This Amount (and Type) of Fish Oil May Protect Against Alzheimer's.

White matter, composed largely of myelinated nerve fibers, facilitates communication between different brain regions. Damage to white matter, observed (i.e., lesions) via MRI, is associated with cognitive decline and increased dementia risk. Plasma concentrations of omega-3 fatty acids in epidemiological research is associated with a reduced burden of white matter lesions (WML)

An RCT published in Neurology (PMID: 39088212) this August looked at the effects of omega-3 supplementation on white matter lesions (size of which can be indicative of neurodegenerative diseases like Alzheimer’s) in adults aged 75 and over.

This study examined whether supplementing with omega-3 fatty acids daily (from 2014-2019) could slow the progression of WML in older adults with low baseline omega-3 levels.

Findings:

• Fish Oil Benefits: reduction in WML progression not statistically significant across the entire cohort. However, participants with the APOE ε4 allele (genetic marker linked to a higher risk of Alzheimer’s) experienced a significant decrease in neuronal integrity breakdown when supplemented with omega-3s.
• EPA for the win? - Plasma levels of the omega 3 fatty acid EPA in this case and past research had the largest association with less white matter lesions (EPA is more abundant in microglia vs. DHA)
• Fish Oil Dosage: The study used 1.65 grams of omega-3 per day, containing 975 mg of EPA and 675 mg of DHA (EPA dominant).
• Fish Oil Side Effects: supplementation at this dosage was well-tolerated, with no significant difference in adverse events between the omega-3 and placebo groups, making it a viable option for long-term use in older adults.

For those concerned about cognitive health, especially if there’s a genetic predisposition to Alzheimer’s, maintaining an adequate intake of omega-3s through diet or supplementation is generally recommended. The fish oil benefits for men and women likely extend beyond cardiovascular health, offering potential protection against the neurodegenerative changes associated with aging especially those at high risk for something like Alzheimer’s disease.

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821809?resultClick=3

Transcript

Speaker 1: 0:00

Hello everyone, I'm William Wallace and welcome to an episode the inaugural episode of Daily Value, where I attempt to inject some value into your day in a manner that is brief and digestible, so that you can be better off than you were before you started the show, but also still be able to get on with your day Now. These broadcasts are meant to explore essential nutrients, nutritive and supplemental interventions to fuel our bodies and minds. Today, we're going to be taking a look at some new research on the role of omega-3 fatty acids in protecting brain health, especially as we age and especially in people who are at high risk for Alzheimer's disease. We'll break down the findings of a recent study that examined whether omega-3 supplementation could slow the progression of nerve cell breakdown in older adults, and we'll talk a bit about the kind and composition of the omega-3 that was used, with the degree of success in this case. So if you find this topic of interest, please stick around to the end of this short breakdown Before I go any further. I must preface with the disclaimer that this video is being generated purely for educational purposes. The contents of this video do not constitute medical advice and are not meant to substitute for standard medical practice. So please consult with your primary healthcare practitioner before beginning any nutrition or supplement-based protocols that we go over here on this show.

Speaker 1: 1:24

Let's start with a bit of background. As we age, our brains undergo various changes, some of which are more problematic than others. One issue that's closely linked to cognitive decline and even dementia is the accumulation of white matter lesions in the brain. White matter essentially helps different parts of the brain communicate. You can think of it like wiring in a computer. It's made up of nerve fibers that are covered in a fatty substance called myelin that consists of fatty acids like DHA, protein and water. White matter lesions are usually picked up on brain scans like an MRI and suggest that there's damage to white matter in the brain, often due to, and also contributing to, blood-brain barrier breakdown, reduced blood flow to the brain. Often due to, and also contributing to, blood-brain barrier breakdown, reduced blood flow to the brain and reduced capacity for oligodendrocytes to restore myelin. White matter lesions can disrupt the brain's normal communication pathways, leading to problems with memory, thinking and other cognitive functions. Over time, this damage can contribute to conditions like Alzheimer's disease. Actually, arteriosclerosis that's when arteries stiffen and lose elasticity coexists with white matter lesions in about 80% of probable Alzheimer's disease cases. So, needless to say, ways to slow or prevent the progression of these lesions is a key area of research in neurodegenerative disease prevention. A key area of research in neurodegenerative disease prevention.

Speaker 1: 2:49

Now, interestingly enough, and not an uncommon finding, is that plasma concentrations of omega-3 fatty acids in epidemiological research is associated with a reduced burden of white matter lesions. Remember that white matter is partly made up of omega-3s, especially DHA. You see, in mechanistic studies, omega-3 fatty acids have been shown to decrease the expression of proteins that, when activated, can damage the blood-brain barrier. Omega-3s themselves can break down into specialized inflammation-resolving metabolites. In fact, past research has shown that omega-3s circulating in blood can explain up to 24% of white matter lesion variation in adults and that high levels of circulating omega-3s are associated with a 40% reduced probability of white matter lesions in older adults. When I say higher levels, I mean a plasma concentration of 11 milligrams per deciliter, which would equate to an omega-3 index of between 5 and 8%, which is very good. Past research has shown that intake of the omega-3s, dha and EPA totaling at least 1.65 grams per day can clinically raise someone's omega-3 status over this neuroprotective threshold in people with mild to moderate Alzheimer's disease.

Speaker 1: 4:01

This new research I mentioned earlier went on to explore this topic further. A clinical trial conducted at Oregon Health and Science University and published in the journal Neurology just over a week ago looked at whether supplementing with omega-3 polyunsaturated fatty acids could reduce the progression of white matter lesions and protect against neuronal damage in adults age 75 and older. These adults had no dementia, but did have significant white matter lesions and low levels of omega-3 in their blood, making them really an ideally group to study the potential of the benefits of omega-3 supplementation, if any at all. Now, participants were either given a supplemental intervention or a placebo. The supplements used in the study provided 1.65 grams of omega-3s per day, yielding 975 milligrams of EPA and 675 milligrams of DHA. Again, these are the two primary omega-3 fatty acids found in most fish oil supplements. This study lasted from May 2014 until the last lab visit in September 2019. The results of the study were somewhat mixed. Overall, the omega-3 group showed less annual progression of white matter lesions compared to the placebo group, but this difference was not statistically significant. This means that, while there was a trend toward benefit, the results weren't strong enough to definitively say that omega-3 slowed lesion progression in the fish oil group overall.

Speaker 1: 5:29

Now, when the researchers looked more closely at a specific group of participants who carried the APOE4 allel, that's, a genetic variant associated with a higher risk of Alzheimer's disease, they found something very interesting In these individuals. Omega-3 supplementation did significantly reduce the breakdown of neuronal integrity, as measured by a type of MRI that can detect changes in the brain's white matter structure, and in this case, it suggested that omega-3s might help preserve brain integrity in those who are at a higher genetic risk for Alzheimer's disease. At least 25% of the global population carries at least one ApoE4 allele, the presence of which increases Alzheimer's disease risk two to three fold. With two alleles, your risk jumps as high as 15-fold. Omega-3s may help protect against the microvascular damage that leads to white matter lesions, especially in those with an APOE4LL. Additionally, omega-3s have been shown to reduce the release of pro-inflammatory proteins from microglia, the brain's immune cells, which may further protect against neuronal damage with age. Remember that I said plasma omega-3 can help to explain variation in white matter lesion volume in older adults. Well, interestingly enough, plasma levels of omega-3 fatty acid EPA in this case and past research had the largest association with less white matter lesions. Past research had the largest association with less white matter lesions. Epa is more abundant in microglia than DHA, and in past cell data, epa has shown to have a greater ability to reduce inflammatory protein release from microglia. That, over time, would allow immune cells from outside the brain to make their way in, once enough damage had been done to the blood-brain barrier, to make their way in, once enough damage had been done to the blood-brain barrier.

Speaker 1: 7:24

In those with an APOE4 allele, who are at a higher risk for Alzheimer's, this anti-inflammatory effect of an EPA-dominant formula, or at least just higher intakes of EPA in general, could be particularly important. The study suggests that omega-3 supplementation may help counteract the genetic vulnerability these individuals have, potentially slowing the progression of brain changes that lead to cognitive decline. So what does this mean for you? Well, fish oil may be worthwhile for people who carry the ApoE4 gene, which indicates a higher risk of developing Alzheimer's, but not necessarily for all older adults. Now, that being said, a high quality omega-3 supplement wouldn't be harmful.

Speaker 1: 8:04

Omega-3s have other known benefits, such as supporting heart health and reducing triglyceride levels. Do you need to take a supplement to achieve recommended omega-3 levels? Not necessarily Fatty fish. Inclusion as part of a healthy diet is recommended for most people anyway, but supplements can certainly help reach omega-3 status in this case, and research does show that omega-3 supplements give you a higher probability of reaching omega-3 recommendations. If you're concerned about cognitive health as you age, ensuring you get enough omega-3s in your diet could be beneficial, especially if you have a family history of Alzheimer's or know that you carry the ApoE4 LEL Now. To wrap up, this study adds to the growing body of evidence suggesting that omega-3s could be a valuable tool in the fight against cognitive decline, particularly in those with genetic risk factors for something like Alzheimer's disease. If you found this episode informative, be sure to subscribe, give it a like and leave a review. That would be wonderful and greatly appreciated on my end. So take care of your brain and body. They are the only ones you've got. No-transcript.