How a Change in Diet Can Change Your Brain

1
Omega Fatty Acids and Mental Health

• How a Change in Diet Can Change Your Brain

Brian Mackin, M.D.
2
(No Transcript)
3
Many Factors of a Complex Decision
4
Overview

• Historical perspective
• Evidence
• Polyunsaturated Fatty Acids
• Omega-3 FA and Omega-6 FA
• Depression
• Schizophrenia
• Alzheimers Disease
• Where can we find Omega-6/3 in diet?
• Changes in our current food supply

5
What will not be covered

• Vitamin B1, B2, B3,B6, B9, B12
• Vitamin A, C, D, K, E
• Folate
• Iron
• Magnesium
• Copper
• Zinc
• Iodine
• Lithium
• Manganese
• Selenium
• Essential amino acids
• Cholesterol

• Carbohydrates
• Fibers
• Sugar and Starches
• Proteins
• Antioxidants
• Toxins
• Mercury, PCBs, Nitrates
• Artificial Sweeteners
• Digestive problems
• Changes in gut flora
• Trans Fatty acids
• Esterified fats
• Disruption of the integrity
• of the blood brain barrier

6
(No Transcript)
7
Big 7 Diseases of USA
8
Improving knowledge
worsening diet.
9
Obesity Escalating
www.admc.hct.ac.ae/hd1/english/graphs/obesity.htm
10
Historic Diet
11
Plant Life - Local - Seasonal - Fresh
12
Marine Life
13
Local Animals
14
(No Transcript)
15
Modern Diet
16
(No Transcript)
17
(No Transcript)
18
First Agricultural Revolution
10,000-3,000 BC
19
Industrial Revolution
150-200 years ago
20
(No Transcript)
21
(No Transcript)
22
A Shift in Balance
23
(No Transcript)
24
The American Diet
25
How Fat Consumption Has Changed Over Time
26
Radical changes in diet have occurred over the
last 200 years or 8 generations
27
(No Transcript)
28
A Breakdown of FAT
29
Two Important types of Polyunsaturated Fatty Acids
30
Natural Form of Monounsaturated Fatty Acid
31
Unnatural Trans Form of Monounsaturated Fatty Acid
32
(No Transcript)
33
Biologic Breakdown of PUFAs
Alpha
34
Omega-3 Polyunsaturated Fatty Acids
Docosahexaenoic Acid (DHA)
Eicosapentaenoic Acid (EPA)
35
Arachadonic Acid (AA)
Omega-6 Polyunsaturated Fatty Acid
36
What role does Omega-3 Fatty Acid play in our
bodies?
37
(No Transcript)
38
DHA is selectively concentrated in synaptic
neuronal membranes and contributes to unique
biophysical properties that mediate receptor
activity and signal transduction
Freeman et al J Clin Psychiatry2006671954-1967
39
Omega 6 FAs and Omega 3 FAs compete
EPA
Arachadonic Acid
DHA
40
Depression
Fish Consumption
41
Post- Partum Depression
Fish Consumption
42
Breakdown of the Prefrontal Cortex
Human Brain 60 Fat
Figure. Brain consists up to 60 of fat. Fatty
acid composition of human postmortem prefrontal
frontal cortex in subjects aged 2945 yrs. RMDR
remainder, is composed of intermediate faty acid
metabolites. Source McNamara and Carlson 2006.
43
Omega 3 in the Human Developing Brain
DHA
Martinez M. Tissue levels of polyunsaturated
fatty acids during early human development, J.
Pediat. 1992 120 S129-138.
44
Studies Looking at Tissues of the Prefrontal
Cortex
45
Will Changes in diet affect the Omega 3 content
of a newborn brain and a young brain?
Control Diet Rich in Omega-3
Low in Omega 3
46
Anderson et al Pediatr Rs 200558 (5)865-872
Prefrontal Cortex of Monkey
Fed Control Diet for 3 years
Prenatal Omega-3 Deficient Diet
47
Brodmann Area 10 Orbitofrontal Cortex
48
Omega 3 FAs Lower in Major Depression
DHA
22 lower DHA in MDD vs. Normal Controls (p
.0018) 32 lower DHA in females/ 16 lower DHA
in males
McNamara et al Biol Psychiatry 2007 6217-24
49
Omega 3 FAs Lower in Schizophrenia
20 lower DHA in SZ vs. Normal Controls p.0051
DHA
McNamara et al Schizophrenia Res. 2007 March 91
(1-3) 37-50
50
(No Transcript)
51
(No Transcript)
52
(No Transcript)
53
(No Transcript)
54
(No Transcript)
55
A Diet Enriched with the Omega-3 Fatty Acid
Docosahexaenoic Acid Reduces Amyloid Burden in an
Aged Alzheimer Mouse Model
Low DHA Diet (0.0)
High DHA Diet (0.6)
Control Diet (0.09)
56
Less Plaques with High DHA Diet
The Journal of Neuroscience, March 23, 2005,
25(12)3032-3040 doi10.1523/JNEUROSCI.4225-04.20
05
57
(No Transcript)
58
FIGURE 1. Multivariate linear regression analysis
of 5-y cognitive decline in 210 elderly men in
relation to fish consumption in 1990, showing the
mean change in cognitive functioning between 1990
and 1995, adjusted for age, education, alcohol
consumption, smoking status, physical activity,
energy intake, and baseline cognitive
functioning. MMSE, Mini-Mental Status
Examination. , Fish consumers , fish
nonconsumers. Significantly different from
cognitive decline in 51 fish nonconsumers, P
0.01.
Eat More Fish and Lose Less Mental Function
Fish consumption, n3 fatty acids, and subsequent
5-y cognitive decline in elderly men the Zutphen
Elderly Study 1,2,3,4 Boukje Maria van Gelder,
Marja Tijhuis, Sandra Kalmijn and Daan Kromhout
American Journal of Clinical Nutrition, Vol. 85,
No. 4, 1142-1147, April 2007
59
Comparison of therapeutic effects of omega-3
fatty acid eicosapentaenoic acid and fluoxetine,
separately and in combination, in major
depressive disorder
Australian and New Zealand Journal of Psychiatry
Peet et al 423, 192-198 March 2008
50 Fluoxetine N 16 56 EPA N 16 81 EPA
Fluoxetine N 16
Fluoxetine 20mg/ EPA 1000mg
60
Childhood Depression

• Omega-3 treatment of Childhood Depression
  a controlled, double-blind pilot study.
• American Journal of Psychiatry 2006. Nemets et
  al.
• 4 months of EPADHA (560mg/600mg) daily
• Only 10 children in each arm
• 7/10 in Omega-3 group had 50 or better
  improvement
• 0/10 in placebo had 50 or better improvement

61
End of 3rd Quarter Quick Review

• Nutrition has a role in mental health
• Evidence supports that dietary deficits in
  Omega-3 PUFA results in deficits in the brain
• Psychiatric illness (MDD and SCZ) is correlated
  with lower Omega-3 concentrations in parts of
  brain
• Cant conclude that Omega-3 deficits are a cause
  of depression/schizophrenia
• Higher Omega 3 diets may reduce plaques
  associated with Alzheimer's disease
• Some evidence supports that dietary Omega-3 can
  improve symptoms of some patients with major
  depression

62
What can we eat that is rich in Omega 3 Fatty
Acids?
63
(No Transcript)
64
Richest source of dietary Omega-3 Fatty Acids DHA
and EPA
65
Fish vs. Fish Oil Enhanced Incorporation of n-3
Fatty Acids from Fish Compared with Fish Oils
Edel et al Lipids, Vol.41, no.12 (2006)

• Salmon
• (1.2g/day DHAEPA)

• Cod Liver Oil
• (3.0g/day DHAEPA)

EPA 106
EPA 129
DHA 25
DHA 45
66
FN-620, Reviewed and Reprinted June 2007 Jane U.
Edwards, Ph.D., LRD, Nutrition and Health
Specialist
67
(No Transcript)
68
Effects of feedlot feeding on growth pattern of
Cattle
Weight of Cow
Age of Cow
Intensive feeding systems for beef production in
developing countries P. Auriol
69
What are Cows fed?
( US Dairy Forage Research Center, 1995 Research
Summaries.)
70
How does the feed effect the Meat?
71
(No Transcript)
72
Fish Farming on the Rise
73
And What about the Fish?
'Only 50 years left' for sea fish
By Richard Black Environment correspondent, BBC
News website Natural protection There will be
virtually nothing left to fish from the seas by
the middle of the century if current trends
continue, according to a major scientific study.
Stocks have collapsed in
Salmon ?92
74
Conclusion

• Shift in the type of fats consumed
• The western diet high in omega-6 and low in
  omega-3 is correlated with psychiatric illness
• Brain concentrations of Omega-3 FA are found to
  be low in MDD and SZ
• Omega 3s in diet are correlated with development
  of Alzheimers plaques
• If we are to suspect that dietary omega-3 FA are
  important in brain development and function then
  we should be concerned about preserving them as a
  food source.

75
Bibliography

• Bourre JM. Effects of nutrients (in food) on the
  structure and function of the nervous system
  update on dietary requirements for brain. Part 1
  micronutrients. The Journal of Nutrition, Health
  and Aging 2006 10(5) 10(5) 377-385.
• Bourre JM. Effects of nutrients (in food) on the
  structure and function of the nervous system
  update on dietary requirements for brain. Part 2
  macronutrients. The Journal of Nutrition, Health
  and Aging 2006 10(5) 386-399.
• Cetin I, Koletzko B. Long chain omega-3 fatty
  acid supply in pregnancy and lactation. Current
  Opinion in Clinical Nutrition and Metabolic Care
  2008 11297-302.
• Elvevoll EO et al. Enhanced incorporation of n-3
  fatty acids from fish compared with fish oils.
  Lipids 2006 41(12) 1109-1114.
• Freeman MP et al. Omega-3 fatty acids evidence
  basis for treatment and future research in
  psychiatry. Journal of Clinical Psychiatry 2006
  December 67(12) 1954-1967.
• Freund-Levi Y et al. Omega-3 supplementation in
  mild to moderate Alzheimers disease effects on
  neuropsychiatric symptoms. International Journal
  of Geriatric Psychiatry 2007 23 161-169.
• Hakkarainen R et al. Is low dietary intake of
  omega-3 fatty acids associated with depression.
  American Journal of Psychiatry 2004 March 161
  567-569.
• Horrobin DF. Omega-3 fatty acid for
  schizophrenia. Am J Psychiatry
  2003160(1)188-189.
• Lakhan SE, Vieira KF. Nutritional therapies for
  mental disorders. Nutrition Journal 2008 72.
• Lim GP et al. A Diet Enriched with the Omega-3
  Fattty Acid Docosahexaenoic Acid Reduces Amyloid
  Burden in an Aged Alzheimer Mouse Model. Journal
  of Neuroscience 2005 25(12) 3032-3040.
• Mamalakis G et al. Lack of an association of
  depression with n-3 polyunsaturated fatty acids
  in adipose tissue and serum phospholipids in
  healthy adults. Pharmacology Biochemistry and
  Behavior 2008 896-10.
• McNamara RK et al. Abnormalities in the fatty
  acid composition of the postmortem orbitofrontal
  cortex of schizophrenic patients gender
  differences and partial normalization with
  antipsychotic medications. Schizophrenia Research
  2007 March 91(1-3) 37-50.
• McNamara RK et al. Omega-3 fatty acid deficiency
  augments amphetamin-induced behavioral
  sensitization in adult mice prevention by
  chronic lithium treatment. Journal of
  Psychiatric Research 2008 42458-468.
• McNamara RK et al. Selective deficits in the
  omega-3 fatty acids docosahexaenoic acid in the
  postmortem orbitofrontal cortex of patients with
  major depressive disorders. Biological
  Psychiatry 2007 67 17-24.
• Montgomery P, Richardson AJ. Omega-3 fatty acids
  for bipolar disorder. Cochrane Database of
  Systematic Reviews 2008,Issue 2.
• Owen C, Rees AM, Parker G. The role of fatty
  acids in the development and treatment of mood
  disorders. Current Opinion in Psychiatry 2008
  21 19-24.
• Ramsden CE. Nutrition by the numbers Optimize
  you health with the NQI. Altlanta Nutritional
  Quality Index 2007.
• Rogers PJ et al. No effect of n-3 long-chain
  polyunsaturated fatty acid (EPA and DHA)
  supplementation on depressed mood and cognitive
  function a randomized controlled trial. British
  Journal of Nutrition 2008 99421-431.
• Ross BM, Seguin J, Sieswerda LE. Omega-3 fatty
  acids as treatments for mental illness which
  disorder and which fatty acid?. Lipids in health
  and disease 2007 621

76
MentalHealth
Nutrition
.com
and
77
(No Transcript)
78
U.S. Food and Drug Administration,
www.cfsan.fda.gov
79
(No Transcript)
80
Committee on Research of Psychiatric Treatments
of the American Psychiatric Association
Omega-3 Fatty Acids Evidence Basis for Treatment
and Future Research in Psychiatry Freeman et al.
Journal of Clinical Psychiatry 67, December 2006
81
Possible Reasons for Mixed Results

• Ethyl EPA may not have beneficial effect
• Dose could be wrong
• Diet of subjects may be changing during study
• Test subjects were not appropriate
• It may take more time for EPA/DHA to affect the
  brain

82
Studies Using Omega-3 to tx MDD as of 2006