Omega-3 Supplements May Lower Anxiety

[Guest guest]

Increasing omega-3 intake may lower both anxiety symptoms and

proinflammatory cytokines in healthy young adults, new research suggests.

In a small randomized controlled trial of medical students, those who

received omega-3 supplements for 3 months showed a 20% reduction in anxiety

scores and a 14% reduction in stimulated interleukin 6 (IL-6) production.

According to the investigators, the study " provides the first evidence that

omega-3 may have potential anxiolytic benefits for individuals without an

anxiety disorder diagnosis. "

" We were impressed by the magnitude of the anxiety effect and the evidence

for its anti-inflammatory effects, suggesting that it might have broader

benefits, " lead study author Janice Kiecolt-Glaser, PhD, professor of

psychiatry and psychology and S. Chair of Medicine at the

Institute for Behavioral Medicine Research at Ohio State University College

of Medicine (OSUMC) in Columbus, told *Medscape Medical News.*

She noted that the significant reduction in IL-6 is especially important

because the young study population had low rates to begin with.

" So our findings could possibly be much more significant in a group that was

older and had more health problems. "

The study was published

online<http://www.sciencedirect.com/science/article/pii/S0889159111004685>July

19 in

*Brain, Behavior and Immunity.*

*Fish Oil Benefits the Body*

" Chronic inflammation has been linked to a broad spectrum of health

problems, including cardiovascular disease, stroke, and rheumatoid

arthritis, " write the researchers.

" Large population studies suggest that greater fish consumption may help

control or protect against the onset of these and other inflammatory

conditions, " they add.

Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are 2 key omega-3

polyunsaturated fatty acids (PUFAs) found in fish oil, which may also

benefit mood.

In fact, previous research, including a study reported on last

year<http://www.medscape.com/viewarticle/724130>by

*Medscape Medical News, *has suggested that omega-3 can lower depressive

symptoms in patients diagnosed as having clinical depression.

Because both depression and anxiety have been found to increase the

production of proinflammatory cytokines, the current investigators

hypothesized that giving omega-3 PUFA supplementation to healthy subjects

would lead to a decrease in this production.

Secondary outcome measures were lowered anxiety and depressive symptoms, as

well as lowered negative mood symptoms associated with taking stressful

exams.

A total of 68 first- and second-year medical students (56% male; mean age,

23.65 years) were enrolled and randomized to receive 3 times daily either

omega-3 supplement capsules (consisting of 2085 mg of EPA and 348 mg of DHA,

n = 34) or fish-flavored placebo capsules (n = 34) for 12 weeks.

" We chose the 7:1 EPA/DHA balance because of evidence that EPA has

relatively stronger anti-inflammatory and antidepressant effects than DHA, "

explain the investigators.

" The supplement was probably about 4 or 5 times the amount of fish oil you'd

get from a daily serving of salmon, " added coauthor Martha Belury, PhD, RD,

professor of human nutrition at Ohio State University, in a release.

All participants were interviewed 6 times, and serial blood samples were

scheduled to be taken during lower-stress days and on the days before major

exams.

In addition, the Center for Epidemiological Studies Depression Scale and

Beck Anxiety Inventory were administered at all visits.

*Reduced Anxiety, Cytokines*

Results showed no significant differences between stress and nonstress days

across all outcomes for either group.

" Thus, the ability of omega-3 supplementation to dampen stress response

could not be tested, " write the researchers.

They note that this was probably due to a sudden change in the medical

school's curriculum. Instead of distributing the major tests during a 3-day

period, as done in the past, the exams were given throughout the year.

" This group was notably unstressed, which was a severe disappointment and a

study limitation. We just didn't get the stress effect we had expected, "

said Dr. Kiecolt-Glaser.

Still, the treatment group showed a significantly greater reduction in

anxiety symptoms at 20% than did the placebo group (*P* = .04).

They also had a greater decrease in their amounts of stimulated IL-6

production (0.15 units lower, *P* = .04).

" Anything we can do to reduce cytokines is a big plus in dealing with the

overall health of people at risk for many diseases, " said coauthor Ron

Glaser, PhD, professor of molecular virology, immunology, and medical

genetics at OSUMC.

There were no significant changes in depressive symptoms for either group.

" Again, this was not a depressed group, and without more severe depression,

you may not see an effect, " said Dr. Kiecolt-Glaser.

" Overall, that both anxiety and inflammation were altered is notable,

especially in a group that was not clinically anxious, " she added.

Even so, the investigators are not yet ready to suggest that everybody

should start taking fish oil pills.

" It may be too early to recommend a broad use of omega-3 supplements

throughout the public, especially considering the cost and the limited

supplies of fish needed to supply the oil. [instead], people should just

consider increasing their omega-3 through their diet, " said Dr. Belury.

Dr. Kiecolt-Glaser reported that the investigators have just finished

another trial that examined the effects of increasing omega-3 in a

population between the ages of 40 and 85 years who have an average body mass

index of 30.

*Omega-3 for All Psychiatric Disorders?*

This study reveals 2 remarkable, clinically solid findings, " Capt. ph R.

Hibbeln, MD, acting chief, Section on Nutritional Neurosciences at the

National Institute on Alcohol Abuse and Alcoholism, National Institutes of

Health (NIH), Bethesda, land, told *Medscape Medical News.*

The first, " which cannot be understated, " is the reduction of anxiety scores

in a normative population, said Dr. Hibbeln, who was not involved with this

study.

" Many trials of omega-3 fatty acids in depression have confused the field

because it's very difficult to reduce depression in people who don't have

the disorder. And it's also very difficult to reduce anxiety in those who

don't have clinically manifest anxiety, " he explained.

" The second was that they probed the question of whether or not omega-3

fatty acids at least work in part through changes in the immune system and

neural-immune interactions by measuring the effects of cytokine release in

the patients' white blood cells ex vivo. "

He noted that the " very marked decrease " in cytokine production in the

treatment group was impressive.

" This is absolutely consistent with the hypothesis that one of the

mechanisms of action for omega-3 fatty acids is not necessarily central but

is through down-regulating the immune system. The study begs the question:

is increased anxiety a manifest symptom of omega-3 fatty acid deficiencies?

And their answer is yes. "

Dr. Hibbeln said that the current 2010 US Department of Agriculture Dietary

Guidelines recommend omega-3 PUFAs for the protection of heart disease and

for pregnant mothers to prevent deficiencies in their offspring.

In 2006, the treatment committee for the American Psychiatric Association

(APA), of which he was a member, issued recommendations that all patients

with a psychiatric disorder should take at least 1 gram a day of omega-3

PUFAs to prevent the medical complications that often co-occur for them,

such as cardiovascular disease and metabolic problems.

" This paper should be another signal that the practicing psychiatrist should

follow the 2006 APA recommendations, " concluded Dr. Hibbeln.

*The study was funded in part by a grant from the National Center for

Complementary and Alternative Medicine, which is part of the NIH. The study

authors and Dr. Hibbeln have disclosed no relevant financial relationships.*

*Brain Behav Immun.* Published online July 19, 2011.

Abstract<http://www.sciencedirect.com/science/article/pii/S0889159111004685>

www.medscape.com

<http://www.sciencedirect.com/science/article/pii/S0889159111004685>

--

Ortiz, MS, RD

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