OmegaThreeFattyAcids < Kitchen

03 Feb 2006 - 22:51

and now for something completely different...

I think Carolyn & I have ESP.

I'm serious.

A few days ago I read an article on fish consumption, IQ, & pregancy in THE ECONOMIST ($). I set it aside because I wanted to write a post about it.

Then yesterday Ed told me we're almost out of omegabrites, and today my cod liver oil for Jimmy & Andrew came in the mail.

AND: I just opened an email from Carolyn to find that she's wondering about fish oil for Ben! (Of course, Carolyn probably read the same article I did....)

My answer is: fish oil for everyone.

brain food

I found out about the Omega 3 fatty acids a few years ago, and was immediately convinced. Since then, the data has just kept coming, all of it good. On my Bayesian scale of certainty, 1 being No Clue and 7 being Death and Taxes, I'm at 7.

Fish oil is one of those 'Lost Knowledge' things....by which I mean that it belongs to the store of cultural knowledge people used to have that's gone missing. (Flash poll: how many women here can name the different cuts of meat in a side of beef? I can't. People used to know this stuff!)

My mom told me that when she was a kid, people gave cod liver oil to their kids, because they considered it 'brain food.'

Well, guess what. It is brain food. But that idea got lost somewhere along the line.

Here's the connection.

Probably everyone here knows that, at some point, the NIH funded research on fish consumption and heart health, which found that high fish consumption was good for your heart.

From there it followed directly that high fish consumption would likely be good for your brain, too, since researchers had already noticed a number of connections between heart health & mental health. For instance, people who suffered heart attacks were likely to suffer depression, too (IIRC I think the connection worked the other way around, as well).

Although people knew these correlations existed, I gather it took researchers a little while to put two and two together. But finally someone did, and the NIH funded, I believe (NOT FACT-CHECKED) an epidemiological study of fish oil consumption and depression. It turned out that there are very low rates of depression in countries and communities with high rates of fish consumption.

Andrew Stoll

I no longer remember when Andrew Stoll came on the scene, but I do remember his story.

Stoll is an expert on bipolar disorder, which meant he was prescribing a lot of lithium to patients. Lithium has numerous side effects; it's a tough drug to take, and can be quite dangerous. (It's a naturally-occurring salt.) IIRC, he and a colleague wanted to find a substance that would work like lithium with fewer side effects.

Apparently there is an enormous, multi-volume dictionary or encyclopedia of all known chemicals, so Stoll and his colleague starting searching through known chemicals to find something that might mimic lithium.

They found that the one chemical closest in structure to lithium was omega 3 fatty acid. Their study of Omega 3 fatty acid used to treat bipolar patients was published in the Archives of General Psychiatry, one of the two best journals in the field.

Three-page excerpts from every chapter of Stoll's book, The Omega-3 Connection, are posted on the omegabrites website. Terrific book.

We buy all of our fish oil from OmegaBrite, because it's manufactured by Stoll's ex-wife and because it's pharmaceutical grade, meaning it can be prescribed by physicians. This may mean nothing in terms of insurance; I don't know. I've never tried to get reimbursement. 'Pharmaceutical grade' in the case of omegabrites means the product can be used in an NIH-funded study.

IIRC, Stoll had a lot of trouble rustling up enough pharmaceutical-grade fish oil to do the study in the first place. I think he had to get the stuff he used from the people who did the heart study....Then, because there was no pharmaceutical commercial-grade product available on the market, his wife, who is also a psychiatrist, decided she would manufacture it herself & start up a whole company. I'm glad she did, but I don't think it's been fun for them.

pharmaceutical grade liquid fish oil?

That reminds me.

I spent years poking holes in zillions of omegabrite capsules every morning so I could squeeze out the oil inside into grape juice & give it to Jimmy and Andrew.

Those days are over.

The last time I spoke to Andrew Stoll, who is a friend of John (Ratey)'s, he said they were going to try to make a liquid version. I'm still waiting.

A couple of months ago I finally gave up and bought some Nordic Natural Complete Omega-3.6.9 oil.

Then I remembered my mom liked Carlson Norwegian Cod Liver Oil, which is what came in the mail today.

I have no idea way of judging their quality. I could use advice.

no more asthma

Fish oil has two important properties of which I'm aware; I'm sure there are lots more:

it is a natural antiinflammatory

it is liquid at very low temperatures

The natural antiinflammatory characteristic means, basically, that fish oil is a cure-all.

For at least the past 10 years researchers & physicians have been focused on inflammation as the source of all evil.

Eventually people began looking into inflammation as a problem for the brain, as well, and I'm sure it is.

Fish oil is a phenomenal antiinflammatory. When we first moved to Westchester Ed, Christopher & I developed asthma. Actually, I'd already had fairly severe asthma for about 10 years, but it had never been diagnosed. People kept telling me I had bronchitis. When Christopher was 4, he spent July 4 having an asthma attack so bad he was throwing up, which, unbeknownst to me, is the Danger Point. He could barely breathe.

All three of us were using inhalers every day when we started taking omegabrites.

Within a few months, all 3 of us had stopped using inhalers.

I think there may be a cumulative effect as well, because for a few years there we'd still have to get on the inhalers every time any of us came down with a cold.

Now we don't need inhalers for colds, either.

Another miracle cure: my mom's bursitis is gone. Bursitis is an inflammatory disorder.

Andrew Stoll's dad, who was in his 70s or 80s when I met him, told me his arthritis was gone. This stuff works.

fluid brain membranes

I don't think anyone knows exactly what Omega 3 fatty acids do in the brain, but one thought has to do with membrane permeability.

Mostly, Americans eat Omega 6's. That's corn oil. We eat HUGE quantities of corn oil, which is fine by me, since my dad was a farmer who raised corn. I've got nothing against corn!

But we're almost certainly way out of whack; we're supposed to be getting a lot more Omega 3s, and a lot less Omega 6.

Here's the way I think about the brain & Omega 3s.

Why don't salmon freeze up stiff as a board when they're swimming around the North Pacific waters?

Because they're made of fish oil.

Now picture a salmon made of margarine.

He's froze-solid, isn't he?

Stoll and others (IIRC) think it's possible fish oil is good for the brain because it replaces Omega 6s in cell membranes, which are made of fat.

If you're eating margarine, your brain cell membranes are made of margarine.

If you're eating fish, your brain cell membranes are made of fish oil.

Apparently, it's good to be a fish.

I have no idea whether this hypothesis is still current, but it's highly motivating. Every time I pull up an image of a semi-sold margarine brain I get serious about sticking with my fish oil regimen.

fish oil, pregnancy, IQ

I think Terri mentioned that they hope to have one more baby, so I wanted to get this study posted.

from THE ECONOMIST story:

...the amount of omega-3 in a pregnant woman's diet helps to determine her child's intelligence, fine-motor skills (such as the ability to manipulate small objects, and hand-eye co-ordination) and also propensity to anti-social behaviour.
[snip]
That, at least, is the conclusion of Joseph Hibbeln, a researcher at America's National Institutes of Health who has been working with a set of data from the Avon Longitudinal Study of Parents and Children. The Avon study was begun 15 years ago by Jean Golding, of the University of Bristol, with the aim of unravelling the genetic and environmental pathways that predispose children to disease. It contains data on 14,000 expectant mothers and their offspring.
[snip]
...the children of those women who had consumed the smallest amounts of omega-3 fatty acids during their pregnancies had verbal IQs six points lower than average...the finding is particularly pertinent because existing dietary advice to pregnant women, at least in America, is that they should limit their consumption of seafood in order to avoid exposing their fetuses to trace amounts of brain-damaging methyl mercury.
[snip]
Dr Hibbeln, however, says his work shows that the benefits of eating such fish vastly outweigh the risks from the mercury in them. Indeed, in the Avon study, it was those children exposed to the lowest levels of methyl mercury who were at greatest risk of having low verbal IQ....at 3½ years of age, those children with the best measures of fine-motor performance were the ones whose mothers had had the highest intake of omega-3s. Their third finding was that a low intake of omega-3s during pregnancy led to higher levels of pathological social interactions such as an inability to make friends as a child grew up.
....the “frightening data” showed how 14% of those seven-year-olds whose mothers had had the lowest intake of omega-3s during pregnancy demonstrated such behaviour, compared with 8% of those born to the highest-intake group.

converging lines of evidence

Studies such as this one, which rely on correlating one variable with another, are not enough to draw firm conclusions on their own, since correlation is not necessarily causation. But these results are supported by several lines of data. One is that the graphs show “dose response” curves—in other words, different levels of omega-3s have different effects. There is also a lot of experimental work showing that omega-3s have behavioural effects on adults. One of Dr Hibbeln's other studies, for example, showed that omega-3 supplements given to violent alcoholics reduced their anger levels by a third within three months

serotonin & dopamine hypothesis

It also helps to have a plausible mechanism, and Dr Hibbeln thinks there is one. Research published in 2000 by a group in Canada showed that giving omega-3 supplements to piglets doubled the levels of molecules called serotonin and dopamine in the frontal cortexes of the animals' brains. One of serotonin's jobs is to show growing nerve cells how they should connect from the frontal cortex, where reasoning takes place, to the limbic system, the seat of many emotional responses

yuck

there is a second way that its level might be reduced—by competition with a similar group of fatty acids called omega-6s. Indeed, it may be the ratio of omega-3 to omega-6 in the membranes of cells—particularly nerve cells—which is at the root of the problem, since this can affect the ability of messenger molecules to pass through the membrane. The average cell membrane of an American, whose diet is low in fish and high in omega-6-rich vegetable oils, contains 20% omega-3-based lipids and 80% omega-6-based ones. (Some 10% of American calories now come from linoleic acid in maize and soya oils, the principal sources of omega-6s.) In a Japanese cell membrane, by contrast, the figures are 40% and 60% respectively.

words to live by

I love this.

Here's the title of Dr. Hibbeln's talk to the McCarrison Society:

The impact of deficiencies of omega-3 fats on homicide, suicide, depression and greater risk of developmental trajectories towards lifelong psychopathy

I think I'll go pour Jimmy & Andrew a slug of their yummy new Norwegian cod liver oil right this minute.

autism & bipolar disorder & fish oil

Which reminds me.

I may have mentioned that Robert DeLong believes autism is caused by the genes for bipolar disorder expressed early in life, when the brain is still developing, instead of later on.

I believe him. When I say I 'believe' him, I mean I think that's what autism IS: autism is bipolar disorder expressed at birth or sometime around there. Until someone proves DeLong wrong, autism = bipolar is my personal hypothesis.

In an article in the March 23 issue of the journal Neurology, [ed.: I think this refers to the 1998 study] DeLong presents a new hypothesis that about two-thirds of children with the most common form of infantile autism actually have a treatable, genetically linked, early-onset form of severe depression. The argument is based on recent genetic analyses, behavioral studies and brain chemistry and imaging analyses on autistic children by researchers at Duke and several other institutions.

Antidepressants Can Break Through the Wall of Many Children's Autism, Duke Researchers Say

gold strike

I've just discovered DeLong has a recent publication on this subject. I've been out of the loop; I had no idea.

wow. It's a review article. So I've got this evening's reading all picked out.

Family history studies of autism consistently reveal a large subgroup with a high incidence of major mood disorder in family members, suggesting the two entities are related clinically and genetically. This review examines this concept, comparing current clinical and biological knowledge of autism and major mood disorder, and advances the hypothesis that this subgroup of autism represents an early-life phenotype of major mood disorder. If confirmed, this hypothesis would suggest that the basic biological defects determining major mood disorders may have prominent neurodevelopmental and cognitive dimensions. Testing of the hypothesis will depend on genetic studies.

The entire text is here: Autism and Familial Major Mood Disorder: Are They Related? J Neuropsychiatry Clin Neurosci 16:199-213, May 2004

in a nutshell

fish oil is good for the brain

fish oil may be especially important for pregnant women

fish oil is probably good for every aspect of brain function, including mood and cognition

we have strong evidence that fish oil treats bipolar disorder

we have very strong evidence (strong as in almost certainly definitive) that autism tracks with mood disorders

since fish oil treats bipolar disorder, it may well treat autism as well

if you're taking fish oil supplements you need to take Vitamins C & E, too. I forget why

American brain: 20% omega-3-based lipids, 80% omega-6-based ones

Japanese brain: 40% and 60%

No wonder we can't do math.

nix on the flax seed oil AND Vitamins C & E

A couple more factoids.

First, if you're taking fish oil supplements, you should take Vitamins E & C, too. I've forgotten why. There's some wonky mechanism where you can end up producing more free radicals (or something) & damaging brain cell membranes, etc.....obviously, I remember essentially nothing of this except that you're supposed to take E & C along with.

Second, I would skip the flax seed oil. First of all, it's different from fish oil somehow....I forget why.

But also, a psychiatrist friend of mine told me she'd heard from other psychiatrists that flax seed oil can actually cause mania.

That was interesting to hear, because I once gave Jimmy & Andrew big honking doses of flax seed oil & they were both up for the entire night, manic as all get out.

update from ktm guest

"So if flaxseed oil isn't good (and I had heard that it wasn't), then what would vegetarians take in order to get a healthy dose of Omega 3s?"
Flax is a good source of ALA, but not EPA and DHA. Fish oil is a good source of EPA and DHA. All three of these are omega-3 fatty acids. ALA can be converted to EPA and DHA, but it doesn't seem like this works very well when humans eat flax oil (according to some researchers). If you're a vegetarian then you're probably just screwed as far as finding a good source of EPA and DHA goes and you'll have to just stick with flax. Maybe there's some way of convincing the ALA to convert to EPA and DHA more readily.
"Is cod liver oil a liquid source of Omega 3?"
Yes. it is about 11% DHA, 7% EPA.

Thank you!

(This is exactly what I recall reading, btw. I also remember - NOT FACT CHECKED that grazing animals like cows can convert ALA to EPA & DHA. That's why cows don't need to eat fish.)

update from Ann

If you go back to the Omegabrite website, they now have OmegaBrite Kidz Tutti-Fruitti or Orange Cream flavor liquid omega 3 for kids. They only have to take 1/4 tsp.

I can't believe I didn't see that!

I'm thrilled.

Of course, first we're going to have to use up our two big honking bottles of Carlson's Norwegian cod liver oil.

The omegabrite website is new and improved. They seem to have posted abstracts of most or all of the psychiatric and cognitive research on the Omega 3s.

Here's where the research stands on autism and Omega 3 fatty acids:

At present, although omega-3 polyunsaturated fatty acids are considered to be a promising therapeutic for autistic children (Kidd, 2002; Richardson and Ross, 2000), the best evidence currently available to support this claim comes from research showing that autistic children have lower DHA levels in blood than children with mental retardation (Vancassel, et al 2001; Bell, et al 2000). Additional support comes from evidence that low plasma omega-3 levels in boys were associated with behavior problems, temper tantrums, and sleep disorders (Stevens, et al 1996).

I should add that I don't see any particular changes in Jimmy & Andrew thanks to fish oil.

I give it to them because it's obvious to me that Omega 3 fatty acids are critically important for the brain, period - and because I do see obvious changes in me thanks to fish oil.

Jimmy & Andrew have such severe forms of autism that I don't think it would be pretty hard to see subtle improvements.

update: Andrew & cod liver oil

Since we have some parents with autistic kids reading the site, I think I should post this.

Both Andrew and Jimmy are highly sensitive to medication changes.

I ran out of my Nordic Natural liquid fish oil a couple of months ago, and didn't get around to ordering new fish oil until last week.

I ordered Carlson's cod liver oil.

Yesterday I gave Andrew 1 tsp, and he had a horrendous half-day. Then he settled down sometime in the afternoon, and was pretty good.

This morning he's been great.

Twenty minutes ago I gave him 1 tsp of Carlson's cod liver oil, and now he's screaming & tantruming.

So.

I don't know what to make of this.

Either he's 'getting readjusted' to fish oil, or he's not supposed to be taking cod liver oil.

I don't remember problems like this with the Nordic Natural product. (Which is not to say they didn't happen. We have so much tantruming & screaming that we often miss the cause.)

Jimmy's been fine both days. But he's 18, and much more stable than Andrew at this point. (fyi: Andrew is 11. He is Christopher's twin.)

I have no idea whether Andrew's tantrums are connected to the cod liver oil.

However, I'll probably go ahead and order the new Omegabrite produce & switch him to that. Jimmy can use up the cod liver oil....

update: Andrew's fine, too

There's obviously no problem with Andrew taking Carlson's product.

update: The Omega Plan

Joseph Hibbeln recommends Artemis P. Simopoulos & Jo Robinson's book, which was the first book I read about the Omega 3s. Simopoulos also did NIH-funded research on the Omega 3 fatty acids, IIRC.

I thought it was terrific.

Nordic Cod Liver Oil from Kirkman Labs

Nordic Naturals Omega 3 oil from iherb.com

Carlson Norwegian Cod Liver Oil

Jo Robinson website (coauthor of OMEGA PLAN)

while we're on the subject of Jo Robinson —

I also like her book When Your Body Gets the Blues very much.

Check out her research page - wonderful stuff on light, mood, & weight (though I can't find the study they used to have posted showing weight loss from sitting in the sun....). The original 'body blues' study is here.

WHEN YOUR BODY GETS THE BLUES is the other alternative-medicine self-help book I believe absolutely.

Ever since reading the book, I try to get all 3 kids outdoors in the sun for 20 minutes every day.

These study findings suggest that a program of moderate-intensity walking, increased light exposure, and selected vitamins can improve women's mood. The high level of adherence to the intervention suggests that women could comfortably incorporate this tri-modal program into their daily lives. These findings extend the work of other studies that have demonstrated the positive influence of each independent component (light, exercise, and vitamins) on mood (Kripke 1998; Wirz-Justice et al. 1996; Blumenthal et al. 1999; Moses et al. 1989; Benton, Fordy, and Haller 1995).
Women in the intervention group improved significantly compared to those in the control group on all five dependent variables that measured mood and well-being. Not only did their depression scores decrease, they also reported greater self-esteem, improved general well-being, and greater happiness.
We were particularly interested in determining whether the intervention addressed symptoms more prevalent in women than men, such as anxiety and fatigue. The subscales of the POMS showed that the women in the intervention group experienced a significant decrease in anger and tension. Meanwhile their vitality improved, as measured by the GWB subscales.

Omega 3 fatty acids
brain food

-- CatherineJohnson - 03 Feb 2006

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I thought they took cod liver oil for regularity.

-- GoogleMaster - 03 Feb 2006

I think another major driver for giving cod liver oil was as an incentive.

"I'm sick. I can't go to school."

"Oh, dear. Well, if you're sick, you'll need to stay in bed; and I'll get the cod liver oil."

"Ummm, I think I feel better now."

-- DougSundseth - 03 Feb 2006

"It turned out that there are very low rates of depression in countries and communities with high rates of fish consumption."

This one looks suspect to me. From the World Health Organization's page on Suicide Rates, which lists the rates in 100 countries, we see these:

Lithuania: #1 Latvia: #4 Estonia: #9 Japan: #11 Finland: #12 Sweden: #33 Norway: #35 Iceland: #37

While this shouldn't be taken as the end of the story, it makes me wonder. (See our recent discussions about facially odd statistics.)

Obviously, there are lots of confounding factors in such a crude measure, but I'd want to see a pretty strong study.

-- DougSundseth - 03 Feb 2006

With Scandinavia, you're dealing with the 3-6 months of near darkness, of course, which probably exacerbates the SAD effect.

So I googled "cod liver oil" and came up with some doozies.

Any time I see a headline like "Cod Liver Oil to Heal Autism (Vaccinations)", my skepticism-o-meter goes through the roof.

Researchers Retract a Study Linking Autism to Vaccination (because of insufficient data)

And less waffly: Newest Study Finds No Link Between MMR Vaccine and Autism

But I'm off track.

Ahh, here we go. "Cod liver oil is extracted from the liver of cod and is a supplement that many may remember being given as a child by parents (in the non-encapsulated form) to maintain bowel regularity. This practice is still quite common in many cold climate European countries." http://www.herron.com.au/products/nhc/codliveroil.html

Yikes, that site is selling it as an aid to reduce respiratory mucus and improve joint mobility.

The sheer amount of claims for cod liver oil sounds FISHY to me.

-- GoogleMaster - 03 Feb 2006

But most of the links I found did mention the "brain food" aspect.

-- GoogleMaster - 03 Feb 2006

Obviously, there are lots of confounding factors in such a crude measure, but I'd want to see a pretty strong study.

I think it's pretty strong. These are major folks.

-- CatherineJohnson - 04 Feb 2006

But most of the links I found did mention the "brain food" aspect.

I had never heard a word of that until my mom told me.

-- CatherineJohnson - 04 Feb 2006

Lipids, Depression, Suicide

(There's a more readable version on PubMed)

-- CatherineJohnson - 04 Feb 2006

CONCLUSIONS: Some epidemiological, experimental and clinical data favour the hypothesis that polyunsaturated fatty acids could play a role in the pathogenesis and/or the treatment of depression. More studies however are needed in order to better precise the actual implication of those biochemical factors among the various aspects of depressive illness.

-- CatherineJohnson - 04 Feb 2006

Serum Lipid Levels in Patients with Dissociative Disorder (so I'll remember the link - cholesterol, not Omega 3s)

-- CatherineJohnson - 04 Feb 2006

brain food!

The first evidence comes from studies in Japan of mice. In an initial experiment, the researchers studied a group of prematurely aging mice they called SAM-P because they were genetically “senescence prone,” (wired to age prematurely). The SAM-P mice showed age-related impairments in memory and learning far earlier than normal mice. Yet when fed perilla oil (from the perilla plant, which contains high levels of the omega-3 fatty acid alpha-linolenic acid), the SAM-P animals were able to learn significantly more effectively than their genetically similar SAM-P siblings fed safflower oil (a source of omega-6 fatty acids). The improved profile for learning with the omega-3 supplement led the researchers to wonder just what kind of mechanism was operating. Had the ability to learn and remember really improved or were the mice merely performing on target thanks to a positive emotional state, including reduced anxiety?

To find out, they decided to test SAM-R (for “senescence-resistant”) strains of mice, which do not show age-related deterioration of learning and memory. The team again fed the mice either perilla oil or safflower oil over the course of two generations, and then tested them for hyperactivity, exploratory behavior, and learning, among other traits. The researchers found that the SAM-R mice fed safflower oil (omega-6) were more hyperactive than those on perilla oil (omega-3) but scored lower when it came to actual exploration of the environment. The more hyperactive the mice were, the less likely they were to display normal, adaptive exploratory behavior.

Mice supplemented with omega-3 oils were also better learners. In one experimental setup, mice were trained to push a lever in response to cues of light or dark; correct responses were rewarded with pellets of food. As the test went on, the mice given omega-3 supplements made significantly fewer mistakes. They were also better at responding when the conditions of the experiment changed. When scientists stopped delivering the pellet reward after numerous trials, the omega-3-supplemented mice noticed the change and adjusted their behavior accordingly, while the safflower-oil-fed, unsupplemented mice did not.

Fat for Thought

Human studies parallel the findings in mice and rats. The most compelling evidence comes from psychologist David Benton, a professor at the University of Wales in the United Kingdom. Benton has found that low-fat diets in general often impede reaction times, memory, and cognitive skills. In a study of 9,003 British participants, for instance, he found that people who consumed more fat, including saturated fat, could react more rapidly to stimulation. In a related study of 153 women, he found lower cholesterol levels—known to lower risk of heart disease— were nonetheless also associated with slower reaction time. Finally, in a recent controlled study of 285 healthy young women, he found that vigilance—attention to task—was significantly enhanced for those on 400 milligrams of DHA a day versus those taking a placebo sugar pill.

Most researchers have traditionally focused on DHA, not EPA, in studies of brain function since DHA is heavily incorporated into the cell membranes of neurons. But fish oil often contains more EPA than DHA. EPA is both incorporated into cell membranes and circulated in the bloodstream, bathing all parts of the body, including brain tissue. Also, the body of someone who is deficient in omega-3 fatty acids will hold on tightly to DHA while EPA levels continue to drop. It is important to remember that even though less EPA is incorporated into membranes than DHA, the EPA that is in the membrane is highly active and has a rapid turnover rate.

-- CatherineJohnson - 04 Feb 2006

yikes

Rejuvenating the Brain

The most exciting finding, it turns out, may be new hope for revving the engine of the aging brain. As the senescent-prone mice illustrate, aging impairs not just memory but also the rapidity and accuracy of thought. Gerontologists on the trail of cognitive decline in humans have focused on a few biochemical factors, including polyunsaturated fats (omega-6 and omega-3 fatty acids). To test the theory that omega-3 fatty acids keep the brain active longer, a team of Dutch scientists studied cognition in a group of men aged sixty-nine to eighty-nine. The men were part of what is known as the Zutphen Elderly Study, which looked at risk factors for chronic diseases in men who live in Zutphen, a town in the eastern part of the Netherlands. Interestingly, the Zutphen Elderly Study is a continuation of the original Zutphen Study, initiated in 1960 as the Dutch contribution to the famed Seven Countries Study that examined nutrients and disease across a range of cultures. This aging group of men with a wealth of health data and well-- documented nutritional profiles was ideal for investigating the impact of omega-3 fatty acids on lifelong maintenance of brain function.

With that in mind, the researchers set out to interview the Zutphen men, documenting their dietary habits in the spring of 1985 and then assessing their cognitive skills in 1990 and again in 1993. The original group consisted of 1,266 men; 555 subjects (44 percent) were still alive in 1985. However, only 342 men (27 percent) were available for the final cognitive assessment in 1993.

The results painted a sobering picture of the aging brain. Thirty-two percent of the surviving subjects were cognitively impaired in 1990, with the oldest and least educated the most impaired of all. The scientists found that the cognitive decline did not alter diet in these men; they ate the same general diet after impairment as before. When the data were analyzed, it became apparent that certain foods—including margarine, butter, baking fat, sauces, and cheese—placed subjects at especially high risk for later cognitive impairment.

The connection between cognitive impairment and fatty acid intake was especially striking: the average intake of total fat and certain polyunsaturated fatty acids (especially linoleic acid, an omega-6 oil) was higher in subjects with cognitive impairment while the intake of fish, EPA, DHA, and total energy was low. Stated another way, high consumption of fish was associated with less cognitive impairment. This makes sense because high levels of the omega-6 arachidonic acid can be neurotoxic. Surprisingly, there was no detectable relationship between lower cognitive impairment and consumption of any of the antioxidants (such as vitamins C and E) thought to protect the brain.

-- CatherineJohnson - 04 Feb 2006

found the citations for two of the main epidemiological studies (also published in the ARCHIVES):

Fish consumption reduces suicide risk

KUOPIO, FINLAND. Researchers at the University of Kuopio report that regular fish consumption reduces the risk of depression and suicide. Their study involved 1767 Finnish men and women who were evaluated for depression and suicidal tendencies using the 21-item Beck Depression Inventory. They were also asked about their fish consumption. The researchers conclude that people who consume fish twice a week or more have a 37 per cent lower risk of being depressed and a 43 per cent lower risk of having thoughts of harming themselves (suicidal tendencies).

The results are consistent with those of a large Japanese study involving 265,000 subjects who were followed up for 17 years. This study found a decreased risk of suicide among people who consumed fish daily. Dr. Andrew Stoll, MD of the Harvard Medical School points out that Icelanders who consume a lot of seafood have far lower rates of seasonal affective disorder (SAD) than do inhabitants of other countries situated at similar latitudes. Both Dr. Stoll and the Finnish researchers urge large-scale trials to conclusively determine whether it is appropriate to recommend increased fish intake or fish oil supplementation to depressed people or indeed to the population as a whole. Tanskanen, Antti, et al. Fish consumption, depression, and suicidality in a general population. Archives of General Psychiatry, Vol. 58, May 2001, pp. 512-13

there are several abstracts of DHA & Omega 3 fatty acid research at that link. here's another:

Omega-3 fatty acid deficiency linked to depression SHEFFIELD, UNITED KINGDOM. The composition of cell membranes has a profound effect on membrane-related proteins such as enzymes and receptors and there is considerable evidence that cell membrane structure is a significant factor in depression. This structure in turn is highly dependent on the presence of certain essential fatty acids, notably docosahexaenoic acid (DHA).

Researchers at the University of Sheffield and the Efamol Research Institute in Nova Scotia now report that they have found a highly significant association between severity of depression and the levels of omega-3 fatty acids in both the diet and the red blood cell membranes.

Their study involved 10 patients with major depression and 14 healthy control subjects with no history of psychiatric disorder (average age of participants was 39 years). All participants had blood samples taken and analyzed for essential fatty acid (EFA) content and also completed a questionnaire to determine their dietary intake of EFAs over the 7 days prior to enrollment.

The severity of depression was found to be inversely proportional with the red blood cell level and dietary intake of omega-3 fatty acids. The correlation between a low level of alpha-linolenic acid in blood cells and depression and between low blood cell levels of DHA and depression were particularly strong. No correlation was found between red blood cell levels of omega-6 fatty acids and depression. However, there was a slight positive correlation between dietary intake of omega-6s and severity of depression when both patients and controls were considered in one group. The researchers conclude that low levels of omega-3 fatty acids in cell membranes are associated with depression. They speculate that supplementation with omega-3 fatty acids may be useful in alleviating depression. Edwards, Rhian, et al. Omega-3 polyunsaturated fatty acid levels in the diet and in red blood cell membranes of depressed patients. Journal of Affective Disorders, Vol. 48, 1998, pp. 149-55

pdf file for DeLong's paper

-- CatherineJohnson - 04 Feb 2006

I have to go choke down some omegabrites

blecch

-- CatherineJohnson - 04 Feb 2006

This is interesting:

Dr. Joseph Hibbeln is a psychiatrist, lipid biologist and chief of the outpatient clinic at the National Institute on Alcohol and Alcohol Abuse, part of the National Institutes of Health. He studied epidemiological data about the rates of diseases and average diets in different parts of the world, and learned of an astonishing link between Omega 3 fatty acids in our diet, and mood disorders like manic depression and depression. Dr. Hibbeln found that diets high in fish were very strongly correlated with freedom from depression. We eat very differently from our ancestors over the last two to three million years, who consumed far less saturated fats and much more Omega 3 unsaturated fatty acids, which occur in leafy green vegetables and fish. In the last hundred years we've seen a radical increase in coronary heart disease, commonly understood to be linked to dietary changes. Dr. Hibbeln attributes the parallel increase in depression to a dietary lack of Omega 3 fatty acids. He cites a recent study of unstable bipolar patients, just discharged from the hospital. In the group receiving a placebo, eight out of fifteen relapsed, but in the group receiving the Omega 3 fatty acids, only one out of fifteen relapsed. (Both groups were on common antidepressant drugs.) Dr. Hibbeln finds that other epidemiological studies show a link between high fish consumption and a low incidence of post-partum depression. He notes that infant formulas in the U.S. are very low in the Omega 3 fatty acids. Since the fatty acids are selectively depleted from the brain by alcoholism, their lack may worsen other disorders in alcoholics. He recommends substituting olive oil for corn and soy oil, and eating fish every one or two days. It should be baked, broiled, poached, but not fried. The highest food source of Omega 3 fatty acids is caviar, with sardines coming in second. Mackerel, halibut, and salmon are all good sources.

For more information, Dr. Hibbeln suggests the book The Omega Plan, by Artemis Simopoulos, published by Harper Collins.

I assume he's talking about The Omega Plan, which is a terrific book.

-- CatherineJohnson - 04 Feb 2006

Catherine,

How many pills do you take in one day?

The amount they suggest seems high.

-- JoAnneC - 04 Feb 2006

So if flaxseed oil isn't good (and I had heard that it wasn't), then what would vegetarians take in order to get a healthy dose of Omega 3s? Or people allergic to seafood?

-- SamanthaRawson - 04 Feb 2006

I am also confused. Is cod liver oil a liquid source of Omega 3? If not, what is?

Thanks for all the info by the way. I have printed out your post and the article from the journal.

-- AnneDwyer - 04 Feb 2006

"So if flaxseed oil isn't good (and I had heard that it wasn't), then what would vegetarians take in order to get a healthy dose of Omega 3s?"

Flax is a good source of ALA, but not EPA and DHA. Fish oil is a good source of EPA and DHA. All three of these are omega-3 fatty acids. ALA can be converted to EPA and DHA, but it doesn't seem like this works very well when humans eat flax oil(according to some researchers). If you're a vegetarian then you're probably just screwed as far as finding a good source of EPA and DHA goes and you'll have to just stick with flax. Maybe there's some way of convincing the ALA to convert to EPA and DHA more readily.

"Is cod liver oil a liquid source of Omega 3?"

Yes. it is about 11% DHA, 7% EPA.

-- KtmGuest - 05 Feb 2006

If you go back to the Omegabrite website, they now have OmegaBrite Kidz Tutti-Fruitti or Orange Cream flavor liquid omega 3 for kids. They only have to take 1/4 tsp. I ordered some. I'll let you know how it is.

-- AnneDwyer - 05 Feb 2006

AND: I just opened an email from Carolyn to find that she's wondering about fish oil for Ben! (Of course, Carolyn probably read the same article I did....)

Yep -- that's right, I did, and it got me thinking.

-- CarolynJohnston - 05 Feb 2006

I hate fish.

And I hate taking vitamins.

Grump.

-- CarolynJohnston - 05 Feb 2006

Hi Jo Anne

I take 5 pills a day, and so does Ed.

It's disgusting.

Stoll used something like - was it 13 grams a day?

No.

It was 9 grams.

That's huge.

I think each capsule is one gram.

Anne

I can't believe you found the liquid!

I had no idea!

That's fantastic.

YEARS of my life poking pins into gelcaps.

-- CatherineJohnson - 05 Feb 2006

Cod liver oil BETTER be full of Omega 3 fatty acid, seeing as how I just ordered two immense bottles of the stuff.

-- CatherineJohnson - 05 Feb 2006

On my Bayesian scale of certainty, I'm at about a 2 on this.

I've heard lots and lots and lots of cases of food products that are meant to solve a massive array of problems.

All backed up by studies and personal testimonies too.

I was having massive problems with my skin - ecezma. Tried several natural and dietary remedies. Then I got my doctor to prescribe some Elcon. Skin problems died away, I stopped using the Elcon, and they haven't come back again, although I was still living the same lifestyle and gave up the special diet.

When my brother was in PTA, a woman was seriously trying to push my parents into giving him something like "glyconutrients". Oh, and they should be taking it too. At something like $100 a week. Dad was being his normal skeptical self, and completely oblivious to her pressure. Mum was more affected. Before they made a decision to try the glyconutrients, my brother came out of PTA and staged as miraculous recovery as was ever promised by the glyconutrients.

-- TracyW - 06 Feb 2006

Here's the final word on nutrition and health. It's a relief to know the truth after all the conflicting medical studies:

1. The Japanese eat very little fat and suffer fewer heart attacks than Americans or British.

2. The Mexicans eat a lot of fat and suffer fewer heart attacks than Americans or British.

3. The Chinese drink very little red wine and suffer fewer heart attacks than Americans or British.

4. The Italians drink excessive amounts of red wine and suffer fewer heart attacks than Americans or British.

5. The Germans drink a lot of beer and eat lots of sausage and suffer fewer heart attacks than Americans or British.

CONCLUSION: Eat and drink what you like. It's speaking English that kills you.

-- TracyW - 06 Feb 2006

"CONCLUSION: Eat and drink what you like. It's speaking English that kills you."

That's hilarious. I laughed out loud at the surprise ending!

-- KarenA - 06 Feb 2006

CONCLUSION: Eat and drink what you like. It's speaking English that kills you.

How do the Aussies and Kiwis compare to the Americans and British in heart attack rates?

-- GoogleMaster - 06 Feb 2006

When I was a kid, my brother and I had to take Norwegian cod liver oil -- LIQUID -- to ward off colds. My mom tried to make it better by having us suck on an orange slice afterward, but the only thing that happened was that later in the day we would burp orange-tinged cod liver oil. When the capsules came out for the first time, we were thrilled. We still burped, but at least that slime didn't coat our tongues on the way down.

I can also safely attest that the "regularity" claims are bogus.

-- BrendaM - 06 Feb 2006

I think you're better placed to answer that question than I am, Google Master.

I don't know. I presume NZ isn't that bad since I don't recall numerous newspaper articles worrying about the high rate of heart attacks. I really don't know about the Aussie rates.

-- TracyW - 06 Feb 2006

Tracy

oh gosh, yes, your experience is typical

the instant you've got brain 'issues' (DING! DING! DING! FAVORITE KTM EXPRESSION!) you're going to hear about glyconutrients and all the rest of it.

The heck of it is, it's probably going to turn out to be true.

I say that as a person who was skeptical for YEARS.

-- CatherineJohnson - 06 Feb 2006

Speaking English WILL kill you!

-- CatherineJohnson - 06 Feb 2006

Everyone knows that.

-- CatherineJohnson - 06 Feb 2006

Brenda

I can also safely attest that the "regularity" claims are bogus.

Is that right?

Interesting.

-- CatherineJohnson - 06 Feb 2006

The basic BAYES-INVOKING thing to remember here is: cell membranes are made of Omega 3 fatty acids.

-- CatherineJohnson - 06 Feb 2006

AND.....the folks researching this stuff are big-time, Harvard, NIH, Science Brain types.

Seriously.

-- CatherineJohnson - 06 Feb 2006

AND.....the folks researching this stuff are big-time, Harvard, NIH, Science Brain types.

Ummm, that's nice for them.

But I don't believe much at all that comes out of nutritional research, regardless of how many science brains are involved. It always seems to be contradicted a few years down the track. It's probably:
- a gap between what people are eating/taking and what they say they're eating/taking
- too difficult to be sure you've controlled for all the other relevant differences.

What's the feedback mechanism? If these guys come up with the wrong linkage, how will they know? What will it cost them?

Plus when it comes to supplements, my opinion of the whole group is tainted because there are some evil people in there who think that carob can be called a subsitute for chocolate. I don't often use the word "evil", but I think this is a case. :)

-- TracyW - 06 Feb 2006

Aussie's have lower heart attack rates than either the US or Britain, but we're still pretty high.

-- SamanthaRawson - 07 Feb 2006

But I don't believe much at all that comes out of nutritional research, regardless of how many science brains are involved.

You will change!

I felt exactly the way you did for the longest time....and then I noticed that certain findings did 'track,' for want of a better word.

I've gotten so I can sometimes predict which studies will be contradicted, and which will stand. (I just scored a major success with the hormone studies - I must BOAST!)

Once you start being able to make predictions with some success, you realize it isn't all bunk; it's just early days in the field.

Stoll & Hibbeln aren't nutritional researchers. They're psychiatric researchers.

CAROB IS A WRETCHED, WRETCHED EXCUSE FOR CHOCOLATE.

-- CatherineJohnson - 07 Feb 2006

I think we can all agree on that.

-- CatherineJohnson - 07 Feb 2006

Aussie's have lower heart attack rates than either the US or Britain, but we're still pretty high.

You guys need to stop speaking English!

-- CatherineJohnson - 07 Feb 2006

OK, I'm going to SHARE!

This comes under the heading of Too Much Information, so some of you should look away.

Shortly after the twins were born I started taking birth control pills (WAY TOO MUCH INFORMATION)....and then I just kept right on taking them, on grounds that Estrogen Is Good.

After we moved to Irvington, I met Erika Schwartz, who is the Arnold Schwarzenegger of nutrients used as therapy & bioidentical hormone therapy.

She's great.

Because I'd met Erika (who was the physician on our health insurance plan at the time) I started using her bioidentical hormones.

Then I kept on using them.

Oh!

Here's the other part of the story.

The other 2 parts.

1. Back in L.A. (BRACE YOURSELVES: WAY TOO MUCH INFO AGAIN) I had a friend who went through menopause unbelievably early. I think she was 40 or something.

She'd been taking birth control pills for some reason....

One day she came over to my house, and we were hanging out, and at some point I looked at her face and thought, 'Gosh, she looks old.'

Now, I am a person who DOES NOT spend time assessing the old-looking-ness of her friends' faces.

BELIEVE ME.

I have zero incentive to look at friends and think: OLD.

About five seconds after I had this thought my friend mentioned that she'd stopped taking the pill.

I never got over that. The difference in a person's face between TAKING ESTROGEN SUPPLEMENTS and NOT TAKING ESTROGEN SUPPLEMENTS has stayed with me.

2. I once saw a photograph of what neurons look like in a mouse brain deprived of estrogen. ZERO DENDRITES, IIRC

These two experiences left me with the firm conviction that Estrogen Is Good, no matter what the Framingham study says.

So I've been using Erika's 'bioidentical' hormones ever since. (They're in cream form, made from plants, supposedly identical in chemical structure to human hormones.)

So flash forward to 2002, when the Women's Health Initiative finds out that women taking HRT have more heart attacks, not less.

You can imagine the hoopla around these parts. ALL women either stopped using hormones, or vowed never, ever to start using hormones.

I mean ALL. 100%. I didn't know a single woman, not one, who planned to 'defy' the Women's Health Initiative Study.

Except me.

I carried on using my groovy bioidentical hormone cream.

I carried on using my groovy bioidentical hormone cream because:

a) the study hadn't used groovy bioidentical hormone cream

b) the loss of estrogen is obviously a bad thing, not a good thing (except where breast cancer is involved, which is another story). So.....one study showing that HRT increases heart attacks doesn't overturn many, many years of research & experience showing that declining estrogen also leads to increased heart attacks. Something's wrong somewhere.

c) the reasoning behind using bioidentical hormones is that bioidentical hormones supposedly don't provoke an immune response, as non-bioidentical hormones do. (I don't know whether people know this for a fact, or whether they assume it to be true. In any case, the logic is sound.)

I used to tell people, "I figure either I'll be alive and my friends will be dead, or my friends will be alive and I'll be dead. Either way things are guaranteed not to work out."

So flash forward to now, and guess what?

Rethinking Hormones Again

Three and a half years after a landmark study stunned physicians by finding that hormone therapy had serious risks and did not prevent heart disease in postmenopausal women, many women continue to turn to hormones for relief. Many gynecologists continue to prescribe them as a first-line therapy for severe menopausal symptoms.

Debates over the study's findings remain heated, with doctors divided between those who believe in the power of hormone therapy to protect the heart and relieve menopausal symptoms and those who think that any heart benefits have been discredited.

Some researchers are testing a new theory, that hormone therapy is beneficial for the heart when it is initiated early, during a narrow ''window of opportunity'' around the time of menopause and before women develop an excessive buildup of atherosclerotic plaque.

A chief criticism of the hormone study, part of the national Women's Health Initiative, was that it included women much older than the average hormone user, who typically initiates therapy around the time of menopause. The average age of the participants in the study was 64. The average age of menopause is 51.4, and some studies suggest that women who initiate hormone therapy later may miss the chance to benefit from the treatment.

This month, a paper in The Journal of Women's Health added credence to that idea. It reported that women who started therapy soon after menopause reduced the risk of coronary heart disease 30 percent, but that the benefit appeared to diminish the longer women waited to initiate treatment. The paper, based on data from the Nurses' Health Study, the large observational trial that reported many years ago that estrogen protected women's hearts, suggested that timing the therapy was critical.

''We still don't have a final answer,'' said Dr. JoAnn^? Manson, the chief of preventive medicine at Brigham and Women's Hospital in Boston, an author of the new study and a principal investigator for the Women's Health Initiative.

The new report, she said, does not mean the findings of the health initiative are invalid, but that the picture is complex. Viewing hormone therapy as ''good for all women or bad for all women is an oversimplification,'' she added.

Many doctors, however, have already made up their minds. ''Personally, in my heart of hearts, I think there is a benefit,'' said Dr. Mary Jane Minkin, a clinical professor of obstetrics and gynecology at Yale. ''However,'' Dr. Minkin said, ''I'm politically incorrect if I say that.''

Still, she said, the tenor of discussion about hormone therapy at the annual scientific meetings of the North American Menopause Society in the fall was substantially different from the scene in 2002, when the figures from the Women's Health Initiative set off a hormone panic.

''Three years ago, the message was, 'You're going to die if you don't stop taking this,' '' said Dr. Minkin, who takes estrogen and is a paid speaker for drug companies that make the estrogen products she prescribes. At the meeting last fall, she said, the feeling was: ''Gee, estrogen is pretty good stuff. If you need it for relief, you shouldn't be afraid to take it.''

-- CatherineJohnson - 07 Feb 2006

This was a good moment for me in terms of trusting my Bayesian perceptions.

I'll add that in fact I don't know if using groovy bioidentical hormone cream actually is or is not a good idea, overall.

I'm guessing it is.

I had a brilliant friend in Los Angeles, a cardiology researcher at UCLA, who said there's tons of data showing that estrogen supplementation is terrible for you.

She said calcium supplements are bad, too. My mother-in-law has never gotten over that one.

She could absolutely be right.

In a nutshell, I've changed my orientation towards 'wellness' research in general.

I now believe there's much to be learned, and that almost certainly some of the studies & theories we have now are correct.

-- CatherineJohnson - 07 Feb 2006

Hormone replacement therapy is plastic surgery for poor people.

-- CatherineJohnson - 07 Feb 2006

Here is a link to a column titled, "Two Ways to Make a Kid Smarter" that popped up on msn today. It was written by Martha Brockenbrough, and one thing she advocates is eating foods rich in omega-3 fats.

http://encarta.msn.com/encnet/departments/elementary/default.aspx?article=twoways

-- KarenA - 07 Feb 2006

oh, wow

thanks!

-- CatherineJohnson - 07 Feb 2006

A study published in the journal Pediatrics showed that kids who took fish-oil supplements, which contain omega-3, showed huge improvements in spelling, IQ, and reading. Even their behavior got better.

-- CatherineJohnson - 07 Feb 2006

Omegas & worse behavior (at Well-Trained Mind)

-- CatherineJohnson - 07 Feb 2006

CAROB IS A WRETCHED, WRETCHED EXCUSE FOR CHOCOLATE.

Wit and Wisdom page. Definitely. Carob is not life-extending, it's life-ending.

-- BrendaM - 08 Feb 2006

I think we have achieved consensus.

-- CatherineJohnson - 08 Feb 2006

I just wanted to let everyone know that I got the Omegabrite kidz tutti frutti omega 3 liquid today. Both of my kids took it without any complaints. As a matter of fact, my notoriously picky daughter has convinced herself that it tastes like bubble gum.

-- AnneDwyer - 10 Feb 2006

wow

that's amazing

I'm using the Carlson's & it's fine. Andrew has been in great shape after his initial meltdown.

btw, I talked to a psychiatrist who's up on all these things yesterday.

She talked to another psychiatrist who doesn't like Omegabrites because Omegabrites use more EPA.....whereas standard fish oil products list towards DHA (something like that).

The other psychiatrist didn't have evidence, except for the fact that one or more of his family members have bipolar disorder and were doing better on the DHA formulations.

DHA is the part of Omega 3 fatty acid that is 'structural'; it stays put in your cell membranes. EPA is the part that's 'hormonal' in a sense; it goes throughout your body in the bloodstream. Most researchers had been thinking DHA was the critical component; Stoll's innovation was to say it's the EPA, not the DHA. This psychiatrist wasn't buying it.

My psychiatrist friend says Stoll (or rather his ex-wife, I assume) reformulated Omegabrites to have even more EPA....so I'm going to try to watch Jimmy & Andrew as closely as I can, and look to see whether maybe I want to list more towards DHA.

Several years ago I was paying a fortune to give them Neuromins, a fish oil formulation that was almost all DHA.

Then along comes Stoll saying DHA isn't what matters.....

-- CatherineJohnson - 10 Feb 2006

The ratio in the Omegabrites kids is 7:1 EPA to DHA. There was a flyer that came with it that explains why the ratio is this way (I must admit, I didn't pay attention.

I also found dried cranberries at Trader Joe's that have omega 3 in them. They take out the seeds, crush them into oil and put the oil back into the cranberries to give them omega 3. (I'm not making this up!)

-- AnneDwyer - 10 Feb 2006

"If you're a vegetarian then you're probably just screwed as far as finding a good source of EPA and DHA..."

I spoke too soon here. Apparently a company called Martek has a process for extracting DHA from a microalgae(Crypthecodinium cohnii). You can buy this oil from http://www.dhadepot.com/ . They could do something similar to get EPA, but a bit of searching doesn't reveal any products or companies doing it yet. My guess is that this is because DHA has a bigger market since it is commonly added to infant formula.

-- KtmGuest - 11 Feb 2006

Those are the neuromins!

I took those for years, and they're expensive as the dickens.

A good product, though.

The one problem with them is that they're mostly DHA, right? (Too sick to go figure it out at the moment.)

Neuromions are probably the ones you want to take if you're pregnant or contemplating getting pregnant

-- CatherineJohnson - 11 Feb 2006

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Title:	and now for something completely different...
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SubjectArea:	AutismAndAspergers, FromTheKitchenTable, LearningDisabilities, OffTopic
LogDate:	200602031750

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