Neurological Benefits of Omega 3’s
Hopefully, you have already boarded the Omega 3 train and are advocating its use regularly for both its anti-inflammatory properties and the role it plays in nerve cell health. My most recent review of the literature finds the evidence mounting in support of its widespread use for both the young and the old.
Benefits
Omega 3 the super nutrient. It is most commonly known for its benefits in improving and maintaining healthy triglyceride levels. It is frequently prescribed by MD’s and dispensed by the pharmacy in its ethyl ester form under the brand name Lovaza.1 It also plays an important role in neurological and vision development in children, as well as slowing the neurological decline in the elderly.
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Types
To better understand Omega 3’s, one must be aware that there are two different types that are in common use today and that they each have distinct benefits. In order to better serve our patients’ needs, we must understand the two different types and prescribe them at a dose and in a ratio that serves them best.
EPA’s
EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are the two Omega 3’s that are commonly found in today’s growing selection of this popular supplement. If the supplement is of higher quality it should indicate how many mg of each it contains per serving. EPA’s primary role and use are for the reduction of cellular inflammation. It achieves this by inhibiting the enzyme D5D (delta-5-desaturase) that produces AA(arachidonic acid). AA is necessary for the production of pro-inflammatory eicosanoids (prostaglandins, leukotrienes, etc.). EPA competes with AA for the enzyme phospholipase A2 necessary to release AA from the membrane phospholipids. Corticosteroids also inhibit the enzyme phospholipase A2, which is what makes corticosteroids effective at reducing inflammation. However, EPA can achieve the same end without the side effects.2
DHA’s
DHA’s primary role and use are for neurological, and vision health. The brain structure is made of up to 60% lipids, with DHA comprising 30% of that. In the eye, DHA can comprise up to 50% of its structure.3 In developing human infants the brain undergoes the most rapid growth within the first 2 years of life, and it is at this time the infant’s dependence on optimal nutrition for brain development is at its greatest. In infancy, the brain is not able to produce enough Omega 3 (DHA) and therefore must derive almost all of it from the mother. Previous studies have demonstrated that the placenta selectively uptakes DHA from the mother to provide an adequate supply for the infant.3 This suggests that with each successive child the mother’s DHA is gradually depleted and with each successive pregnancy there is less DHA supply for the developing child. As a result in women whose dietary intake of Omega 3 is low, the baby may also be deficient in DHA. A study found greater maturation in the retina and visual cortex of 6-month-old infants receiving supplementation of Omega 3 over those that were deficient. In another study performed on cognitive development during infancy, researchers found that low maternal and fetal DHA levels at birth correlated with attention deficit and distractibility at 12 to 18 months of age.3
The neurological impact of low DHA levels in mothers following birthing has been suggested to have profound effects on the psychology of the mother, especially following multiple births when the diet has not been improved. Severe deficiencies have been suggested to result in increased rates of postpartum depression.
Effects of DHA
In the membrane of nerve cells is where DHA provides its benefit. It is its structure (22 carbons and 6 double bonds), size and the fact that it is highly unsaturated that makes the nerve cell membrane so permeable. It is this permeability that allows for greater transmission of signals from one nerve cell to another. This improves the nerve cells’ ability to release neurotransmitters (including dopamine, serotonin, norepinephrine, acetylcholine, and glutamate). Deficiencies in DHA have been shown to lower the levels of dopamine and dopamine receptors in the frontal lobe which have been found to be associated with attention and learning.4 DHA deficiency likely plays a role in decline of mental function in healthy adults, which is indicated in a study from 2010 conducted at 19 U.S. clinical sites on 485 subjects aged 55 and older who met criteria for age-associated memory impairment. The study found DHA taken for six months decreased heart rate and improved memory and learning in healthy, older adults with mild memory complaints. These findings indicate the importance of early DHA intervention and provided a statistically significant benefit to cognitive function in individuals over 50 years of age. Higher DHA levels in middle-aged adults are related to better performance on tests of nonverbal reasoning and mental flexibility, working memory and vocabulary.
Selecting an Omega 3 Supplement
Most Omega 3 supplements that are used and dispensed by those in our community come in a ratio of EPA: DHA that ranges from 2:1 to 3:2 in favor of EPA. This is commonly the case because we treat so many with inflammatory musculoskeletal complaints. However, many of us treat wellness patients who practice a healthy lifestyle and may not be suffering from any obvious inflammatory process. Sometimes these patients may have complaints of not feeling like their former selves and that they are becoming forgetful, absent-minded, or having difficulty concentrating. You may also treat the growing number of pediatric patients whose parents are seeking alternatives to the drugs being prescribed for ADD, ADHD, or even depression. Therefore it is important to know for whom and for what purpose you are prescribing the omega 3’s.
When selecting an Omega 3 supplement, one must consider what form to offer patients (triglyceride, ethyl ester, supercritical CO2 extraction, to name a few). My research concludes that there can be arguments made in favor of all of them. I personally use and recommend the triglyceride form derived using the supercritical CO2 extraction method, simply for the reason that I have to prescribe fewer pills at the end (high bio-availability). For most adults, I prescribe at a ratio of 3:2 (EPA: DHA) and children at a ratio of 3:1 (DHA: EPA). The above ratios are for general supplementation and may vary depending on the patient diagnosis and how aggressively you want to treat the condition.
Conclusion
My initial inclination for most patients would say to them, “Change your diet, put down the tablet, get some exercise, and get to sleep on time….. every day, for the rest of your life.” But since that’s not likely to happen, I’ll offer them a research-proven supplement with minimal risk compared to the pharmaceutical alternatives.
References
- http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000414/
- Sears B. The Zone. Regan Books. New York, NY (1995)
- http://www.lef.org/magazine/mag2008/jan2008_report_dhafishoil_01.htm
- http://en.wikipedia.org/wiki/Neurotransmitter
- http://en.wikipedia.org/wiki/Docosahexaenoic_acid
