Omega 3's and your mental

Last week, I highlighted in my latest blog post that research within the last decade has shown that nutritional deficiencies exist in those with mental health disorders and that one of the most common nutritional deficiencies is Omega-3 fatty acids. There are now tons of supplements and headlines promoting the need for Omega-3 fatty acids, but do you know why? Why is this particular kind of fatty acid so important and how does it affect our mental?

Fats have gotten so demonized in our culture and unfortunately it has led many people to not have them in their diets. Fats are one of the three macronutrients (the others being proteins and carbohydrates) that we need to fuel our bodies and our mental. Fats are classified into a few different categories: saturated, unsaturated, monounsaturated, and polyunsaturated. Omega 3 fats are one type of Polyunsaturated Fatty acid (PUFAs). In terms of it’s chemical composition, this class of fats (PUFAs) consist of long chains of carbon atoms with a carboxyl group at one end of the chain and a methyl group at the other end. There are three main types of Omega-3s, Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and Alpha-linolenic acid (ALA). ALA is present in plant oils, such as flaxseed, soybean, and canola oils, while DHA and EPA are found most abundantly in fish, fish oils and krill oils. One of the most important roles in the body that fats play is being a major structural component of every cell in your body (Read that again: FATS ARE STRUCTURALLY PART OF EVERY SINGLE CELL IN YOUR BODY). All of our cell membranes in our bodies are made up of fats (phospholipids). They are important because they separate the cells in the body from their outside (their membrane) and they facilitate the exchange of nutrients between cells. This wouldn’t happen if not for fats.

Following consumption of these fats, omega-3 fatty acids are incorporated into cell membranes in all tissues of the body. Whether the source of these omega-3 fatty acids is fish, fish-oil supplements or food products fortified with the appropriate omega-3 fatty acids, measurable changes in cellular membrane content occur within days of increasing the daily consumption of these fatty acids. Dietary changes that include healthful PUFAs have a significant impact on the cell’s function. These fats help important signaling and communication within and between cells. Specifically, DHA, being the most abundant Omega-3 found in the brain, has been shown to be crucial for maintaining nerve cell structure and function. Both EPA and DHA have been shown to help the brain support healthy memory, cognition and emotional well-being. EPA and DHA also promote healthy blood flow, which is essential for brain function and memory. EPA and DHA are being studied extensively to assess the wide range kind of effects these two Omega-3 fats have on the brain. For instance, a recent meta analysis found that although blood EPA, DHA and total Omega-3 PUFAs are significantly decreased in patients with dementia, only EPA was found to be significantly lower in patients with pre-dementia syndrome, leading the researchers to suggest that EPA may be a biomarker and a risk factor for age-related cognitive impairment. This suggests that your Omega-3 intake, specifically DHA, can help possibly prevent cognitive decline.

Let’s take a look at some studies to see what the research has to say about how Omega-3’s protect the brain. The Easton Center for Alzheimer’s Disease Research report examined levels of DHA in red blood cells in a group of over 1500 men and women aged 67 +/- 9 years who were dementia free. The study measured the size of their brains and evaluated the subjects using a variety of cognitive assessments. Results indicated that those individuals having the lowest DHA levels had significantly lower total brain volume and greater levels of small strokes in their brain compared to those with higher levels of DHA. Additionally, those individuals with lower levels of DHA performed worse on tests for visual memory and executive function.  This is more evidence that suggests that DHA protects our brain, allowing for optimal functioning despite the chronological aging process.

There is also evidence that Omega-3’s may be useful as a supplement for the treatment of bipolar disorder related depression and evidence that EPA-supplemented food is helpful in patients suffering depression. More research is needed to make this conclusive, since due to participant recall and diet-related systematic differences, there is complexity in interpreting the literature in order to make specific conclusions.

Although epidemiological research has shown that an increase in the symptoms of depression is correlated with lower intakes of dietary omega-3 fish oil, omega-3 fatty acids have not, so far, proved significant as a monotherapy for major depressive disorder. Individuals experiencing the symptoms of depression were also found to have lower serum concentrations of essential fatty acids, which was also revealed by several studies of EPA and DHA.

Besides treating depression, omega-3 fatty acids may also be useful in treating and preventing dementia. Nine epidemiological studies now support that increased dietary intake of fish is associated with reduced risk for cognitive decline or dementia with several of the studies showing a 40–50% reduced risk of dementia! DHA has also been shown to be specifically protective against Alzheimer’s Disease. One of the ways it does this is by limiting the production and accumulation of the amyloid β peptide toxin that is widely believed to drive the disease. Pretty amazing!

What happens when Omega-3 fats are used in conjunction with medication treatment for depression? Results of one study that evaluated Omega-3 fatty acids with and without SSRI fluvoxamine suggest that the patients treated with a combination of omega-3 fatty acids and fluvoxamine showed a significant difference compared with those treated with fluvoxamine alone in improving depression symptoms. Among women in the USA, depressed symptoms were examined in relation to intake of omega-3 fatty acids and omega-6 fatty acids. Higher intake of omega-3 fatty acids than omega-6 fatty acids was found to be associated with decreased risk of heightened symptoms of depression.

So does this mean that you can use foods rich in Omega-3 to help manage depression and mood disorders? The answer is yes, as a supplement to other forms of therapy that have been shown to be effective (i.e. Cognitive Behavioral Therapy, exercise, stress management techniques).  It is important to note that while these studies listed above all have promising and positive results, there are other studies that have been inconclusive or have shown that Omega-3s when compared to medication management for depression (i.e. an SSRI) have not demonstrated significant statistical effects. More research is needed to help clarify these results, specifically with regards to dosing, quality of the Omega-3s being used in studies, and severity of depression or said mood disorder. Other factors that may be responsible for these variable results are differences in sample size, biological and genetic differences among patients, environmental variability, and variability in response to Omega-3 fatty acids. It is also important to note that severity of the mental health diagnosis will dictate what will be necessary in order to manage the disorder. Someone with more chronic mood disorders that also have a strong familial component, might not benefit from the use of Omega-3 fatty acids as much as someone whose presentation isn’t as severe, or whose depression is more caused from environmental or stress related factors. Depression is a disorder that is caused by many different factors and depression due to insufficient Omega-3 fatty acids can be of one type. What this research does demonstrate is that eating nutrient dense whole foods that have a balanced macronutrient profile (fats/proteins/carbs) will have both short term and long term benefits for your mental. Disease accumulates in the body after months or years of “bad habits” i.e. poor diet, poor stress management, lack of exercise, etc. It is much more beneficial to act preventatively and feel the benefits that feeding your mental will have on your day-to-day life. At the very least, you will have improved energy, improved focus and attention, improved overall brain function, and increased satiety. Adding these healthful Omega-3s to your diet will only help protect your brain and other systems of the body (cardiovascular, immune).

The best sources of Omega-3 include fatty fish, such as salmon, mackerel, tuna, herring, and sardines. Other sources include grass fed meat, chia seeds, flax seeds, soybeans, and oysters. In terms of how much to eat? No Recommended Daily Allowance has been set for total fat or individual fatty acids, however, it is estimated that it is healthful to have these healthy fats be between 20-35% of total calories. It’s interesting to note that during hunter-gatherer times, our ancestors ate between 28-58% fat.

According to Dr. Janelle Sinclair, a biochemist and a registered natural medicine practitioner, in order to treat depression with Omega-3, you need to take a considerable amount. In fact, studies show that you need to take between 1000-2000mg EPA per day to treat depression. She further recommends that in order to treat depression, taking EPA over DHA is more effective and that the supplement is most effective when it has twice as much EPA as DHA.

I hope this helped to provide a general overview of how Omega-3’s can affect our mental and how incorporating this powerful nutrient can help provide long lasting benefits.

References

Appleton K.M., Hayward R.C., Gunnell D., Peters T.J., Rogers P.J., Kessler D. Effects of n-3 long chain polyunsaturated fatty acids on depressed mood: systematic review of published trials. Am J Clin Nutr. 2006;84:1308–1316.

Cole G.M., Ma Q.L., Frautschy S.A. Omega-3 fatty acids and dementia. Prostaglandins Leukot Essent Fatty Acids. 2009;81:213–221.

Hegarty B., Parker G. Fish oil as a management component for mood disorders—an evolving signal. Curr Opin Psychiatry. 2013;26:33–40.

Lin PY, Chiu CC, Huang SY, Su KPJ Clin Psychiatry. 2012 Sep; 73(9):1245-54.

Marangell L.B., Martinez J.M., Zboyan H.A., Kertz B., Kim H.F., Puryear L.J. A double- blind, placebo-controlled study of the omega-3 fatty acid docosahexaenoic acid in the treatment of major depression. Am J Psychiatry. 2003;160:996–998.

Safa M., Fallah Tafti S., Ghassem Boroujerdi F., Talischi F. Clinical trial in the treatment of 80 Iranian patients with major depression disorder by the combination of omega 3fatty acid and a selective serotonin reuptake inhibitor. Ther. Adv Psychopharmacol. 2013;3:186–190.

Wani, A., Bhat, S., and Ara, A. Omega-3 fatty acids and the treatment of depression: a review of scientific evidence. Integr Med Res. 2015 Sep; 4(3): 132–141.