New research has confirmed that eating foods rich in omega-3 fatty acids can preserve brain health and improve cognition in middle age. Having at least some omega-3s in red blood cells has been associated with better brain structure as well cognitive function among healthy volunteers in the study between the ages of 40 and 50.
The faculty of the University of Texas Health Science Center at San Antonio (UT Health San Antonio) and other researchers from the Framingham Heart Study conducted the analysis.
The results of the Research have been published in the scientific journal Neurology.
Omega3 and cognitive health: here’s what the new study says
“Studies have looked at this association in older populations. The new contribution here is that, even at a younger age, if you follow a diet that includes some omega-3 fatty acids, you are already protecting your brain for most of the brain aging indicators we see in middle age, ”Claudia said. Satizabal, Ph.D., Assistant Professor of Population Health Sciences at the Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases at UT Health San Antonio. Satizabal is the lead author of the study.
The average age of the volunteers was 46. The team examined the relationship between omega-3 fatty acid concentrations in red blood cells with MRI and cognitive markers of brain aging. The researchers also studied the effect of omega-3 red blood cell concentrations in volunteers carrying APOE4, a genetic variation linked to a higher risk of Alzheimer’s disease.
The study, based on 2,183 participants without dementia and without stroke, found that:
A higher omega3 index was associated with larger hippocampal volumes. The hippocampus, a structure in the brain, plays an important role in learning and memory.
Consuming more omega3s was associated with better abstract reasoning or the ability to understand complex concepts using logical thinking.
APOE4 carriers with a higher omega-3 index had small vessel disease. The APOE4 gene is associated with cardiovascular disease and vascular dementia.
The researchers used a technique called gas chromatography to measure the concentrations of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) from red blood cells. The omega-3 index was calculated as DHA plus EPA.
“Omega3 fatty acids such as EPA and DHA are key micronutrients that improve and protect the brain,” said study co-author Debora Melo van Lent, Ph.D., a postdoctoral researcher at the Biggs Institute. “Our study is one of the first to observe this effect in a younger population. Further studies are needed in this age group ”.
The team divided the participants into those who had very little concentration of omega-3 red blood cells and those who had at least some and more. “We saw the worst results in people who had the least consumption of omega-3s,” Satizabal said. “So this is something interesting. Even if the more omega3 the greater the benefits for the brain, you just have to eat some to see the benefits ”.
Researchers don’t know how DHA and EPA protect the brain. One theory is that because those fatty acids are needed in the membrane of neurons, when they are replaced with other types of fatty acids, it is then that the neurons (nerve cells) become unstable. Another explanation may have to do with the anti-inflammatory properties of DHA and EPA. “It’s complex. We don’t understand everything yet, but we show that, somehow, if you increase your omega-3 consumption a little, you are protecting your brain, ”Satizabal said.
It is encouraging that DHA and EPA have also protected the brain health of APOE4 carriers. “It’s genetic, so you can’t change it,” said Melo van Lent, referring to the vulnerability of this risk group. “So if there is a modifiable risk factor that can overcome the genetic predisposition, that’s a big plus.”
the Doctor Roberto Marchioli (Medical Director, Therapeutic Science & Strategy Unit, IQVIA, Milan) stated about the benefits of Omega 3 long-chain (EPA + DHA): “all the studies that evaluated the relationship between long-chain omega-3 supplementation (EPA + DHA) and cardiovascular health were based on observations collected worldwide on the direct association between regular consumption of fish (at least two or three times a week), as the main source of these fatty acids, and reduction of coronary risk in the general population. These observations are now well known even to the general public ”.
“From here arose the working hypothesis on the possible protective role of a supplementation with these omega-3s (that is, at levels higher than those achievable with food intake alone) in subjects with pre-existing coronary artery disease”.
“The hypothesis was then supported by the information, collected in the 70s – 80s, on the pharmacology of these compounds, which had documented – at the typical doses of supplementation – theantiplatelet action, anti-inflammatory, control of plasma triglyceride levels and antiarrhythmic “.
“In 1998, in fact, in perfect agreement with these data, the GISSI-Prevention highlighted a reduction in cardiovascular mortality by 20% and sudden death by 45% in subjects supplemented with EPA + DHA compared to controls.
A decade later, the Japanese JELIS study had provided similar results with the EPA alone, especially on the reduction of non-fatal vascular events. Subsequent research, however, has not always confirmed these data: probably because, in the meantime, the therapy of subjects at high cardiovascular risk and that of acute heart attack have evolved and enriched ”.
“Now all subjects with a previous heart attack, in clinical trials, take the so-called“ best treatment ”, including the statin, the ACE inhibitor, the beta-blocker, the antiaggregant; the majority of them, in the presence of an acute coronary event, are also subjected to coronary revascularization, which substantially reduces the subsequent cardiovascular risk. Overall, this is an approach that contributes to completely modifying the clinical evolution, and prognosis, of these patients ”.
“A premise is necessary. The current meta-analysis was signed byOmega3 Treatment Trialists’ Collaborationwhich was set up precisely to clarify, on the basis of current knowledge, what is today the role of long-chain omega-3 supplementation in cardiovascular prevention “.
“We have therefore included the 10 most rigorous clinical trials, in which long-chain omega-3s had been administered to at least 500 subjects, for at least one year, in comparison with placebo (randomized protocols), or with control subjects (open-label protocols). In these trials, the protective efficacy of supplementation against the risk of: non-fatal myocardial infarction was evaluated; coronary heart disease mortality; stroke (all causes); events following revascularization, coronary and otherwise; all these events together ”.
“Let’s start with the characteristics of the people involved and the long-chain omega-3 concentrations used. In all, the 10 studies involved 77,917 people with an average age of 64, the majority (61.4%) men.
66.4% of these subjects were coronary heart disease28% had suffered from a stroke and 37% were diabetic, obvious high cardiovascular risk factors. The amount of EPA (eicosapentaenoic acid) taken each day ranged from 226 to 1,800 mg, that of DHA (docosahexaenoic) was between 0 and 1,700 mg / day, with daily doses of EPA + DHA ranging from 376 mg to 2550 mg. The average duration of employment was 4.4 years “.
“In these 10 studies the regular supplementation with omega3 (in the various dosages considered) does not bring significant advantages to the vascular health of the subjects involved, even when divided by age or sex groups, or by previous disease, lipid profile, therapy or not with statins “.
“However, there is a slight (although not significant) trend towards the reduction of events (as in other meta-analyzes with different selection criteria of the studies considered) and, on a strictly statistical level, it is not possible to exclude a reduction in the risk of major vascular events (heart attack and stroke) up to 7-10% “.
“Twenty years ago, post-heart attack therapy was in full evolution and that long-chain omega-3s represented an effective and innovative defense. Today the landscape is much more complex and better targeted. And that’s why research on omega3 goes on. The main question to be answered is: what are the conditions in which long-chain omega-3 supplementation plays a significant role? ”.
“It is necessary to increase the daily dosage, for example up to 3-4 g per day, as the REDUCE-IT study is doing (comparison of therapy with a statin and combination of statins and omega-3s, in subjects with hypertriglyceridemia and at least one other high vascular risk factor) and the STRENGTH study (comparison between statin + diet and statin + diet + omega3 always in subjects at high vascular risk)? “.
“Or are there patients who may respond better to omega-3 supplementation, such as the diabetic patient (the British ASCEND study is investigating this) or people with low circulating levels of these fatty acids?” The demonstrations of the direct relationship between regular consumption of fatty fish from cold seas, the richest in Omega 3and overall health (not just cardiovascular) are so many and so solid that they do not give rise to doubts “.
“Also because, beyond the possible preventive effects, of an almost pharmacological nature, these fatty acids they are essential for the functioning of vital organs and tissues of our organism: brain, retina, electrical control centers of the heart. Omega-3 supplementation, at doses equal to those that would be obtained with a regular consumption of fish, can be an alternative for healthy people who cannot (intolerances or allergies), or do not want to (some vegetarian regimens and the regimen vegan) to consume fish “.
“As regards the effects of a pharmacological nature, especially in secondary prevention, the most correct approach is probably to suspend judgment, pending new studies in progress”.
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