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This article originally posted 15 February, 2011 and appeared in

<http://www.diabetesincontrol.com/diabetes-in-control-newsletters/diet>

Diet,

<http://www.diabetesincontrol.com/topics/complications-and-co-morbidities>

Complications and Co-morbidities,

<http://www.diabetesincontrol.com/diabetes-in-control-newsletters/prevention

> Prevention,

<http://www.diabetesincontrol.com/diabetes-in-control-newsletters/aging-and-

diabetes> Aging and Diabetes,

<http://www.diabetesincontrol.com/diabetes-in-control-newsletters/561> Issue

561

Study Reveals How Omega 3's Work in Preventing Several Forms of Blindness

A follow-up study from Children's Hospital Boston, now reveals exactly how

omega-3's provide protection, and provides reassurance that widely used

COX-inhibiting drugs like aspirin and NSAIDs don't negate their benefit....

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Omega-3 fatty acids -- fats commonly found in fish oil -- were shown several

years ago to prevent retinopathy, a major form of blindness, in a mouse

model of the disease. The new published findings, also suggest that

omega-3's may be beneficial in diabetes.

Retinopathy -- an eye disease caused by the proliferation of tortuous, leaky

blood vessels in the retina -- is a leading cause of blindness, affecting

4.1 million Americans with diabetes (a number expected to double over the

next 15 years) and many premature infants. Another 7 million-plus Americans

have age-related macular degeneration (AMD); this too will increase as the

population ages. The most common " wet " form of AMD is also caused by

abnormal blood vessel growth.

Children's ophthalmologist Lois , MD, PhD, senior investigator on the

study stated that, " The ability to prevent these " neovascular " eye diseases

with omega-3 fatty acids could provide tremendous cost savings. " " The cost

of omega-3 supplementation is about $10 a month, versus up to $4,000 a month

for anti-VEGF therapy, " she says, referring to drugs such as Macugen and

Lucentis used in AMD and diabetic retinopathy. " Our new findings give us new

information on how omega-3s work that makes them an even more promising

option. "

Omega-3 fatty acids, highly concentrated in the retina, are often lacking in

Western diets, which tend to be higher in omega-6 fatty acids. In 's

previous study, mice fed diets rich in omega-3 fatty acids by 's team

had nearly 50 percent less pathologic vessel growth in the retina than mice

fed omega-6-rich diets. and colleagues further showed that the omega-3

diet decreased inflammatory messaging in the eye.

In the new study, they document another protective mechanism: a direct

effect on blood vessel growth (angiogenesis) that selectively promotes the

growth of healthy blood vessels and inhibits the growth of abnormal vessels.

In addition, and colleagues isolated the specific compound from

omega-3 fatty acids that has these beneficial effects in mice (a metabolite

of the omega-3 fatty acid DHA, known as 4-HDHA), and the enzyme that

produces it (5-lipoxygenase, or 5-LOX). They showed that COX enzymes are not

involved in omega-3 breakdown, suggesting that aspirin and NSAIDs -- taken

by millions of Americans -- will not interfere with omega-3 benefits.

" This is important for people with diabetes, who often take aspirin to

prevent heart disease, and also for elderly people with AMD who have a

propensity for heart disease, " says . (One drug used for asthma,

zileuton, does interfere with 5-LOX, however.)

Finally, the study demonstrated that 5-LOX acts by activating the PPAR-gamma

receptor, the same receptor targeted by " glitazone " drugs such as Avandia,

taken by patients with Type 2 diabetes to increase their sensitivity to

insulin. Since these drugs also increase the risk for heart disease,

boosting omega-3 intake through diet or supplements might be a safer way to

improve insulin sensitivity in patients with diabetes or pre-diabetes.

" There needs to be a good clinical study in diabetes, " says.

An earlier retrospective study, AREDS1, found higher self-reported intake of

fish to be associated with a lower likelihood of AMD. In addition, is

collaborating with a group in Sweden that is conducting a clinical trial of

omega-3 fatty acids in premature infants, who are often deficient in

omega-3. That study will measure infants' blood levels of omega-3 products

and follow the infants to see if they develop retinopathy. If results are

promising will seek FDA approval to conduct a clinical trial in

premature infants at Children's.

Science Translational Medicine, February 9, 2011

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