Nutrition and Traumatic Brain Injury Improving Acute and Subacute Health Outcomes in Military Personnel (2011) / Chapter Skim
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13 Eicosapentaenoic Acid (EPA) and Docosahexaenoic Acid (DHA)
13 Eicosapentaenoic Acid (EPA) and Docosahexaenoic Acid (DHA)
Pages 188-204
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From page 188... ...
, which is enzymatically transformed into inflammatory prostaglandins or leukotrienes that contain two and four double bonds, respectively. Prostaglandins and leukotrienes synthesized from n-3 fatty acids contain three and five double bonds, respectively, and are less biologically active (Jones and Kubow, 2006)
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From page 189... ...
The most effective way to increase body stores of EPA and DHA is through increased dietary intake of oil from cold-water fish species and from krill. Intake of up to 1 g/day of n-3 fatty acids from dietary fish intake is generally regarded as having very low risk, but higher intakes can increase the risk of gastrointestinal upset as well as increases in blood glucose and concentrations of low-density lipoprotein (LDL)
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From page 190... ...
placebo- polyunsaturated Although PUFA was associated with lower controlled trial fatty acids mortality rate, the trend was not statistically (PUFA, significant. na=72 stroke 500 mg)
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From page 191... ...
. DeGiorgio Refractory Randomized, 9,600 mg of fish An average 11% increase in seizure et al., 2008 epilepsy double-blind, oil/day (2,800 frequency from baseline was observed in cross-over mg of n-3 fatty patients taking fish oil, and an average clinical trial acids)
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From page 192... ...
Puri et al., Chronic Pilot, EPA (1 g) + Treatment with n-3 fatty acids had 2007 refractory randomized, DHA (0.7 g)
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From page 193... ...
193 EICOSAPENTAENOIC ACID AND DOCOSAHEXAENOIC ACID TABLE 13-1 Continued Type of Type of Study Reference Injury/Insult and Subjects Treatment Findings/Results Yuen et al., Epilepsy Randomized, 1 g of EPA + Greater proportion of patients on PUFA than on placebo had a > 50% seizure 2005 placebo- 0.7 g of DHA controlled, or matching reduction in the first 6 weeks (17% vs.
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From page 194... ...
groups confirmed that PUFA group was n=11,324 at lower risk for combined endpoints of patients aged death, non-fatal MI, and non-fatal stroke 49–70 years (RR=0.85, 95% CI: 0.74–0.98; p=0.023) with recent (≤ and combined endpoints of cardiovascular 3 months)
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From page 195... ...
Increased risk of ischemic stroke also was observed in these two groups consuming fried fish/fish sandwiches (1–3 times/month: HR=1.17, 95% CI: 0.96–1.43; ≥ 1 time/ week: HR=1.36, 95% CI: 1.08–1.72; p for trend=0.008)
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From page 196... ...
. Risk of stroke increased with consumption of n-3 fatty acid.
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From page 197... ...
And effects of fish consumption on ischemic stroke were not modified by use of fish oil, vitamin E, aspirin, or linolenic acid. Schlanger Epilepsy n=5 5 g/day of After 6 months, seizures of grand mal et al., 2002 secondary to a spread stopped completely in 3 patients, reduced to observation other CNS containing 65% once a month in 1 patient, and reduced to period: 6 diseases n-3 PUFAs 3 times/week in another patient.
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From page 198... ...
in the 5th quintile. When n-3 fatty acid intake exceeded 3 g/day (or, approximately the consumption of fish 3 times or more per day)
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From page 199... ...
sham-injured rats) , but n-3 2007 fluid Dawley rats diet percussion supplemented fatty acid supplementation significantly restored it (p < 0.05)
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From page 200... ...
. But injured rats fed with n-3 fatty acid supplemented diet had significantly lower level of oxidized protein compared to injured rats on regular diet and sham-injured rats on both diets (p < 0.01)
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From page 201... ...
EVIDENCE INDICATING EFFECT ON TREATMENT Human Studies There have been no clinical trials conducted to determine the efficacy of n-3 fatty acid infusion for treatment of TBI. Nevertheless, n-3 fatty acid infusion into healthy human subjects affects several inflammatory pathways in a way that could be beneficial for TBI patients: platelet aggregation and thromboxane B2 synthesis were reduced within 60 minutes of infusion (Elmadfa et al., 1993)
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From page 202... ...
RECOMMENDATION 13-2. Based on the evidence that fish oil decreases inflamma tion within hours of continuous administration, human clinical trials that investigate fish oil or purified n-3 fatty acids as a treatment of TBI are recommended.
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From page 203... ...
2010. Omega-3 fatty acid supplementation and reduction of traumatic axonal injury in a rodent head injury model.
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From page 204... ...
2004. Dietary omega-3 fatty acids normalize BDNF levels, reduce oxida tive damage, and counteract learning disability after traumatic brain injury in rats.
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