Clinical Studies on Fish Oil

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Clinical Studies on Fish Oil

JoAnn Guest

Nov 12, 2003 21:13 PST

 

Clinical Studies on Fish Oils

 

In a previous newsletter (The Importance of Pharmaceutical Grade

Marine Lipids 01:02:2003), I stressed that one of the most

significant developments in nutritional medicine is the recent

introduction of truly pharmaceutical grade fish oils.

 

Over 600 clinical studies now exist that show the benefits of the

omega-3 fatty acids EPA and DHA. In this newsletter I want to

highlight three recent double-blind clinical trials that once again

reinforce the importance of the long-chain omega-3 fatty acids in

good health and modern medicine.

 

The studies that I chose to review in this issue center around the

importance of omega-3 fatty acids to proper brain function and

development.

 

 

Omega-3 Fatty Acids and the Brain

 

If you have come to one of my lectures, undoubtedly you have heard

me say that your brain is literally a vat of fat -

so don't be upset when people call you a " fat head. "

 

Let them know, however, that your brain is likely functioning better

than theirs because you are getting enough of the right fats. The

type of fat that you consume in your diet and through

supplementation determines the

 

type of fat that you have in your brain.

 

And, the type of fat that you have in your brain goes a long way in

determining how well your brain functions.

 

The importance of omega-3 fatty acids to brain function relates to

their role in the phospholipid composition of nerve cell membranes.

 

While it is thought the cell is programmed to selectively

incorporate the different fatty acids it needs to maintain optimal

function,

the lack of essential fatty acids (particularly the omega-3 oils)

and excess of saturated fats, margarine, cholesterol, and animal

fatty acids leads to the formation of cell membranes which are much

less fluid than normal.

 

A relative deficiency of essential fatty acids in cellular membranes

substantially impairs cell membrane function. Since the basic

function of the cell membrane is to serve as a selective barrier

that regulates the passage of molecules into and out of the cell, a

disturbance of

structure or function disrupts homeostasis.

 

Because the brain is the richest source of *phospholipids* in the

human body and proper nerve cell function is critically dependent on

proper membrane fluidity, alterations in membrane fluidity impacts

behavior, mood, and mental function.

 

Studies have shown that the physical properties, including fluidity,

of brain cell membranes directly influences neurotransmitter

synthesis,

signal transmission, uptake of serotonin and other

neurotransmitters, neurotransmitter binding, and the activity of key

enzymes that break down neurotransmitters like serotonin,

epinephrine, dopamine, and

norepinephrine.

 

All of these factors have been implicated in depression, attention

deficit disorder, and other psychological disturbances.

 

 

Fish Oils Effective in Major Depression

 

Fish oils concentrated for EPA and DHA have been shown to have

positive effects for patients with schizophrenia in several studies

as well as in bipolar disorder (manic depression).

 

Given the central role that these omega-3 fatty acids play in brain

chemistry and nerve cell function, a double-blind study was

conducted to evaluate their role in depression.

 

Previous studies have shown quite convincingly that patients with

depression have significantly low EPA and DHA in cell tissue

contents

(red blood cell membrane, plasma, etc.) and presumably their brain.

 

This fact alone is probably reason enough to supplement with a

pharmaceutical grade fish oil. However, now there is even more

evidence.

 

In the recent study, 28 patients with major depression were given a

hefty dosage of omega-3 fatty acids (4.4 g EPA/2.2 g DHA) or

placebo, on the top of their usual treatment, for 8 weeks.

Evaluation of the subject with the Hamilton Rating Scale for

Depression showed that those taking the fish oils a significantly

decreased score compared to those in the placebo group (P < 0.001).

 

These results are quite exciting and suggested that continued use

may produce even greater benefit as there was a continued downward

trend

with time on the symptoms of depression.

 

Reference: Su KP, Huang SY, Chiu CC, Shen WW. Omega-3 fatty acids in

major depressive disorder. A preliminary double-blind,

placebo-controlled trial. Eur Neuropsychopharmacol 2003;13:267-71.

 

 

Fish Oils in Borderline Personality Disorder

 

This next study is one that I am particularly excited about. It

showed fish oil supplementation to be very effective in improving

borderline personality disorder (BPD). If you are not familiar with

this term, it

is used to describe a pervasive pattern of instability of

interpersonal relationships, self-image, and mood, and marked

impulsivity beginning by early adulthood. Some of the major

indicators of BPD include the following:

 

Relationships with others are intense but stormy and unstable with

marked shifts of feelings and difficulties in maintaining intimate,

close connections.

 

Frantic efforts to avoid real or imagined abandonment.

 

Markedly and persistently unstable self-image or sense of self

Impulsivity in at least two areas that are potentially self-damaging

(e.g., spending, sex, substance abuse, reckless driving, binge

eating).

 

Recurrent suicidal behavior, gestures, or threats, or self-

mutilating

behavior

Tremendous mood swings.

Chronic feelings of emptiness.

Inappropriate, intense anger or difficulty controlling anger (e.g.,

frequent displays of temper, constant anger, recurrent physical

fights).

 

Transient, stress-related paranoia.

 

In the study, only EPA was used. I view that as a shortcoming given

the

importance of DHA to brain function.

 

Nonetheless, in the study 30 women with BPD were given either 1 g of

EPA or a placebo for 8 weeks. Detailed analyses using sophisticated

measures found EPA to be superior to placebo in

diminishing aggression as well as the severity of depressive

symptoms.

 

The authors of the study went so far as to conclude that EPA may be

a

safe and effective form of primary therapy for women with moderately

severe borderline personality disorder.

 

The significance of this study is profound given that an estimated 6

million people in the United States are believed to suffer from

symptoms of BPD. All told, this disorder touches an estimated 36

million lives

counting spouses and children. If pharmaceutical grade fish oil can

help BPD (and I believe that it does), it would be a godsend to many.

 

Reference: Zanarini MC, Frankenburg FR. Omega-3 fatty acid treatment

of

women with borderline personality disorder: a double-blind,

placebo-controlled pilot study. Am J Psychiatry. 2003;160(1):167-9.

 

 

Can Fish Oils Make Kids Smarter?

 

EPA and DHA are critical for proper brain development - especially

during the fetal and infant stage. In particular, there is a growth

spurt in the human brain of the fetus during the last trimester of

pregnancy and the first few months after birth that is characterized

by

a large increase in the cerebral content of DHA. This fact makes

insuring adequate intake of DHA during pregnancy and breastfeeding

absolutely essential.

 

On a side note, do not rely on flax seed oil for accomplishing this

goal as detailed research has shown that the capacity for elongation

and desaturation of alpha-linolenic acid (18:3 n-3) to DHA is

inadequate in both the mother and in the fetus and the newborn.

 

Did you know that breastfed infants are smarter and have higher IQs

than formula fed infants? According to a large amount of research it

is true

and the availability of DHA to the developing brain is one of the

key reasons. Just recently the FDA has allowed manufacturers of

infant

formulas to fortify their products with DHA.

 

A recent study tested the hypothesis that supplementing the maternal

diet during pregnancy and lactation with DHA and EPA could benefit

the fetus and the newborn infant by demonstrating greater cognitive

function. In the study, a total of 341 pregnant women were

supplemented with either omega-3 fatty acids (1200 mg DHA, 800 mg

EPA) or corn oil from 18 weeks of pregnancy through completion of

lactation, and the

children were examined at 4 years of age with an intelligence test.

 

All of the children evaluated had been breastfed exclusively for the

first three months.

 

Results indicated that the group getting the DHA and EPA did in fact

score considerable higher on the Mental Processing Composite of the

K-ABC at 4 years of age as compared with children whose mothers had

taken corn oil.

 

Think about the ramifications of helping children get a head start

in life by making sure that their brains have all of the important

nutrients and building blocks it needs to develop properly -

including DHA.

 

Sadly, low levels of DHA during fetal and infant brain development

may be one of the critical reasons why we are seeing so many

children of psychoactive drugs for attention deficit disorder,

depression, obsessive

compulsive disorder, and other psychological illnesses.

 

Reference: Helland IB, Smith L, Saarem K, Saugstad OD, Drevon CA.

Maternal supplementation with very-long-chain n-3 fatty acids during

pregnancy and lactation augments children's IQ at 4 years of age.

Pediatrics 2003;111:e39-44.

 

 

Choose the Right Product

 

I have stressed the importance of using a pharmaceutical grade fish

oil in previous newsletter. In order to represent itself as

pharmaceutical grade a fish oil product must possess the following

characteristics:

 

It must be manufactured in a certified GMP facility approved for

pharmaceutical products.

 

It must be manufactured according to pharmaceutical standards that

include quality control steps to insure the product is virtually

free from lipid peroxides, heavy metals, environmental contaminants,

and other harmful compounds.

 

It must provide at least a 60% concentration of the most active

long-chain omega-3 fatty acids (EPA and DHA).

 

The ratio of omega-3 fatty acids to arachidonic acid must be greater

than 50:1

It must contain the optimal amount of natural vitamin E as a

preservative.

 

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