M. Klurfeld, Martha Clare Morris, and Jay Whelan

Two Canadian reports suggest that highly purified ethyl-eicosapentaenoic acid (E-EPA) omega-3 fatty acid supplementation may alleviate hot flushes and psychological distress in middle-aged women. The daily dosage was 1,050 grams in both trials.

The departments of Psychiatry and Obstetrics and Gynecology gynecology at Saint-François d’Assise Hospital (Centre Hospitalier Universitaire de Québec) Canada investigated the effects of enriched ethyl-eicosapentaenoic acid (E-EPA) omega-3 fatty acid supplementation with those of placebo on hot flashes (HFs) and distress among middle-aged women.

Women were considered for participation if they were between 40 and 55 years of age and had hot flushes and moderate to severe psychological distress. A total of 120 women were randomly assigned to E-EPA or placebo for 8 weeks.

Hot Flashes
At baseline, the average number of hot flushes was 2.8 per day. After 8 weeks, the frequency and score decreased significantly in the E-EPA group compared with the placebo group. Frequency of hot flushes declined by a mean of 1.58 per day in the E-EPA group and by 0.50 per day in the placebo group.

“Supplementation with E-EPA omega-3 fatty acid reduced HF frequency and improved the HF score relative to placebo. These results need to be confirmed by a clinical trial specifically designed to evaluate HFs in more symptomatic women”, the authors conclude.

Psychological Distress
Psychological distress (PD) and depressive symptoms are commonly observed during menopausal transition. Studies suggest that omega-3 (n-3) fatty acids may help alleviate depression. The objective of tris trial was to compare (E-EPA) supplementation with placebo for the treatment of PD and depressive symptoms in middle-aged women.

Women with moderate-to-severe PD (n = 120) were randomly assigned to receive 1.05 g E-EPA/d plus 0.15 g ethyl-docosahexaenoic acid/d (n = 59) or placebo (n = 61) for 8 wk. The main outcomes were 8-wk changes in PD scores [Psychological General Well-Being Schedule (PGWB)] and depressive scales [20-item Hopkins Symptom Checklist Depression Scale (HSCL-D-20) and the 21-item Hamilton Depression Rating Scale (HAM-D-21)].

At baseline, women with PD were mildly to moderately depressed, and 24% met the major depressive episode (MDE) criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. After 8 wk, outcomes improved in both groups, but no significant differences were noted between them. Differences in adjusted 8-wk changes between the E-EPA group with MDE (n = 13) and the placebo group (n = 16) were not significant.

“To our knowledge, this is the first trial of n-3 supplementation in the treatment of PD and depressive symptoms in middle-aged women. In women with PD without MDE at baseline, the 8-wk changes in PD and depressive scales improved significantly more with E-EPA than with placebo”, the authors write (2).

This trial was registered at Controlled Clinical Trials under ISRCTN69617477.

Lucas M, Asselin G, Mérette C, Poulin MJ, Dodin S. Effects of ethyl-eicosapentaenoic acid omega-3 fatty acid supplementation on hot flashes and quality of life among middle-aged women: a double-blind, placebo-controlled, randomized clinical trial. Menopause. 2008 Nov 20. Abstract

Lucas M, Asselin G, Mérette C, Poulin MJ, Dodin S. Ethyl-eicosapentaenoic acid for the treatment of psychological distress and depressive symptoms in middle-aged women: a double-blind, placebo-controlled, randomized clinical trial. Am J Clin Nutr. 2008 Dec 30. PubMed

New research from Trinity College Dublin published in this month’s Annals of Surgery points to a potentially significant advance in the treatment of patients undergoing major cancer surgery.

The study was carried out by the oesophageal research group at Trinity College Dublin and St James’s Hospital. A randomised controlled trial showed omega-3 fatty acids given as part of an oral nutritional supplement resulted in the preservation of muscle mass in patients undergoing surgery for oesopahageal cancer, a procedure normally associated with significant weight loss and quality of life issues.

The trial was designed by Professor John V Reynolds, Professor of Surgery at Trinity College Dublin and St James’s Hospital, Dublin, and Dr Aoife Ryan PhD, a research dietitian at St James’s Hospital, Dublin*.

Omega 3 fats are essential fats found naturally in oily fish, with highest concentrations in salmon, herring, mackerel, and sardines. Recently food manufacturers have begun to add omega 3 to foods such as yogurt, milk, juice, eggs and infant formula in light of a body of scientific evidence which suggests that they reduce cardiovascular disease risk, blood pressure, clot formations, and certain types of fat in the blood.

Previous studies had found that nutritional supplements containing one form of omega 3 fat, eicosapentaenoic acid (EPA), significantly reduced weight loss among inoperable cancer patients. The researchers hypothesised that a nutritional supplement rich in calories and a high dose of EPA would stem the debilitating weight loss seen in patients following oesophageal surgery. The group chose to study patients undergoing surgery for oesophageal cancer as this surgery is one of the most stressful and serious operations a patient can undergo.

Professor John V Reynolds, Professor of Surgery at TCD and St James’s Hospital and the lead researcher on the study said: “There are almost 450 new cases of oesophageal cancer diagnosed every year in Ireland and Ireland has one of the highest rates of oesophageal cancer in Europe. An increasing number of patients are treated with chemotherapy alone or in combination with radiation therapy before they undergo surgery. The surgery is a serious operation lasting several hours and can take weeks to recover from surgery and up to six months to recover pre-illness quality of life. Weight loss is extremely common both before and especially after this type of surgery, and any approach that can preserve weight, in particular muscle weight and strength, may represent a real advance”.

In a double-blinded randomised control trial, the gold standard in medical research, patients awaiting oesophagectomy surgery were randomly assigned to treatment and control groups. While both groups received a 240ml nutritional supplement twice daily starting five days before surgery (which was identical in calories, protein, micronutrients and flavor), patients in the treatment group received an enriched formula with omega 3 (2.2 gram EPA/day). Immediately following surgery, the supplement was given through a feeding tube for 14 days while patients recovered in hospital. Once patients could resume oral feeding, they continued drinking the supplement until 21 days post surgery.

Results:

The oesophageal research group at Trinity College Dublin and St. James’s Hospital found that patients given the standard feed (without omega 3) suffered clinically severe weight loss post surgery - losing an average of 4 lbs of muscle mass post surgery, where as in the omega 3 group patients maintained all aspects of their body composition

Commenting on the significance of the results, Dr Aoife Ryan said: “The results were extraordinary in the sense that no previous nutritional formulation had revealed such an outcome, with supplemented patients maintaining all aspects of their body composition in the three weeks following surgery. Patients given the standard supplement without omega 3 lost a significant amount of weight comprising 100% muscle mass. In fact 68% of patients suffered ‘clinically severe’ weight loss post surgery in the standard group (without omega 3) versus only 8% in the omega 3 group. The significant finding was that the patients did not lose just fat, as one would expect with weight loss, but instead they depleted their muscle stores significantly. Research has shown that a loss of 5lbs of weight produces significant effects on quality of life and a patient’s ability to mobilise and perform simple activities of daily living. Losing 4 lbs of muscle is even more significant”.

Professor John Reynolds said: “Omega 3 enriched nutrition appears to prevent loss of muscle mass by reducing the amount of inflammatory markers in the blood - this means the metabolism is not as stressed as it usually is post surgery. We also saw that the omega 3 group was less likely to have a fever in the first week post surgery which points to the ability of omega 3 to suppress inflammation. Looking at their blood tests omega 3 fed patients had much lower ‘inflammatory compounds’ circulating in their blood which points to the ability of omega 3 to reduce inflammation”.

Using specialised nutritional feeds with a highly purified form of EPA, the researchers were able to administer a dose of omega 3 that was much higher than that typically found in food. They noted that treatment with omega 3 enriched supplement is only slightly more expensive than traditional nutritional therapy, and previous studies have yielded significant cost-savings in the form of fewer complications following surgery using immuno-nutrition feeds similar to this. “Initial treatments like this may be cost-effective for our cash-strapped health care system”, said Dr Ryan.

Commenting in an accompanying editorial in the Annals of Surgery Dr Michael Meguid, Professor of Surgery at State University of New York noted: “This study is a significant step forward because it underscores the message to surgeons of the importance of using omega 3 based nutrition as an adjunct therapy started at least 5 days before surgery. It should no longer be a surgeon’s preference, but the standard of expected norm for the practice of elective complex gut cancer surgery”.

In conclusion, Professor John Reynolds said: “This study has provided an interesting insight into how nutritional therapy can positively impact on the major stress of cancer surgery. More studies need to be done, in particular to address whether such approaches lead to more rapid recovery of quality of life, reduce complications, and improve outcomes. Throughout cancer care, many patients undergoing therapy nowadays have a combination of surgery, chemotherapy and radiation therapy, and studies addressing whether nutritional supplementation with omega 3 for the entire duration of treatment should be considered. Finally, we do not expect these findings are unique to cancer surgery, and similar benefits may accrue to patients needing complex surgical care for non-cancer problems, for instance liver transplantation or major cardiac surgery.”

SOURCE: http://www.tcd.ie/

OK… This one I simply could not resist, courtesy of CNN.com:

(CNN) — The benefits to humans of omega 3 fatty acids in fish oils are well documented, but a new study has found that fish oils can have a wider benefit to the environment — by reducing the amount of methane produced by cows.

The report produced by University College Dublin found that by including two percent fish oil in the diet of cattle they achieved a reduction in the amount of methane released by the animals.

Lowering methane emissions is important for the environment, as the gas given off by farm animals is a major contributor to greenhouse gas levels.

More than a third of all methane emissions, around 900 billion tonnes every year, are produced by methanogen bacteria that live in the digestive systems of cattle, sheep and goats.

By volume, methane is 20 times more powerful at trapping solar energy than carbon dioxide making it a potent greenhouse gas.

“The fish oil affects the methane-producing bacteria in the rumen part of the cow’s gut, leading to reduced emissions,” said Dr Lorraine Lillis, one of the researchers, speaking at the Society for General Microbiology meeting in Harrogate, England.

“Understanding which microbial species are particularly influenced by changes in diet and relating them to methane production could bring about a more targeted approach to reducing methane emissions in animals.”

Approximately 50 percent of Irish agricultural methane emissions result from farm animals, which has led to suggestions that, to help combat global warming, the numbers of cattle, sheep and goats should be capped.

The researchers believe that it may not be necessary to limit the number of farm animals if their methane levels are reduced through diet.

SOURCE: CNN.com

With aging and vascular disease, arterial elasticity diminishes, bringing with it increased risk of hypertension, stroke and cardiovascular mortality. The consumption of omega-3 polyunsaturated fatty acids (n-3 PUFAs), both long-chain docosahexaenoic acid (DHA) and medium-chain alpha-linolenic acid, has modest blood pressure-lowering effects, but there is limited information about their effects on arterial elasticity. In a preliminary study, 1.8 g eicosapentaenoic acid (EPA) daily for one year was associated with a slight decrease in pulse wave velocity compared with a significant increase in this measure in the control group. Pulse wave velocity uses ultrasound waves to assess the speed of blood in determining the elasticity of the artery walls. More rigid blood vessels hasten the pulse wave, while a slower velocity reflects greater arterial elasticity. In another study of more than 500 elderly men with hyperlipidemia who consumed 2.4 g n-3 LC-PUFAs daily for 3 years, arterial elasticity measured increased significantly, i.e., pulse wave velocity decreased compared with the control participants.

In the study reported here, Dr. S. Wang and colleagues of Xi’an Jiaotong University in China, used pulse wave velocity to assess arterial elasticity in 43 overweight Chinese patients with hypertension who consumed fish oil or placebo supplements for 8 weeks. Daily n-3 LC-PUFA supplementation provided 900 mg/day of n-3 LC-PUFAs from salmon oil, containing 540 mg EPA and 360 mg DHA. Participants had a body mass index of ≥23 and systolic blood pressure ≥140 with diastolic pressure ≥90. Blood pressure control medications were suspended for 2 weeks prior to the study. Measures of pulse wave velocity, plasma lipids and blood pressure were obtained at baseline and after 56 days.

After 8 weeks of fish oil supplementation, there was a significant 21% increase in arterial elasticity, but no changes in the placebo group. Heart rate, systolic and diastolic blood pressures, plasma lipids and soluble vascular adhesion molecule-1 did not change significantly in either group during the study. As expected, n-3 PUFAs in serum fatty acids increased significantly only in the fish oil group, mainly at the expense of monounsaturated fatty acids.

The primary outcome in this study was a significant increase in arterial elasticity with the consumption of 900 mg/day of n-3 LC-PUFAs for 8 weeks. This change occurred despite the lack of change in blood pressure. Large artery elasticity has a genetic component, but is also blood pressure dependent, with decreased elasticity occurring at high blood pressure. However, hypertension triggers arterial hypertrophy, which reduces arterial stiffness. It is noteworthy that a significant reduction in arterial stiffness occurred in a relatively short time, 8 weeks, with a dose of n-3 LC-PUFAs that has been linked to reduced cardiovascular mortality in survivors of myocardial infarction. These results strengthen previous findings of improved arterial compliance with the consumption of n-3 LC-PUFAs, suggesting another way in which these fatty acids protect heart health.

SOURCE: PUFA Newsletter

Various studies have implicated low fish consumption or reduced blood levels of long-chain omega-3 fatty acids (n-3 LC-PUFAS) in the occurrence of various psychiatric disorders, alcoholism and among substance abusers. It has been known since 1996 that n-3 PUFAs, especially eicosapentaenoic acid (EPA), are reduced in major depression. A recent post-mortem analysis reported significantly lower levels of cortex docosahexaenoic acid (DHA) in patients with major depressive disorder. Clinical trials using n-3 LC-PUFAs or purified EPA or DHA to treat a variety of mental disorders have generally, but not always, reported favorable outcomes. It is unclear whether both EPA and docosahexaenoic acid (DHA) are effective and if so, what a suitable dose range is for each fatty acid. For example, some studies in depressed patients have used high doses (>6 g/day), while others reported that 1 g/day was effective, but doses of 2 to 4 g/day were less so. In a pilot study among substance abusers, supplementation with 3 g/day of EPA+DHA for 3 months was associated with reduced anxiety scores. In one report, both n-3 and n-6 PUFAs were significantly lower in substance abusers who relapsed compared with those who did not.

This study reports the associations between changes in anger and anxiety scores and serum levels of EPA and DHA in 22 substance abusers who consumed about 3 g/day of n-3 LC-PUFAs or soybean oil for 3 months. The n-3 LC-PUFA capsules provided 2.2 g/day of EPA, 500 mg/day DHA, and 50 mg of n-3 docosapentaenoic acid and alpha-linolenic acid. Participants were enrolled in an outpatient substance abuse program in Brooklyn, New York, and were free of major psychiatric and physical illnesses and had liver function tests no greater than 1 SD above maximum normal values.

Participants completed a dietary history questionnaire and a modified version of the Profiles of Mood States questionnaire 1, 2 and 3 months following the start of the study and gave blood samples at the beginning and end of the study. Fatty acids were determined in plasma. The Profiles in Mood States includes scores for anger, anxiety, depression, vigor, confusion and fatigue. Eight patients received methadone treatment and 5 took antidepressants in stable doses throughout the study. Participants did not differ at baseline in body mass index, energy consumption or low intake of n-3 LC-PUFAs.

After 3 months of treatment, participants consuming the n-3 LC-PUFAs had a significant decline in their anger scores, whereas scores in those taking the placebo capsules increased slightly. Scores reached their maximum after 2 months of n-3 LC-PUFA consumption. Anger scores continued to decline throughout the 3-month period for those on the active n-3 LC-PUFA treatment. A similar pattern of significantly improved anxiety scores was observed for substance abusers consuming the n-3 LC-PUFAs, but scores were unchanged in those taking the placebo.

When the investigators examined the relationship between the anger and anxiety scores at the end of the study with the percent change in plasma fatty acids over the 3-month study, they observed significant associations (Figure 1). Lower anger scores were associated with increased DHA, n-3 docosapentaenoic acid and total n-3 LC-PUFAs, but not with increased EPA concentrations. In contrast, reduced anxiety was associated with increased EPA, but not with changes in DHA. Changes in anger and anxiety scores were not associated with changes in any n-6 PUFAs.

It is worth noting that improved scores for anger and anxiety related to increased DHA and EPA, respectively, but neither behavior related to both DHA and EPA when these fatty acids were examined individually. However, both behaviors were significantly associated with increases in the total concentration of n-3 LC-PUFAs measured in µg/ml.

Only a few studies have reported an association between low plasma DHA and hostility in violent men and young urban males. Students under the stress of school exams who consumed 1.5 to 1.8 g/day of DHA exhibited no aggression against others compared with increased aggression observed in those taking a placebo. This study adds another link between DHA and aggressive behavior as reflected in anger scores.

As with anger, studies of anxiety and n-3 PUFAs are scarce. A few have suggested a link between increased anxiety and low levels of EPA or n-3 LC-PUFAs. The administration of a mixture of n-3 and n-6 PUFAs to anxious college students was associated with improved appetite, mental concentration and academic organization. Patients with social anxiety disorder had significantly lower concentrations of n-3 PUFAs compared with those not having this disorder. Moderate fish consumption (83 to 112 g/day or 3 to 4 oz/day) or n-3 LC-PUFA intake was associated with a significant 30% lower risk of incurring depression, anxiety or stress in a 2-yr prospective study of Spanish adults. The present report identified increased EPA specifically with improved anxiety scores and higher DHA with less anger.

 Although it may be tempting to suggest that EPA and DHA influence anxiety and anger behaviors through different mechanisms, and plausible explanations could be proffered, these specific associations need more robust confirmation before reaching firm conclusions. Investigation of EPA and DHA administered individually without the other would be useful across an array of mental disorders. This study supports others in demonstrating that anxious or angry substance abusers who have low blood levels of n-3 LC-PUFAs achieve significant improvements in their mental health when treated with a moderate dose of EPA and DHA. This finding could ease the mind and, one hopes, encourage additional research.

Buydens-Branchey L, Branchey M, Hibbeln JR. Associations between increases in plasma n-3 polyunsaturated fatty acids following supplementation and decreased anger and anxiety in substance abusers. Prog Neuropsychopharmacol Biol Psychiatry 2008;32:568-575. [PubMed]

Long-chain omega-3 polyunsaturated fatty acids (n-3 LC-PUFAs) have been used as an adjunct therapy in treating patients with major depressive disorder with mixed, but often encouraging, results. A meta-analysis of placebo-controlled trials concluded that n-3 PUFAs have significant antidepressant effects, but there are insufficient data to distinguish whether combined treatment with the two major n-3 LC-PUFAs in fish oils, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), or each fatty acid given individually provides greater benefit. Studies have tended to find positive results with EPA rather than DHA and a rationale for this observation has been suggested. In most, if not all, trials to date, n-3 LC-PUFAs have been provided in conjunction with current antidepressant medications. Difficulties with patient compliance, unwanted or adverse side effects of medications and resistance to treatment make treating depression especially challenging.

In this study, Shima Jazayeri and colleagues at the Tehran University of Medical Sciences in Iran sought to evaluate the effectiveness of fluoxetine (Prozac), EPA or a combination of them in patients with major depressive disorder as indicated by Hamilton Depression Rating Scale scores of 15 or greater. Patients did not have other psychiatric disorders or any other significant medical problems or substance abuse. They were not taking n-3 PUFA supplements nor eating more than one serving of fish/week. All participants were free of medication for at least 6 weeks prior to enrolment.

Sixty patients were recruited from referrals to the Roozbeh Psychiatric Hospital in Tehran and randomized to consume 20 mg of fluoxetine or 1 g EPA or a combination daily for 8 weeks. Each participant consumed either a fluoxetine placebo or a rapeseed oil placebo to mimic the type of capsules taken in each group. No placebo-only group was included for ethical reasons. Patients were assessed by the Hamilton Scales at baseline and every 2 weeks thereafter. Of the 60 patients enrolled, 48 completed at least 4 weeks of the study.

Over the course of the 8-week study, all patient groups exhibited significant reductions in their Hamilton depression scores as early as 2 weeks from baseline. Scores for patients treated with fluoxetine or EPA did not differ throughout the study. At 4 and 6 weeks, those consuming both EPA and fluoxetine showed a significantly greater improvement in their Hamilton ratings (as determined by analysis of covariance) compared with either treatment alone. Depression scores continued to improve from the 4th to the 8th week. Response rates for achieving at least a 50% reduction in depression score were 50% for fluoxetine, 56% for EPA and 81% for those taking both fluoxetine and EPA. More adverse events occurred in the fluoxetine and combination groups than in the EPA group and ranged from gastro-intestinal effects, anxiety and decreased appetite to single reports of tremor, nightmare and constipation.

These results suggest a greater improvement in depression with the combination of EPA and fluoxetine, but the effects of either one alone may have been no different from a placebo, had there been one. Other studies have reported a placebo effect of trial participation. This study supports those that have reported significant improvement in depression using a modest dose (1 g/day) of EPA as an adjunct treatment to current medication.

SOURCE: Jazayeri S, Tehrani-Doost M, Keshavarz SA, Hosseini M, Djazayery A, Amini H, Jalali M, Peet M. Comparison of therapeutic effects of omega-3 fatty acid eicosapentaenoic acid and fluoxetine, separately and in combination, in major depressive disorder. Aust N Z J Psychiatry 2008;42:192-198. [PubMed]

US scientists have reported that the stable nitrogen isotope 15N may be a suitable biomarker to analyse blood levels of EPA and DHA intake in clinical and epidemiologic studies.

Scientists from the University of Alaska Fairbanks and the Fred Hutchinson Cancer Research Center in Seattle report that the ratio between 15N and 14N is elevated in fish, and therefore levels of 15N could be a suitable measure for EPA and DHA intake.

Writing in the American Journal of Clinical Nutrition, they report that analysis of the 15N levels in red blood cells of Yup’ik Eskimos were “strongly correlated with red blood cell EPA and DHA”, and “also correlated with dietary EPA and DHA intake”.

“The results strongly support the validity of RBC {delta}15N as a biomarker of EPA and DHA intake. Because the analysis of RBC {delta}15N is rapid and inexpensive, this method could facilitate wide-scale assessment of EPA and DHA intake in clinical and epidemiologic studies,” they concluded.

Source: American Journal of Clinical Nutrition
March 2009, Volume 89, Number 3, Pages 913-919, doi:10.3945/ajcn.2008.27054 “Red blood cell {delta}15N: a novel biomarker of dietary eicosapentaenoic acid and docosahexaenoic acid intake”
Authors: D.M. O’Brien et al.

Readers of the PUFA Newsletter may recall the JELIS trial conducted among hypercholesterolemic patients treated with statins to lower their low-density lipoprotein cholesterol. Half the participants received 1.8 g/day of eicosapentaenoic acid (EPA) with their statin medication. Five years later, patients taking both a statin and EPA incurred significantly fewer major coronary events, such as fatal or nonfatal myocardial infarctions and cardiac-related hospital admissions. In this report, the authors conducted a subanalysis of the original 18,645 JELIS participants with respect to the incidence of stroke.

In Japan, mortality from stroke is more than twice that of US men and about 1.5 times higher for women. The risk is related mainly to hypertension and also to diabetes, hypercholesterolemia and smoking. In this analysis of the JELIS study participants, the authors investigated the occurrence of a first or subsequent stroke in both treatment groups. Overall, the incidence of stroke was low, 114 (1.3%) in the statin group and 133 (1.5%) in the statin plus EPA group. This difference between the two groups was not statistically significant.

To assess secondary prevention, the investigators examined the 5-year recurrence of stroke (for example, cerebral thrombosis, embolism or hemorrhage) in patients who had a previous stroke. There were 457 stroke patients in the control group and 485 in the EPA group. Stroke recurred in 48 controls (10.5%) and 33 EPA patients (6.8%), a significant 20% reduction in risk with EPA consumption.

This is the first study to report a significantly reduced risk of stroke recurrence with EPA. Although this investigation observed no effect of EPA on stroke prevention, one epidemiological study reported an inverse association between fish or omega-3 fatty acid consumption and the risk of stroke in women. Other epidemiological studies have not observed a relationship between fish consumption and stroke. As the authors noted, the plasma concentration of EPA (2.8 mol%) prior to supplementation was already 10-fold higher than in the US Caucasian population, yet a benefit of increased consumption was still observed. If validated in western populations with low fish consumption, this study suggests there may be substantial opportunity to lower the risk of recurrent stroke with EPA.

SOURCEL Tanaka K, Ishikawa Y, Yokoyama M, Origasa H, Matsuzaki M, Saito Y, Matsuzawa Y, Sasaki J, Oikawa S, Hishida H, Itakura H. Kita T, Kitabatake A, Nakaya N, Sakata T, Shimada K, Shirato K; JELIS Investigators, Japan. Reduction in the recurrence of stroke by eicosapentaenoic acid for hypercholesterolemic patients: subanalysis of the JELIS trial. Stroke 2008;39:2052-2058. [PubMed]

New research conducted by researchers at the University of Navarra, Iceland and University College Cork, published in the journal, Appetite, [i] suggests that taking omega-3 whilst following a weight loss programme makes people feel fuller for longer, helping to reduce appetite.

The results of this research provide useful information for the nutritional treatment of obesity, in addition to encouraging changes in dietary habits to increase and maintain weight loss.

With hundreds of weight loss products on the shelves of every supermarket and health food shop, the food industry now clearly recognises the needs of the increasingly overweight population for solutions to weight loss and weight management. This category of health supplement is already estimated to be worth $7bn, and growing fast. Clinical research studies linking obesity and other life-threatening conditions such as diabetes, metabolic syndrome, cardiovascular disease, stroke and cancer are another driving force behind this growth.

The findings

Over 200 volunteers were recruited to this study, who were classified as either overweight or obese. Participants were randomly allocated to an energy restricted diet and supplemented with either low (260 mg per day) or high dose (1300 mg per day) omega-3 for eight weeks. The researchers measured appetite during the last two weeks of the study.

The interesting findings of the study relate to the hunger-influencing properties of long-chain omega-3 fatty acids. Subjects fed dinners rich in long-chain omega-3 fatty acids felt less hungry and remained fuller for up to 2 hours after meals compared with those who ate a low omega- diet. The researchers hypothesise that long-chain omega-3 fatty acids must modulate hunger signals. Whilst these findings suggest a potential weight-management role for long-chain omega-3 fatty acids, further research must be conducted in order to fully understand this mechanism.

Blood sample analysis also showed that a higher omega-3 concentration, and a greater ratio of omega-3 to omega-6 were associated with higher satiety. With the ideal ratio of omega-3 to omega-6 in the region of 2:1, the average diet is now quite significantly out of balance, with an average ratio of approximately 25:1. Changes in the Western diet, modern food processing techniques and increased consumption of refined vegetable oils have been blamed for this shift, which has been linked to increases in a range of conditions including emotional problems, difficulties with the circulatory system, obesity, skin problems and inattention in children.

[i] Dolores Parra, A.D. Ramel, N. Bandarra, M. Kiely, J.A. Martinez, I., “A diet rich in long chain omega 3 fatty acids modulates satiety in overweight and obese volunteers during weight loss”, Appetite, 2008, June. Awaiting publication.

SOURCE: Igennus.com

Natalie Sinn, a researcher mentioned in this post is continuing her work in researching the benefits of PUFAs. The announcement follows:

A new study at UniSA’s Nutritional Physiology Research Centre will test the benefits of fish oil on memory and mood in older people.

UniSA researcher Dr Natalie Sinn is looking for volunteers aged 65 or over who are experiencing some memory loss, but do not have dementia, to participate in the study.

“We all find that our memory and thinking slows down as we age,” Dr Sinn said.

“For many people this can occur more rapidly and interfere with their daily lives leading to dementia and in some cases depression. Dementia and depression have been associated with poorer blood flow in the brain, and there is some evidence that lifestyle factors including diet may alleviate mood and cognitive decline.”

Dr Sinn said that omega-3 fatty acids play a number of important roles in brain function and blood flow and have been associated with reduced risk of dementia and depression.

“We want to investigate therefore the benefits of omega-3s for cognition and memory with ageing, and determine whether improvements in cognition and memory are associated with improved blood flow in the brain,” she said.

“This study will compare, for the first time, the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). These are both important for brain function, however different fish oils have different quantities of DHA and EPA and we don’t know which ratio is most effective.

“We also want to run analyses of volunteers’ blood to measure fatty acids and biological markers that will assist us in gaining greater understanding of physical underpinnings of cognitive decline and response to fish oil. This may help us to gain further understanding about the biological profiles of these people and also work out who may get the most benefit from taking omega-3s.”

The study is being undertaken at UniSA and is supported by the Australian Research Council and Novasel Australia with collaborators at CSIRO Human Nutrition and the University of Oxford in the UK.

Dr Sinn is looking for adults aged over 65 who have been noticing signs of memory loss but who do not have dementia. They can’t currently be taking any fish oil supplements or eat fish more than once a week. For further information phone Dr Sinn on 8302 1757 or Catherine Milte on 8302 1452.

Contact: Kelly Stone office (08) 8302 0963 mobile 0417 861 832 email kelly.stone@unisa.edu.au

North American children do not receive enough omega-3 in their diets, according to new research which found only 22 percent of young children received adequate amounts of the long-chain omega-3 fatty acids, DHA and EPA.

The researchers from the University of Guelph in Ontario found daily consumption of EPA (eicosapentaenoic acid) at 38.4mg and DHA (docosahexaenoic acid) 54.1mg, in a sample group of 4-8 year-olds.

At these levels only 22 percent of the 41 Canadian children trialed received Institute of Medicine-recommended levels for EPA and DHA.

In comparison, at 1161mg per day, 61 percent of children received adequate alpha-linolenic acid (ALA) levels, a fact the researchers put down to its wider availability in the diet.

“The substantial intake of ALA is not surprising in view of its common occurrence in canola oil, soybean oil, flaxseed, walnuts, and processed foods containing these ingredients as constituents,” the researchers wrote.

But the researchers did not go as far as to say whether, “this apparently low level of longer-chain omega-3 intake results in suboptimal health in this age group.”

Methods and findings

The research, published in the March edition of the Journal of Nutrition, analyzed the dietary patterns of the 41 children over three days, found EPA and DHA was mostly consumed in the form of fish and seafood and represented only seven percent of total omega-3 intake.

Comparison was made with a recent Australian and New Zealand study that found only 51 percent of children met the intake for EPA/DHA and another long-chain omega-3 fatty acid, DPA (docosapentaenoic acid).

With the assistance of parents, they collected data from a typical week day as well as a weekend day in a three-day window.

The researchers said it was the first rigorously obtained evidence demonstrating DHA and EPA deficiencies among Canadian children.

They concluded: “There is an apparent need to create greater awareness of the importance of the long-chain (LC) omega-3 polyunsaturated fatty acids (PUFA) among both health professionals and the general public as well as the existing gap between actual and recommended intakes from various sources. This gap can be readily filled with an increased consumption of fish/seafood containing DHA/EPA, the increased availability of foods that have been nutritionally enriched with various delivery forms of LC PUFA (DHA/EPA), and the use of supplementation where necessary.”

Source: Journal of Nutrition
March 2009, Volume 139. Pp 528-532
“Direct diet quantification indicates low intakes of (n-3) fatty acids in children 4 to 8 years old”
Authors: Sarah M M Madden, Colin F Garrioch, Bruce J Holub

SOURCE: NutraIngredients-USA.com

Although there are many reasons why people develop major depression, the condition is more frequent in younger than older adults. Nonetheless, it is a concern in the aging population. In the elderly, depression is more likely to occur in those with impaired cognition and in certain disturbances of endocrine metabolism. Depression also occurs more frequently in people with low fish consumption or low levels of long-chain omega-3 fatty acids in their blood. Higher levels of these fatty acids have also been linked to slower loss of cognition in aging. If this link between depression and nutrition becomes firmly established, it offers a fairly simple way to lower the chance of developing this unwelcome condition.

To learn more about the link between long-chain omega-3s and major depression in aging, investigators in France examined the omega-3 fatty acid levels in elderly individuals recruited from the general population. To be eligible for the study, participants had to be at least 65 years old and living in the community. Those who were considered to have major depression had scores on a depression assessment rating above an established level for the disorder. Those free of depression served as controls. On average, the participants were 75 years of age.

The investigators then measured the concentrations of omega-3 fatty acids in the blood of both groups. They observed that the concentrations of EPA (eicosapentaenoic acid), one of two major long-chain omega-3 fatty acids, were significantly lower in the depressed older adults compared with those free of depression. The concentrations of DHA (docosahexaenoic acid) did not differ in the two groups. Other studies, however, have reported reduced DHA levels in depression, including the DHA content of specific regions in the brain cortex.

In addition, patients taking antidepressant medications had more severe symptoms as their EPA dropped. This relationship with severity of the condition held after accounting for other variables, such as high blood cholesterol levels and the number of drugs the patients were taking.

Because this was an observational study, it does not address the question of causation. We do not know whether the low levels of EPA were the result of depression or increased susceptibility to it. To date, other evidence favors the latter interpretation. There is evidence suggesting that inflammation is linked to depression. EPA is an important substance for reducing inflammation, suggesting that a connection between low EPA and major depression is plausible.

Considering the many other health benefits associated with regular fish or long-chain omega-3 consumption on heart health, visual function and cognition, it would reflect the wisdom of aging to have fish on the menu at least twice a week.

SOURCE: Fats of Life Newsletter

Various studies have reported that consumption of fish or fish oils may affect vascular function in ways that increase forearm blood flow and arterial elasticity, while reducing blood pressure. However, there is some disagreement about the effects on vascular relaxation of docosahexaenoic acid (DHA), a long-chain omega-3 polyunsaturated fatty acid (n-3 LC-PUFA), in spite of its association with improved endothelial function.

High-fat meals can impair endothelial function and flow-mediated dilation within 3 to 4 hours, the time when peak postprandial lipemia, the rise in blood fats following a meals occurs. Different fatty acids also affect flow-mediated dilation, at least in individuals with type 2 diabetes, with saturated fatty acids reducing it and n-3 PUFAs increasing it. However, others have reported increased forearm blood flow and flow-mediated dilation in healthy volunteers following a fatty meal, changes that were not associated with impaired endothelial nitric oxide release. Increases in flow-mediated dilation may offset reductions in blood flow, helping to maintain healthy vascular reactivity. Diminished endothelial function is believed to contribute to atherosclerosis and diabetes. In this report, the effect of eicosapentaenoic acid (EPA), an n-3 LC-PUFA, on postprandial vascular function, including oxidative stress, nitric oxide production, was examined in 21 healthy, non-smoking, young men, aged 18 to 35 years. Seventeen men completed the study.

After an overnight fast, participants were given a high-fat test meal containing 51 g of fat mainly from high-oleic sunflower oil that included either 5 g of EPA (and about 700 mg DHA) or 7 g of additional oleic acid. Measurements of blood pressure, digital volume pulse to assess arterial stiffness and vascular tone, and plasma isoprostanes, triglycerides and fatty acids were obtained at baseline, 3 and 6 hours after consumption of the test meal. Participants consumed a second high-fat meal containing 44 g fat (26 g saturated fat) after 4 hours to enhance any lipemia-induced change in arterial function and mimic typical eating behavior.

Men consuming the EPA-enriched meals exhibited a steep increase in plasma EPA that peaked 5 hours after the test meals (Figure 1). There was a small, but statistically significant, increase in DHA as well. Neither fatty acid concentration was altered by consumption of the placebo high-oleic acid meal. Arterial stiffness calculated from the digital volume pulse measurements was significantly reduced 6 hours after the EPA test meal, but not after the placebo meal. Vascular tone decreased at 6 hours in both groups, suggesting vasodilation, but did not differ between the two meals. Plasma 8-isoprostane F2α concentration, a marker of lipid peroxidation, increased after 6 hours in the EPA group, but the two groups did not differ significantly. Lack of group difference is likely attributable to the small number of participants. Total nitrate and nitrite, metabolites of nitric oxide, decreased in both groups compared with baseline values, but changes did not differ between the groups. There were no significant differences in blood pressure and heart rate either.

The reduced arterial stiffness observed with increased consumption of a high dose of n-3 LC-PUFAs—5 g of EPA—supports previous reports of improved endothelial function with n-3 LC-PUFAs (vasodilation, brachial artery dilation) in healthy individuals and patients with type 2 diabetes and hyperlipidemia. The marked increase in plasma 8-isoprostane F2α suggests increased lipid peroxidation not specific to EPA. Overall, the study suggests that consumption of EPA contributes to improved endothelial function during postprandial lipemia that may offset the potentially harmful effects of high-fat meals associated with impaired vascular activity.

SOURCE: Hall WL, Sanders KA, Sanders TAB, Chowienczyk PJ. A high-fat meal enriched with eicosapentaenoic acid reduces postprandial arterial stiffness measured by digital volume pulse analysis in healthy men. J Nutr 2008;138:287-291. [PubMed]

For reasons we do not understand, fish and fish oil consumption, which protects against heart disease mortality and sudden cardiac death, has little effect on the occurrence of nonfatal heart events in western populations. This is not the case among the Japanese, who consume nearly 10 times as much fish as westerners. The Japanese also have half the chance of dying from heart disease. In trying to understand these striking differences, researchers have turned their attention to the long-chain omega-3 fatty acids found in fish. These fatty acids are also more abundant in the blood of Japanese fish-eaters than in most westerners. Although there is good reason to think long-chain omega-3s are at least part of the answer, a relationship between the two has not been observed in westerners.

Now the potential relationship between blood long-chain omega-3 fatty acid concentrations and the occurrence of nonfatal heart events, such as a heart attack, has been examined in a large sample of US women who were monitored for 6 years. This was a case-control study in which the investigators identified participants who incurred a nonfatal heart attack and then matched them with women having the same age and smoking status, but who did not have such an event. Blood samples were obtained from both groups of women. This study included 146 women with a nonfatal heart attack and 288 control women without a heart attack. On average, the women were 60 years old.

When the two groups of women were compared, those who had had a heart attack weighed more, consumed less alcohol and were more likely to have diabetes, hypertension and high blood cholesterol levels, as well as a parental history of heart attack. Women who had higher levels of EPA (eicosapentaenoic acid), a long-chain omega-3 fatty acid, in their blood plasma had a 77% lower chance of having a nonfatal heart attack compared with women having lower levels. The reduced chance of heart attack was not related to their blood levels of DHA (docosahexaenoic acid), another long-chain omega-3 found predominantly in fatty fish.

The researchers also noted that women with higher long-chain omega-3s in their plasma had higher HDL levels (“good” cholesterol) and lower triglycerides (blood fats). Overall, this study provides some support in western women for fewer nonfatal heart attacks with higher levels of long-chain omega-3s in blood. The study had some other perplexing observations that are not easy to explain. For example, why was the relationship observed only for plasma omega-3s and not red blood cell omega-3s? Plasma values reflect more recent dietary intakes. It is also not clear why plasma DHA was not related to nonfatal heart attacks, as it too is associated with fish and fish oil consumption. What is encouraging about these findings is that they suggest that westerners may improve their heart health from a preventive point of view, just as happens in the fish-loving Japanese.

Children and adolescents with attention deficit hyperactivity disorder (ADHD) often have other behavioral problems, such as learning difficulties, reading or writing abnormalities, motor coordination, defiant behavior and others. In addition, it has been noted often that the pattern of polyunsaturated fatty acids in their blood differs from children without this disorder. In particular, ADHD children usually have lower amounts of long-chain omega-3s, even though they consume the same amounts as other children. A shortage of these fatty acids may contribute to the condition. For example, it has been noted by some researchers that the severity of the condition is worse as levels of red blood cell DHA (docosahexaenoic acid), one of the two main long-chain omega-3s, decrease.

The situation is more complex than simply providing more of these fatty acids. This was shown in a study comparing the responses of healthy and ADHD children when supplemented with long-chain omega-3 and omega-6 fatty acids. Both groups of children improved with the supplements, but the fatty acid deficiency was not corrected. On the other hand, trials among children with a range of ADHD symptoms who consumed long-chain fatty acids reported significant improvements in behavior and learning. It takes months, however, to observe the changes.

In a new study from Sweden, researchers wanted to see if they could obtain the same encouraging results as others had in children with diverse ADHD symptoms. The children were 8 to 18 years of age. One group of children was given a modest dose of long-chain fatty acids, mostly omega-3s, while the other received olive oil as a placebo. The study lasted 6 months.

The children generally fell into two categories; those with a combined type of ADHD with hyperactive and impulsive behavior and those who were mainly inattentive. More than three-quarters of the children had other associated difficulties, such as reading or writing problems, defiant behavior, developmental coordination disorder and the like. Nearly all were boys. Their behaviors were assessed in detail by a clinician and the parents before and after the study.

For the first 3 months, children consumed either the long-chain fatty acids or olive oil. After that, all children consumed the long-chain fatty acids for another 3 months. That study design yielded two groups of outcomes for 3 months of treatment, plus a group that received the fatty acids for 6 months.

As often happens in studies, both groups showed changes in their behaviors. After 3 months, the children taking the long-chain fatty acids showed significant improvement in their clinician-based scores compared with the placebo group. Their ADHD assessment scores also improved, but not enough to reach statistical significance. At six months, the children who had been taking the long-chain fatty acids continued to improve, as did those who had been taking the placebo, but differences between the two groups were not significantly different.

Next, the investigators examined the changes in children considered to be “responders.” Those children showed at least a 25% improvement in their scores, regardless of which group they were in. At 3 months, 26% of children taking the long-chain fatty acids were considered responders, whereas only 7% of the placebo children were responsive. Moreover, nearly half the responders in long-chain fatty acid group improved their symptoms by 50% or more, but none in the placebo group improved that much.

When the investigators looked at which type of ADHD the responsive children had, it was the inattentive type more than the other forms. They were also more likely to be in the 13- to 18-year age category. Further, the children with the greatest improvement experienced enhanced daily functioning.

This study contributes new information about the responses of ADHD children to supplementation with long-chain fatty acids. It suggests that children with predominantly the inattentive type of ADHD may be more likely to respond. In addition, children continued to improve the longer they consumed the supplements up to 6 months. Thus, consumption for 6 months was more effective than for 3. Finally, the study confirms previous reports that a modest amount of long-chain fatty acids may be clinically useful in at least some children with ADHD.

SOURCE: Fats of Life Newsletter

Minami Nutrition’s fish oil products were among the highest rated for purity by independent testing organization, Consumer Labs. Thanks, CL for confirming what we’ve know all along!

Here’s the press release:

The popularity of fish oil supplements has been growing exponentially over the past several decades. As more studies tout the benefits of the supplements containing omega-3 fatty acids for heart health, as well as arthritis and depression, there are more of the products on the market than the average consumer can or is willing to analyze. Enter ConsumerLab.com and its new report on fifty fish oil supplements and fortified foods.

The Nutrition Business Journal reported that dietary supplements containing omega-3’s sold to the total of approximately $35 million in 1995. Ten years later, the 2005 sales number was at $359 million, and the number had increased to $489 million in 2006. If the trend dictates, the number in 2008 will likely be well over the $500 million mark. For such a booming business, it is only appropriate that consumers and medical professionals alike have a comprehensive study that examines the supplements and foods associated with omega-3 and looks at amounts of EPA and DHA (two principal polyunsaturated fatty acids found in fish), product purity, and freshness.

ConsumerLab.com has done just that. The private company is based in New York and is known for being a leading provider of consumer information and independent evaluations of health and nutrition products. In this case, researchers compared a total of 50 products, including dietary supplements, food and beverages, 23 of which were selected by ConsumerLab.com and 27 of which were included at the request of their manufacturers through the Voluntary Certification Program. Some products were several of the most popular on the market, such as Vitamin Shoppe, Yoplait, Nature Made, and Nature’s Bounty, and others were store brands like Origin from Target and Spring Valley from Wal-Mart.

The results of the study were multi-fold. Most importantly, all of the products tested were found to have safe levels of mercury, lead, and PCB’s (a type of carcinogen). In addition, all were found to have the amounts of EPA and DHA that their labels maintained, though those levels ranged from 16 milligrams to 1000 milligrams, depending on the product.

On the other side of the coin, it was discovered that one capsule-Kirkland Signature Enteric Coated Fish Oil-released its oil too early into the human body and thus failed its test, becoming the one of only two products not approved by ConsumerLab.com. The other product that did not meet appropriate standards for approval was Lipiderm International Veterinary Sciences, a pet supplement that contained only 25% of the alpha-linolenic acid required and 593% of the linolenic acid needed. It should also be noted that some food products claimed to provide percentages of the “daily value” of omega-3’s, which is a false claim as there is no determined daily value, but this did not warrant an approval failure in those products, which included Tropicana, Silk Soymilk, Yoplait Kids Yogurt, and Aristo nutrition bars.

The levels of EPA and DHA ranged from 8% concentration to 79% of the liquid content of the products, and it varied greatly among the items tested. While higher concentrations are not necessarily better, the intake amount matters when it comes to the frequency and quantity taken. Every person’s requirements are different and unique, but to get the highest concentration from the smallest serving size of the product, the only three products rating very high in that category were OmegaBrite, VitalOils, and Minami Nutrition. Rating very low were Mega Smart for Kids and Lipiderm International Veterinary Sciences for pets.

Overall, the research provides the public with guidelines for supplements and food or beverage items that may work in conjunction with a proper diet to provide the omega-3’s being sought. It also helps doctors, nutritionists, and other medical professionals with a tool to gauge exactly what each patient needs and can handle.

With fish oil supplements being touted as having positive effects on cardiovascular health, reducing inflammation in those with diseases like arthritis and Crohn’s disease, lessening the effects of depression and other mental disorders, aiding in the treatment of asthma, chronic fatigue syndrome, cystic fibrosis, osteoporosis, and reducing the risk of prostate and colorectal cancers, it is easy to see why their popularity continues to rise. Therefore, the ComputerLab.com study is imperative to help analyze the growing market.

SOURCE:  Health News

Don’t like seafood? You can still get your heart-healthy omega-3s. A new study published in the American Journal of Clinical Nutrition shows that, when it comes to providing omega-3 fatty acids, fish oil supplements are just as good as actually eating fish.

Experts tested a group of 23 women ages 21 to 49. Each participant ate either two servings of tuna and salmon each week or consumed the same amount of omega-3s in capsule form. After four months, the omega-3 blood levels – in all of the women – had risen by 40-50 percent in red blood cells and 60-80 percent in blood plasma. It didn’t make any difference whether the women had received the omega-3s from the seafood or the supplements.

In fact, the American College of Cardiology and the American Heart Association suggest people prone to heart disease should consume at least one gram of omega-3s per day by eating fatty fish or by taking an omega-3 fish oil supplement. Other experts recommend even more: up to two to three grams per day. If you go the seafood route, this could mean consuming tuna or salmon more than once a day!

It could also mean environmental pollutants. Some fish store contaminants in their organs, posing serious health consequences for those who eat them – and particularly for women who are pregnant or nursing young children. The FDA and the EPA have issued an advisory on this matter, but the Institute of Medicine has reported that the benefits of eating fish generally outweigh potential risks.

Fish oil supplements, on the other hand, have been purified to remove harmful compounds. They’re harvested only from the fishes’ bodies – not the organs, where pollutants are stored. And for many, capsules are simply more convenient to consume.

SOURCE: Nutrition Horizon

Recently, a study came out showing that EPA was a viable alternative to Prozac and furthermore, that taking the two together proved even more superior results in resolving or improving unipolar depression. Read on:

Unipolar depressive disorder was ranked as the fourth highest global burden of disease in 2000. For the ages 15-44 they generated the second highest burden. If current trends for epidemiological and demographic transition continue, depression would become the highest ranking cause of disease in the developed regions and the second leading cause of disability-adjusted life years lost worldwide. A systematic review of the treatment of depression comparing placebo with antidepressants demonstrated that 56% to 60% of patients responded well to antidepressants. Overall, 19% to 34% of patients will become treatment resistant.
 
Complementary and alternative treatments are commonly used by patients with depression as is the use of dietary supplementation. Little is known however about the interaction between drugs and supplements and from a clinical perspective this is very important to establish. Omega-3 fatty acids (ω- 3 FAs) such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are the two key long-chain polyunsaturated fatty acids (LC-PUFA) and deficiencies are considered to have important implications for depression. Studies have reported that long term consumption of ω- 3 FAs in adolescents, adults and the elderly are inversely linked to depression in the Island of Crete. Furthermore, several countries have provided evidence of a negative correlation between fish consumption and major depressive disorder (Hibbeln, 1998). Edwards et al. (1998) demonstrated that the severity of depression negatively correlated with the red blood cell membranes of ω- 3 FAs and their dietary intake with depressed patients. Evidence to date although inconsistent, suggests that ω- 3 FAs may have therapeutic benefits to unipolar depression. Research has reported that an elevated ratio of ω- 6/ω- 3 FAs can predict the risk of suicide behaviour in depressed patients. Recent reviews of the effects of ω- 3 FAs to improve depression have suggested more research trials are required (Appleton et al., 2006). Yet contrasting evidence supports a protective effect of ω- 3 intake in both mood disorders, bipolar and unipolar depression and recommended that trials are needed to establish which FA is optimal in different disorders.
 
Patients aged 20-59 years of age were referred from the Roozbeh Psychiatric Hospital in Tehran, Iran to take part in this study. Written informed consent was obtained and the protocol adhered to the guidelines of the Declaration of Helsinki and was approved by the Ethical Committee of Tehran University of Medical Sciences. The patients met the DSM-IV criteria for major depressive disorder without psychotic features based on the semi-structured interview. Scores were less than 15 on the 17 item Hamilton Depression Scale and patients were free of medication for at least 6 weeks prior to recruitment. Exclusion criteria also included consumption of ω- 3 supplementation and dietary intake of more than 1 portion of oily fish weekly.
 
Soft gel capsules containing 550 mg of ethyl-EPA (500 mg of pure EPA and 11 mg vitamin E as antioxidant) were supplied. The placebo contained 550 mg of rapeseed oil, 11 mg of vitamin E and was identical to the active capsule. Participants (approximately 15 in each group) were randomly allocated into 3 groups to receive 2 capsules (i) (1000 mg) of EPA plus fluoxetine placebo, (ii) 1 fluoxetine capsule (20 mg fluoxetine) plus ethyl-EPA placebo, or (iii) 2 ethyl-EPA soft gels (1000 mg EPA) plus 1 fluoxetine capsule (20 mg fluoxetine) for 8 weeks. The study was double blind and because the fluoxetine capsule and EPA gel were not identical a double dummy model was used to blind patients and physician. Psychiatric assessments were carried out at weeks 2, 4, 6, and 8. Compliance was set at 90% of consumption of the medication.
 
Analysis of covariance (ANCOVA) for HDRS at week 8 was performed on the data. Baseline HDRS, age of onset and number of previous episodes were covariates. Treatment, age of onset and baseline HDRS had a significant effect on HDRS at week 8. The fluoxetine + EPA combination was significantly better than fluoxetine or EPA alone. Fluoxetine and EPA appeared to be equally effective in controlling depressive symptoms. ANCOVA for HDRS at week 2 were not significant. Treatment was shown to have an effect at both weeks 4 and 6 (p = 0.016, 0.02 respectively). Response rates ( > 50% decrease in baseline HDRS) were 50%, 56% and 81% in the fluoxetine, EPA and combination groups respectively. Repeated measure analyses of variance were carried out to test for significant differences in depressive scores within each group over time. When all groups were combined together there was a significant effect of time within each group starting at week 2 (in al cases p < 0.05).
 
This study had limitations in that it contained a small sample size and lacked a placebo group yet the findings suggest that EPA had equal therapeutic benefits to fluoxetine but was more superior as an adjunctive treatment with fluoxetine. The authors concluded that the consumption of dietary supplements may be more acceptable to patients than antidepressants. Furthermore, because major depression is also a risk factor for cardiovascular disease, supplementation with EPA may be of mutual benefit, reducing inflammatory cytokines and controlling depressive symptoms.

SOURCE: Jazayeri, S., Tehrani-Doost, M., Keshavarz, S. A., Hosseini, M., Djazayery, A., Amini, H., Jalali, M. & Peet, M. (2008). Comparison of therapeutic effects of omega-3 fatty acid eicosapentaenoic acid and fluoxetine, separately and in combination in major depressive disorder. Australian and New Zealand Journal of Psychiatry, 42, 192-198.

Various studies have reported that consumption of fish or fish oils may affect vascular function in ways that increase forearm blood flow and arterial elasticity, while reducing blood pressure. However, there is some disagreement about the effects on vascular relaxation of docosahexaenoic acid (DHA), a long-chain omega-3 polyunsaturated fatty acid (n-3 LC-PUFA), in spite of its association with improved endothelial function.

High-fat meals can impair endothelial function and flow-mediated dilation within 3 to 4 hours, the time when peak postprandial lipemia—the rise in blood fats following a meal—occurs. Different fatty acids also affect flow-mediated dilation, at least in individuals with type 2 diabetes, with saturated fatty acids reducing it and n-3 PUFAs increasing it. However, others have reported increased forearm blood flow and flow-mediated dilation in healthy volunteers following a fatty meal, changes that were not associated with impaired endothelial nitric oxide release. Increases in flow-mediated dilation may offset reductions in blood flow, helping to maintain healthy vascular reactivity. Diminished endothelial function is believed to contribute to atherosclerosis and diabetes. In this report, the effect of eicosapentaenoic acid (EPA), an n-3 LC-PUFA, on postprandial vascular function, including oxidative stress, nitric oxide production, was examined in 21 healthy, non-smoking, young men, aged 18 to 35 years. Seventeen men completed the study.

After an overnight fast, participants were given a high-fat test meal containing 51 g of fat mainly from high-oleic sunflower oil that included either 5 g of EPA (and about 700 mg DHA) or 7 g of additional oleic acid. Measurements of blood pressure, digital volume pulse to assess arterial stiffness and vascular tone, and plasma isoprostanes, triglycerides and fatty acids were obtained at baseline, 3 and 6 hours after consumption of the test meal. Participants consumed a second high-fat meal containing 44 g fat (26 g saturated fat) after 4 hours to enhance any lipemia-induced change in arterial function and mimic typical eating behavior.

Men consuming the EPA-enriched meals exhibited a steep increase in plasma EPA that peaked 5 hours after the test meals (Figure 1). There was a small, but statistically significant, increase in DHA as well. Neither fatty acid concentration was altered by consumption of the placebo high-oleic acid meal. Arterial stiffness calculated from the digital volume pulse measurements was significantly reduced 6 hours after the EPA test meal, but not after the placebo meal. Vascular tone decreased at 6 hours in both groups, suggesting vasodilation, but did not differ between the two meals. Plasma 8-isoprostane F2α concentration, a marker of lipid peroxidation, increased after 6 hours in the EPA group, but the two groups did not differ significantly. Lack of group difference is likely attributable to the small number of participants. Total nitrate and nitrite, metabolites of nitric oxide, decreased in both groups compared with baseline values, but changes did not differ between the groups. There were no significant differences in blood pressure and heart rate either.

The reduced arterial stiffness observed with increased consumption of a high dose of n-3 LC-PUFAs—5 g of EPA—supports previous reports of improved endothelial function with n-3 LC-PUFAs (vasodilation, brachial artery dilation) in healthy individuals and patients with type 2 diabetes and hyperlipidemia. The marked increase in plasma 8-isoprostane F2α suggests increased lipid peroxidation not specific to EPA. Overall, the study suggests that consumption of EPA contributes to improved endothelial function during postprandial lipemia that may offset the potentially harmful effects of high-fat meals associated with impaired vascular activity.

Hall WL, Sanders KA, Sanders TAB, Chowienczyk PJ. A high-fat meal enriched with eicosapentaenoic acid reduces postprandial arterial stiffness measured by digital volume pulse analysis in healthy men. J Nutr 2008;138:287-291.

SOURCE: PUFA Newsletter