Omega-3 fatty acids and brain health

A recent study published in the Journal of the American Heart Association looked at the relationship between consumption of omega-3 polyunsaturated fatty acids and some physical measures of the brain that have been linked to “brain health” and “cognitive health.” This research was a bit different from many other studies of omega-3 fatty acids and potential health benefits, because most other studies have looked for relationships between dietary intake of these compounds (found especially in deep water fish like salmon, sardines, tuna, and mackerel) and major health outcomes, such as cardiovascular disease or depression. The JAHA article, on the other hand, narrowed the focus by examining measurable small-scale physical changes in the brain over a period as long as five years.

The results: people with higher omega-3 fatty acid levels showed a significantly lower number of the small-scale physical brain changes that may be associated with brain dysfunction or cognitive decline.
The study authors concluded that, among the older men and women who were the study’s subjects, higher blood levels of omega-3 fatty acids, “and in particular DHA, were associated with specific findings consistent with better brain health.”

Our comment: a fascinating study, because it adds another level of evidence contributing to the already widely accepted view that omega-3 fatty acids are beneficial for your brain, and indeed may provide important help in maintaining brain function as you age.

See the NYBC catalog for a selection of fatty acids, and note especially the Nordic Naturals Pro Omega choices, which are excellent quality fish oil supplements, containing the omega-3 polyunsaturated fatty acids studied in the JAHA article:

FATTY ACIDS in the NYBC CATALOG

Of special interest is the Jarrow supplement Max DHA, which provides an enhanced dose of the omega-3 fatty acid often associated with brain health:

MAX DHA (Jarrow)

Reference:

Virtanen JK, Siscovick DS, Lemaitre RN, Longstreth WT, Spiegelman D, Rimm EB, King IB, & Mozaffarian D (2013). Circulating omega-3 polyunsaturated fatty acids and subclinical brain abnormalities on MRI in older adults: the Cardiovascular Health Study. Journal of the American Heart Association, 2 (5) PMID: 24113325

Supplements for Bone Health: A Special Note for People with HIV

Bone health has been a growing concern for people with HIV, since studies have indicated that HIVers experience higher than expected rates of osteopenia (bone mineral density lower than normal) and osteoporosis (bone mineral density very low, with heightened risk of fractures). A 2012 review from Johns Hopkins researchers, for example, concluded that the “increasing prevalence of osteoporosis in HIV-infected persons translates into a higher risk of fracture, likely leading to excess morbidity and mortality as the HIV-infected population ages.”

The Johns Hopkins study urged more attention to Vitamin D deficiency and supplementation as one way to counter these HIV-related bone issues. But we think it’s also worth looking at recent Canadian research, not focused especially on people with HIV, but with some striking findings about the value of multiple supplements to support healthy bone mineral density levels. The supplements investigated included vitamin D(3), vitamin K(2), strontium, magnesium and docosahexaenoic acid (DHA), all chosen because of previous evidence about their benefit to bone health. Following a year-long study of patients with varying levels of bone loss, the Canadian researchers determined that this supplement regimen was as effective as a class of drugs often prescribed for osteoporosis (bisphosphonates, such as Fosamax or Boniva). And, they found that the combination of supplements was even effective for people who had failed to benefit from the prescription osteoporosis drugs.

We hope to see further study of supplement combinations for bone loss in people with HIV. It’s an acknowledged problem as HIVers get older, and if there’s a potential way to lower this health risk over the long run, let’s take a serious look at it!

Note: NYBC stocks Jarrow’s Bone Up or Ultra Bone Up, plus Max DHA or EPA-DHA Balance, which provide most of the micronutrients in the Canadian study (missing is the Strontium, but NYBC hopes to have a recommendation for that in the near future).

Visit the NYBC website for more information:

http://www.newyorkbuyersclub.org/

References:

The Johns Hopkins study: Walker Harris V, Brown TT. Bone loss in the HIV-infected patient: evidence, clinical implications, and treatment strategies. J Infect Dis. 2012 Jun;205 Suppl 3:S391-8. doi: 10.1093/infdis/jis199.

The Canadian study: Genuis SJ, Bouchard TP. Combination of Micronutrients for Bone (COMB) Study: bone density after micronutrient intervention. J Environ Public Health. 2012;2012:354151. doi: 10.1155/2012/354151.

Omega-3 fatty acids (especially DHA) may protect against ulcerative colitis

Omega-3 fatty acids (for example, the EPA and the DHA in your fish oil supplements) have an anti-inflammatory effect, of interest to researchers in a recent study of inflammatory bowel disease, specifically ulcerative colitis. This large study, which focused on people from 45 to 74 years old, found that those with the highest consumption of DHA (410 mg to 2,000 mg per day) had a 77% reduction in the risk of developing ulcerative colitis over an average period of four years than those consuming the lowest amount (up to 110 mg per day). On the basis of their research, the study authors suggest that higher intake of omega-3 fatty acids, especially DHA, could have a protective effect against development of ulcerative colitis.

For more information on DHA, EPA and other fatty acid supplements, see the NYBC category:
Fatty acid supplements
Note that NYBC stocks a variety of these supplements, both from fish oil (Nordic Naturals and Jarrow), and from vegetarian (algae) sources.

Reference:
John, S et al. Dietary n-3 polyunsaturated fatty acids and the aetiology of ulcerative colitis: a UK prospective cohort study. Eur J Gastroenterol Hepatol. 2010 May; 22(5):602-6

DHA Omega-3 (algae-based, no fish)

NYBC recently added to its catalog this omega-3 fatty acid supplement which is derived from a vegetable source (algae) rather than from fish:

DHA Omega-3 (Natrol) Each bottle, 30 softgels. Each softgel, 100 mg of DHA derived from algae (no fish/vegetarian). Suitable for vegetarians who wish to avoid fish/menhaden sources. This product recently passed a consumerlabs test as the only example of a non-fish-based omega-3 fatty acid supplement. Suggested use is 1 softgel with a meal or as directed.

See other entries under Omega-3 fatty acids on this Blog for evidence and recommendations for use.

Omega-3 fatty acids improve heart function

A study published in Jan, 2011 in the Journal of the American College of Cardiology found that omega-3 fatty acid (fish oil) supplementation improved heart function, exercise function, and peak oxygen uptake in heart failure patients on standard therapies. This study, led by Mihai Gheorghiade, MD, of Northwestern University in Chicago, added detail to a large, long-term investigation demonstrating that omega-3 fatty acids reduce mortality and cardiovascular hospitalizations in patients with chronic heart failure.

The study randomly assigned 133 heart failure patients to receive either a placebo or the omega-3 fatty acids. (Active treatment consisted of 1-gram capsules containing about 850mg of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Patients took five capsules daily for the first month, followed by two capsules daily for the rest of the study). After a year, the patients who took the omega-3 fatty acids had a significant improvement in left ventricular ejection fraction (a measure of heart function), whereas those on placebo showed a decline in this measure. Furthermore, while 30% of the patients on placebo required cardiovascular hospitalization during the year, only 6% of those taking the omega-3 supplements were hospitalized due to cardiovascular condition.

In addition to the high-quality Pro Omega Nordic Naturals fish oils supplements, NYBC now stocks Jarrow’s EPA-DHA Balance, which provides another convenient way to match the omega-3 fatty acid supplementation levels used in research studies:

EPA-DHA Balance (Jarrow)

Pro Omega Nordic Natural (1000mg/60 softgels)

Pro Omega-Nordic Naturals (1000mg/180 softgels)

Can this omega-3 fatty acid make you think better?

We don’t often put up such a “believe it or not” / “popular science” sounding headline on this Blog, but here’s a rather neatly done scientific study from 2010 that seems to confirm those old sayings about fish being “brain food.”

University of Pittsburgh researchers recently reported on an interesting study about the connection between omega-3 fatty acids (such as those found in fish oil) and cognitive function. The research study followed 280 healthy adults, aged 35-54, and looked at how they performed on tests of nonverbal reasoning and working memory. Researchers found that those who registered higher blood levels of the omega-3 fatty acid docosahexaenonic acid (DHA) performed significantly better on these tests. They did not find any association between two other omega-3 fatty acids, a-linolenic acid (ALA) and eicosapentaenoic acid (EPA), and mental performance measures. They conclude that “DHA is associated with major aspects of cognitive performance in nonpatient adults [up to 55 years old]. These findings suggest that DHA is related to brain health throughout the lifespan…”

Our comment: in recent years there have been several studies relating dietary intake of fish or omega-3 fatty acids and better early brain development and lowered risk of cognitive disorders in late life. (Also , higher fish oil/omega-3 fatty acids intake has been linked to lower rates of depression.) This 2010 study adds evidence that it is specifically DHA that delivers cognitive benefit such as improved reasoning and working memory.

Reference: Matthew Muldoon et al, Serum Phospholipid Docosahexaenonic Acid Is Associated with Cognitive Functioning during Middle Adulthood. The Journal of Nutrition – J. Nutr. 140: 848–853, 2010

NYBC stocks this supplement, which, as the tradename suggests, focuses on providing a substantial dose of DHA, the omega-3 fatty acid found to be effective in the Univ. of Pittsburgh study:

DHA Max (Jarrow)

Fish oil (omega-3 fatty acids) and its benefits for Type 2 Diabetes

The Linus Pauling Institute at Oregon State University provides a good review of research on fish oil (omega-3 fatty acids) and Type 2 diabetes (see excerpt below). Although there was some concern that fish oil supplements might interfere with glycemic control (= control of blood sugar levels) in diabetics, that does not seem to be the case. Moreover, fish oil supplementation can significantly lower triglycerides in people with diabetes, and there is good epidemiological evidence that over the long term higher omega-3 fatty acid intakes may also decrease the risk of cardiovascular disease in diabetics.
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Cardiovascular diseases are the leading causes of death in individuals with diabetes mellitus (DM). Hypertriglyceridemia […] is a common lipid abnormality in individuals with type 2 DM, and a number of randomized controlled trials have found that fish oil supplementation significantly lowers serum triglyceride levels in diabetic individuals. Although early uncontrolled studies raised concerns that fish oil supplementation adversely affected blood glucose (glycemic) control, randomized controlled trials have not generally found adverse effects of fish oil supplementation on long-term glycemic control. A systematic review that pooled the results of 18 randomized controlled trials including more than 800 diabetic patients found that fish oil supplementation significantly lowered serum triglycerides, especially in those with hypertriglyceridemia. A more recent meta-analysis that combined the results of 18 randomized controlled trials in individuals with type 2 DM or metabolic syndrome found that fish oil supplementation decreased serum triglycerides by 31 mg/dl compared to placebo, but had no effect on serum cholesterol, fasting glucose or hemoglobin A1c concentrations. Although few controlled trials have examined the effect of fish oil supplementation on cardiovascular disease outcomes in diabetics, a prospective study that followed 5103 women diagnosed with type 2 DM, but free of cardiovascular disease or cancer at the start of the study, found that higher fish intakes were associated with significantly decreased risks of CHD over a 16-year follow up period. Thus, increasing EPA and DHA intakes may be beneficial to diabetic individuals, especially those with elevated serum triglycerides. Moreover, there is little evidence that daily EPA + DHA intakes of less than 3 g/day adversely affect long-term glycemic control in diabetics. The American Diabetes Association recommends that diabetic individuals increase omega-3 fatty acid consumption by consuming two to three 3-oz servings of fish weekly.

See also the NYBC entry on DHA Max, a DHA/EPA supplement from Jarrow.

New findings on fish oil’s mechanism against Alzheimer’s

Here’s a Jan. 2, 2008 post on the www.sciencedaily.com website reporting on new findings on the mechsnism of action of fish oil as a deterrent to Alzheimer’s Disease.

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Greg Cole, professor of medicine and neurology at the David Geffen School of Medicine at UCLA and associate director of UCLA’s Alzheimer Disease Research Center, and his colleagues report that the omega-3 fatty acid docosahexaenoic acid (DHA) found in fish oil increases the production of LR11, a protein that is found at reduced levels in Alzheimer’s patients and which is known to destroy the protein that forms the “plaques” associated with the disease.

The plaques are deposits of a protein called beta amyloid that is thought to be toxic to neurons in the brain, leading to Alzheimer’s. Since having high levels of LR11 prevents the toxic plaques from being made, low levels in patients are believed to be a factor in causing the disease.

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The researchers examined the effects of fish oil, or its component DHA, in multiple biological systems and administered the oil or fatty acid by diet and by adding it directly to neurons grown in the laboratory.

“We found that even low doses of DHA increased the levels of LR11 in rat neurons, while dietary DHA increased LR11 in brains of rats or older mice that had been genetically altered to develop Alzheimer’s disease,” said Cole, who is also associate director of the Geriatric Research Center at the Veterans Affairs Medical Center.

To show that the benefits of DHA were not limited to nonhuman animal cells, the researchers also confirmed a direct impact of DHA on human neuronal cells in culture as well. Thus, high levels of DHA leading to abundant LR11 seem to protect against Alzheimer’s, Cole said, while low LR11 levels lead to formation of the amyloid plaques.

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 Quite an interesting supplement, fish oil. The first focus on its health benefits was directed at heart health and cardiovascular concerns. However, more recently there has been a lot of investigative energy devoted to the effect of omega-3 fatty acids on cognitive function and mood.

See, for example, the posts on “Depression” on this blog, which detail some of the recent findings about fish oil’s potential for addressing mood.

The New York Buyers’ Club stocks

DHA Max (Jarrow). See description here.

Fish and Omega-3 Fatty Acids: American Heart Association Recommendation

This recommendation appears on the website of the American Heart Association:  
Omega-3 fatty acids benefit the heart of healthy people, and those at high risk of — or who have — cardiovascular disease. We recommend eating fish (particularly fatty fish) at least two times a week.  Fish is a good source of protein and doesn’t have the high saturated fat that fatty meat products do.  Fatty fish like mackerel, lake trout, herring, sardines, albacore tuna and salmon are high in two kinds of omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).To learn about omega-3 levels for different types of fish — as well as mercury levels, which can be a concern — see our Encyclopedia entry on Fish, Levels of Mercury and Omega-3 Fatty Acids.We also recommend eating tofu and other forms of soybeans, canola, walnut and flaxseed, and their oils. These contain alpha-linolenic acid (LNA),  which can become omega-3 fatty acid in the body. The extent of this modification is modest and controversial, however. More studies are needed to show a cause-and-effect relationship between alpha-linolenic acid and heart disease.The table below is a good guide to use for consuming omega-3 fatty acids.Summary of Recommendations for Omega-3 Fatty Acid Intake

Population	Recommendation
Patients without documented coronary heart disease (CHD)	Eat a variety of (preferably fatty) fish at least twice a week. Include oils and foods rich in alpha-linolenic acid (flaxseed, canola and soybean oils; flaxseed and walnuts).
Patients with documented CHD	Consume about 1 g of EPA+DHA per day, preferably from fatty fish.  EPA+DHA in capsule form could be considered in consultation with the physician.
Patients who need to lower triglycerides	2 to 4 grams of EPA+DHA per day provided as capsules under a physician’s care.

 Patients taking more than 3 grams of omega-3 fatty acids from capsules should do so only under a physician’s care.  High intakes could cause excessive bleeding in some people.

Background

In 1996 the American Heart Association released its Science Advisory, “Fish Consumption, Fish Oil, Lipids and Coronary Heart Disease.” Since then important new findings have been reported about the benefits of omega-3 fatty acids on cardiovascular disease.  These include evidence from randomized, controlled clinical trials.  New information has emerged about how omega-3 fatty acids affect heart function (including antiarrhythmic effects), hemodynamics (cardiac mechanics) and arterial endothelial function.  These findings are outlined in our November 2002 Scientific Statement, “Fish Consumption, Fish Oil, Omega-3 Fatty Acids and Cardiovascular Disease.”

The ways that omega-3 fatty acids reduce CVD risk are still being studied.  However, research has shown that they

• decrease risk of arrhythmias, which can lead to sudden cardiac death
• decrease triglyceride levels
• decrease growth rate of atherosclerotic plaque
• lower blood pressure (slightly)

What do epidemiological and observational studies show?

Epidemiologic and clinical trials have shown that omega-3 fatty acids reduce CVD incidence.  Large-scale epidemiologic studies suggest that people at risk for coronary heart disease benefit from consuming omega-3 fatty acids from plants and marine sources.

The ideal amount to take isn’t clear.  Evidence from prospective secondary prevention studies suggests that taking EPA+DHA ranging from 0.5 to 1.8 grams per day (either as fatty fish or supplements) significantly reduces deaths from heart disease and all causes.  For alpha-linolenic acid, a total intake of 1.5–3 grams per day seems beneficial.

Randomized clinical trials have shown that omega-3 fatty acid supplements can reduce cardiovascular events (death, non-fatal heart attacks, non-fatal strokes).  They can also slow the progression of atherosclerosis in coronary patients.  However, more studies are needed to confirm and further define the health benefits of omega-3 fatty acid supplements for preventing a first or subsequent cardiovascular event.  For example, placebo-controlled, double-blind, randomized clinical trials are needed to document the safety and efficacy of omega-3 fatty acid supplements in high-risk patients (those with type 2 diabetes, dyslipidemia, hypertension and smokers) and coronary patients on drug therapy.  Mechanistic studies on their apparent effects on sudden death also are needed.

Increasing omega-3 fatty acid intake through foods is preferable.  However, coronary artery disease patients may not be able to get enough omega-3 by diet alone.  These people may want to talk to their doctor about taking a supplement.  Supplements also could help people with high triglycerides, who need even larger doses.  The availability of high-quality omega-3 fatty acid supplements, free of contaminants, is an important prerequisite to their use.

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For NYBC’s fish oil supplement, see the product description for Jarrow’s Max DHA.

And we add some general dietary advice about fat:

Remember that the balance of fats you eat is the first, most important step to consider. Dump the hydrogenated fats (found in cookies, margarine and lots of things; read labels!), limit saturated fat intake (dairy, red meat, fried stuff) and increase good fat intake (deep sea fish like salmon, tuna; olive oil, hemp oil, etc.) Lastly: in controlling cholesterol through modifications in diet, it’s not always emphasized enough that sugar intake will also influence your cholesterol levels!