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Healthnotes Newswire (July 31, 2008)—Premature babies are at risk for complications in their mental development, but new evidence shows that their brains may get a boost from fatty acids: A study in Pediatrics reports that breast milk supplemented with omega-3 DHA (docosahexaenoic acid) and omega-6 AA (arachidonic acid) may improve brain development in premature infants.DHA and AA are two types of fatty acids essential for many bodily functions including brain, eye, and nervous system development. The optimal amounts of these fatty acids for premature infants has not been determined, but researchers suggest that increasing the amounts in early infancy may reduce the risk of developmental problems later in life.

Learning disabilities and school-related problems are more common among premature infants than full-term infants. Prior studies, however, have shown that premature infants who are breast-fed have higher IQs than babies receiving formula milk. This finding was attributed to higher concentrations of DHA found in human milk compared with formula milk. The authors of the new study considered the possibility that increasing the DHA content of human milk and adding AA could further improve preemies’ brain development.

Study results encouraging

In the study, 141 premature infants weighing less than 1,500 grams (about 3 pounds) were randomly assigned to receive human breast milk supplemented with either 32 mg of DHA and 31 mg of AA per 100 ml of milk, or breast milk supplemented with soy oil and medium-chain triglyceride oil. Infants received more than 100 ml of human milk per kilogram of body weight per day beginning on the first or second day of birth and continuing until discharge from the hospital (an average of nine weeks).

At six months of age, infants who received the human milk supplemented with DHA and AA were better at problem-solving and were better able to discriminate between familiar and unfamiliar objects compared with infants in the control group.

“There is growing evidence that DHA and AA have specific functions related to memory and problem-solving,” said Christine Henriksen, PhD, lead author of the study from the Department of Nutrition at the University of Oslo, Norway. Dr. Henriksen and her colleagues point out that these functions are critical for being able to focus, be attentive, learn, and process information. Further research is needed to understand the long-term impact of supplementing with fatty acids on school performance and attention capacity later in life.

Ensure you eat your EFAs

Babies are dependent on breast milk and/or fortified formula milk for DHA and AA, but there are other important sources of essential fatty acids (EFAs) to consider as the child grows older. In addition, recent research has shown that it is important for pregnant women to eat plenty of fatty acids in order to help optimize their baby’s brain function. You can find them in these sources:

• Fatty fish such as salmon, halibut, and tuna are good sources of DHA, which is also found in smaller amounts in eggs. Pregnant women should balance the need for fatty acids from fish with reducing exposure to mercury by limiting the amount of fish they eat and avoiding fish high in mercury content.

• AA is found in meat, chicken, and eggs.

• Some people may benefit from supplements that contain fatty acids. Check with your doctor about the appropriateness of using supplements to further enrich your diet.

(Pediatrics 2008;121:1137–45)

Healthnotes Newswire (July 17, 2008)—Everyone knows that fish is good for you, but it turns out that some is better than others for certain health needs and goals.

A new study, published in the Journal of the American Dietetic Association, analyzed 30 species of wild and farmed fish and found that while wild fish is generally more healthful than farm-grown, fish such as salmon and trout still maintain a beneficial fatty acid profile. Other farmed fish, such as talapia, do not, so while these may be incorporated into a regular diet as an occasional inexpensive, low-fat protein source, people wanting to maximize disease-fighting health benefits from fish will opt in favor of those with a better balance of fatty acids.

The ratio is the real measure of risk

A wealth of research shows that eating fish rich in omega-3 fatty acids may help prevent and treat diseases such as heart disease, diabetes, inflammatory and autoimmune diseases, and some cancers. However evidence increasingly points to the ratio of omega-3 to the less discussed omega-6 fatty acids in the diet as the indicator of disease risk.

• Fish with an omega-3 to omega-6 ratio of greater than one are considered beneficial because of their effect on the fatty acid profile of the entire diet.

• Fish with a ratio of 0.5 or lower are considered not protective against disease.

As a polyunsaturated fat, omega-6 also plays a role in supporting health, as long as it is consumed in moderation.

The best fish for fending off disease

The authors of the study collected samples of commonly eaten fish—including tuna, snapper, mahi-mahi, cod, sole, halibut, haddock, talapia, swordfish, catfish, salmon, and trout—from distributors in the US and Chile, from fish farms in the US, Chile, Canada, Ecuador, Honduras, Norway, and New Zealand, and from supermarkets in the US. Some highlights of their findings include:

• Sockeye salmon, Coho salmon, Copper River salmon, and farmed rainbow trout had a beneficial fatty acid pattern—in other words, a high ratio of omega-3 to omega-6 fatty acids.

• Farm-raised Atlantic salmon had high levels of omega-3 fatty acids but their levels of omega-6 fatty acids were higher than those of the wild salmon, making their ratio slightly less favorable, though still healthy.

• Tuna, one of the most commonly eaten fish in the US, had a low level of omega-3 fatty acids, but it also had a low omega-6 level, so its ratio remained favorable.

• On the other end of the spectrum, farmed talapia and catfish had low levels of omega-3 and poor ratios of omega-3 to omega-6 fatty acids.

Balancing factors besides fatty acids also important

Of all the fish reviewed in this study, tilapia has received the most attention for its unfavorable fatty acid content. “All other nutritional content aside, the inflammatory potential of hamburger and pork bacon is lower than the average serving of farmed tilapia,” the article cautions. However, keep in mind that a fish not being highly protective against heart disease does not mean it needs to be avoided entirely. Other health factors, such as heavy metal contamination—which are high in otherwise healthful fatty fish like tuna, but low in less heart-healthy fish like tilapia—should also be taken into account.

To give the pros and cons of fish consumption some real world perpective, consider that eating moderate amounts of farmed tilapia is roughly equivalent to other staples of the average diet, and may be a reasonable option for some people. For those at risk for inflammatory diseases such as heart disease, fish with a good omega-3 to -6 ratio such as salmon or trout are the best choice.

(J Am Diet Assoc 2008;108:1178–85)

Healthnotes Newswire (June 26, 2008)—It is well known that folic acid may help prevent birth defects if taken during pregnancy, and more evidence emerges all the time about the role of other nutrients, such as essential fatty acids from fish and other sources. Prior studies have shown that children who don’t get enough fatty acids in early childhood may have impaired vision and brain functioning and recent studies suggest that essential fatty acids taken by a mother in pregnancy support a developing child’s brain and central nervous system. Most recently, the American Journal of Clinical Nutrition reports that pregnant women who supplement with an omega-3 fatty acid have babies with sharper vision.

The current study sought to determine if supplementing with the omega-3 fatty acid DHA (docosahexaenoic acid) among pregnant women could improve their infants’ development. Among 135 women, 14 to 16 weeks into their pregnancy, half were randomly assigned to take 400 mg per day of supplemental DHA—the equivalent of eating about one pound of fatty fish such as salmon per week—or placebo.

All women continued their usual diet, which provided 10 to 760 mg of DHA per day. Compared to baby girls from the placebo group, babies whose mothers supplemented with DHA had significantly higher visual acuity scores 60 days after birth.

The International Society for the Study of Lipids and Fatty Acids recommends that all women consume 300 mg per day of DHA. The study’s authors determined that a DHA supplement of 400 mg per day should result in a low risk for DHA deficiency, although the optimal daily dosage is still not known.

Good sources of omega-3 fatty acids

To get more omega-3s in your diet, try these foods:

• Fatty fish such as salmon and sardines, and catfish, shrimp, and canned light tuna. Pregnant women are advised to limit their fish intake to two servings per week and to avoid fish that are more likely to be contaminated, such as shark, swordfish, king mackerel, and tilefish.

• Beans, seeds, and nuts such as soybeans, walnuts, and flaxseed.

• Dark green vegetables.

Mothers-to-be should check with their doctor about appropriate dietary and supplemental recommendations.

(Am J Clin Nutr 2008:87:548–57)

Healthnotes Newswire (June 19, 2008)—Until recently, attention deficit–hyperactivity disorder (ADHD) was considered mainly a childhood disorder. Today it is recognized as a common condition in many adults throughout the world, and now there is evidence that the condition may interfere with work performance).

The World Health Organization dustributed a World Mental Health Survey Initiative in ten countries to collect data from more than 11,000 people, ages 18 to 44. Approximately 3.5% of workers had adult ADHD, and men were more likely than women to suffer from the disorder. When compared with their colleagues, people with ADHD were less productive. This lost time was due to poor work quality, reduced quantity, or a complete inability to carry out their tasks. The survey revealed that most adults are not treated for their ADHD.

Symptoms of adult ADHD may include difficulty with concentrating or focusing on a task, being easily distracted, difficulty with following instructions, problems with organizing and prioritizing, and restlessness. The disorder may affect a person’s work performance because he or she is not able to complete a task on time or at all due to lack of focus or procrastination, or because the person is often very busy but not accomplishing a lot. People with ADHD often have other mental or substance abuse disorders that may affect their work performance as well.

“ADHD is a relatively common condition among working people in the countries studied and is associated with high work impairment in these countries,” according to the study authors. “This impairment, in conjunction with the low treatment rate and the availability of cost-effective therapies, suggests that ADHD would be a good candidate for targeted workplace screening and treatment programs.”

Finding focus

Treatments for the condition include self-regulating techniques such as learning about the disorder, instituting time and project management techniques, and creating structure that can be followed. Some people seek professional help for therapy to help them regulate their behaviors, and medications are available to help ease symptoms.

Natural treatments that have been found to benefit children with ADHD include consuming less refined sugar and food additives, identifying and avoiding allergenic foods, and supplementing with B vitamins, magnesium, and essential fatty acids. These treatments have not been studied in adults with ADHD.

(Occup Environ Med 2008; doi:10.1136/oem.2007.038448)

Healthnotes Newswire (June 5, 2008)—Skin affected by eczema might seem to be crying out for creams and salves to ease itching and inflammation, but what’s on the inside might be more important than what’s on the outside. A new study found that supplementing with the omega-3 fatty acid DHA (docosahexaenoic acid) helped relieve symptoms in people with eczema.

In the study, published in the British Journal of Dermatology, 44 adults with eczema received either 5.35 grams of DHA per day or placebo for eight weeks. At the study’s beginning, mid point, and end, scores were given to each person based on symptom severity, including the size of the affected area, redness, swelling, crusting, scabbing due to scratching, thickening, dryness, itching, and sleeplessness.

Symptom scores in people using DHA improved over the course of the study, but scores for those in the placebo group did not change significantly. In particular, the size of the affected area decreased 42% in the DHA group but did not change in the placebo group.

Eczema is a common inflammatory skin condition that is typically treated with topical and occasionally oral steroids. People with eczema often have other inflammatory conditions such as asthma, allergies, and food sensitivities. Many people with eczema notice that flare-ups can be triggered or exacerbated by stress.

DHA and EPA (eicosapentaenoic acid) are the omega-3 fatty acids found primarily in fish. Their anti-inflammatory effects are well established, and a number of studies have found that fish oil or EPA-DHA combinations are effective in treating conditions such as rheumatoid arthritis, Crohn’s disease, asthma, and cardiovascular disease. One previous study found that taking about 2 teaspoons of fish oil per day reduced symptoms in people with eczema.

“Our findings suggest that DHA might be helpful in supporting the standard treatment of eczema,” commented the principal investigator of the study, Dr. Margitta Worm, at the Charite-Universitatsmedizin in Berlin, Germany. “This is the first study to look at DHA alone in the treatment of eczema, so more research is needed to confirm our findings and identify the amount that would result in greatest improvement.”

Save your skin

People with eczema can take the following steps to reduce their symptoms:

• Identify food sensitivities and avoid reactive foods. Some of the most common reactive foods in people with eczema are wheat and other grains with gluten, dairy, eggs, and corn, including corn syrup.

• Manage stress through exercise and relaxation.

• Supplement with 3 grams per day of evening primrose oil or 2 or 3 teaspoons per day of sunflower or safflower oil, which have anti-inflammatory omega-6 fatty acids.

• Eat plenty of cold-water fish that are rich in EPA and DHA such as salmon, tuna, mackerel, sardines, and herring. Or consider a supplement with these omega-3 fatty acids.

(Br J Dermatol 2008;158:786–92)

Healthnotes Newswire (May 29, 2008)—Sometimes one of the many emotional and physical changes women experience as they prepare to give birth, depression during and after pregnancy has very few treatment options that are considered safe for pregnant and nursing mothers. Fortunately, a new study found that supplementing with omega-3 fatty acids from fish can safely relieve pregnancy-related depression.

The study, published in the Journal of Clinical Psychiatry, followed the progress of 36 pregnant women who began experiencing major depression during their second and third trimesters. They were given either 2.2 grams of EPA (eicosapentaenoic acid) plus 1.2 grams of DHA (docosahexaenoic acid) per day or a placebo for eight weeks.

Depression symptoms began to diminish within the first two weeks after starting treatment. The women using the omega-3 supplements saw greater improvement than the women in the placebo group, and this difference was more dramatic at weeks six and eight.

Hoping for a happy, healthy pregnancy

Mothers-to-be and their doctors are often anxious about using medications during pregnancy out of concern for the developing fetus. There is evidence that antidepressant medications might be associated with a higher rate of complications around childbirth, including premature delivery and low birth weight in newborns. On the other hand, untreated depression in pregnancy can also pose problems for the mother and baby.

Low levels of EPA and DHA have been linked to increased risk of depression, and several studies have foundthat omega-3 fatty acids from fish can be helpful. Pregnant women have lower levels of these fatty acids, as well as a number of other nutrients, because the growing fetus draws nutrients from the mother. Some studies have suggested that omega-3 fatty acid supplementation during pregnancy might benefit the fetus because these fatty acids are essential for normal neurological development.

“Mothers and their healthcare providers want treatments for pregnancy-related depression that are harmless for both the infant and mother, during pregnancy and nursing,” said lead study author Dr. Kuan-Pin Su at the Mind–Body Interface Center of the China Medical University Hospital, Taiwan. “In light of our findings, omega-3 fatty acids are a promising treatment option for depression during pregnancy. Further research will help to determine optimal dosage and ratio of EPA and DHA in treating depression during pregnancy and breast-feeding.”

Getting omega-3s in the diet

EPA and DHA are produced by cold-water fish such as salmon, tuna, and herring. Expecting mothers should steer clear of fish with high levels of mercury, a heavy metal contaminant that can cause neurological problems. Best bets include canned chunk light tuna, pink salmon, and herring, which are low in mercury and rich in EPA and DHA. The Natural Resource Defense Council, using data from the US Food and Drug Administration and Environmental Protection Agency, has determined that as much as 12 ounces of canned chunk light tuna per week can safely be eaten during pregnancy.

Another way to get EPA and DHA is by eating omega-3 eggs, which come from chickens that have been fed a diet high in flax meal. Flaxseeds are rich in an omega-3 fatty acid that is converted to EPA and DHA by the chicken.

Mothers-to-be can increase their chance of being healthy throughout pregnancy by staying well-nourished; eating plenty of fruits and vegetables, whole grains, legumes, and nuts and seeds; avoiding alcohol, refined sugar, and excessive caffeine; and staying physically active. Including some cold-water fish and omega-3 eggs, and possibly taking an EPA/DHA supplement, might also help them avoid pregnancy-related depression.

(J Clin Psychiatry 2008:e1–e8)