Omega-3 supplements

Omega-3 supplements may be more effective in preventing autoimmune diseases?

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A new study looks into the preventive potential of vitamin D and omega-3 supplements for autoimmune diseases.

  • Autoimmune diseases like rheumatoid arthritis, psoriasis, lupus, and inflammatory bowel disease affect more than 24 million Americans.
  • Supplements that help regulate inflammation and chronic pain — and that can forestall the effects of autoimmune diseases — have shown to be effective.
  • Researchers have been looking into two supplements in particular — vitamin D and omega-3 fatty acids.
  • A recent study of more than 20,000 participants showed that two years after a randomized five-year trial period, the benefits of vitamin D in preventing autoimmune diseases had waned while those of omega-3 were still strong.

A recent study of more than 20,000 participants showed that two years after a randomized five-year trial period, the benefits of vitamin D in preventing autoimmune diseases had waned while those of omega-3 fatty acids were still strong.

In the study, published in January in the journal Arthritis & RheumatologyTrusted Source, the authors said that 21,592 participants in the VITAL trials — conducted among more than 25,000 total participants to determine the effects of vitamin D and omega-3 supplements on cancer and cardiovascular disease — were followed for an additional two years after the supplements were discontinued.

Among that population of the participants, who were men over 50 and women over 55, the study authors found 236 new cases of confirmed autoimmune disease since the initial trial’s results were published, 65 probable cases in the 5.3 years of the randomized trial, and 42 probable cases diagnosed during the 2-year observational phase.

After the two-year observation period, 255 people who had randomly received vitamin D had a newly developed confirmed autoimmune disease, compared with 259 who had received a vitamin D placebo, a nonsignificant hazard risk (HR) of 0.98.

There were 234 confirmed autoimmune disease cases among people who received omega-3 supplements, compared with 280 among those who received a placebo — a statistically significant HR of 0.83.

“Two years after trial termination, vitamin D 2000 IU/day’s protective effects dissipated, but 1000 mg/day n-3 fatty acids had a sustained effect in reducing AD incidence,” the authors wrote.

How do supplements work in fighting autoimmune diseases?

Autoimmune diseases, which affect more than 24 million peopleTrusted Source in the United States, are diseases characterized by the immune system attacking otherwise healthy tissue. They include conditions like psoriasis, psoriatic arthritis, rheumatoid arthritis, lupus, Hashimoto’s thyroiditis, Grave’s disease, inflammatory bowel disease (IBD), celiac disease, and type 1 diabetes.

Treatments for these conditions can be costly and long-term, and the effects of vitamin D and omega-3 supplements have long been known as beneficial to stall autoimmune diseasesTrusted Source.

According to the study in question, vitamin D is capable of regulating genes involved in inflammation, and the body cannot make the essential n-3 fatty acids eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA), which are found in fish oil supplements.

Randomized controlled trials conducted in the 1980s and 1990s have shown the effectiveness of fish oil supplements against inflammation and pain associated with autoimmune diseases.

Melanie Murphy Richter, a registered dietitian nutritionist and the director of communications for Prolon, who was not involved in the study, told Medical News Today that the overall lack of vitamin D in most people means supplementation is critical.

“Most people (even those who live in sunny locations like Los Angeles or Florida) are deficient in vitamin D. In fact, 1 billion people worldwide have a vitamin D deficiency, with 50% of the population having a vitamin D insufficiencyTrusted Source (low-normal levels). In the U.S. alone, more than 35% of adults are deficient,” Richter said.

“Vitamin D is revered in the medical community for its antioxidant-like qualities and its ability to regulate a variety of immune functions, like B cell and T cell regulation (the functions responsible for suppressing pro-inflammatory cytokines in the body and increasing anti-inflammatory properties in the body). It has the ability to reduce inflammation and plays a role in maintaining the integrity of the gut lining. Our gut health is critical in managing symptoms for autoimmune patients, too.”
— Melanie Murphy Richter, dietitian nutritionist

How should I choose vitamin D or omega-3 supplements?

Kristin Kirkpatrick, a registered dietitian at the Cleveland Clinic Dept of Department of Wellness & Preventive Medicine in Cleveland, Ohio, and a senior fellow at the Meadows Behavioral Healthcare in Wickenburg, Arizona, who was also not involved in the study, told MNT that while the study supports the use of these supplements, there are a number of other factors to consider when it comes to a holistic look at health.

“Supplementation should be considered only with the addition of high-nutrient-dense diet, good quality sleep, stress management and limitation of sedentary behavior,” Kirkpatrick said, adding that consumers should have some caveats when it comes to looking for vitamin D or omega-3 supplements.

What to look for in supplements

“Two things come to mind that are important for both. 1. Quality – not all supplements are created equal and in an unregulated market, consumers need to do their homework on the best options. 2 – dose. The dose for vitamin D, for example, may be considered alongside current D levels. and for omega 3’s, dose may be dependent on outside consumption from food of omega 3’s.”
— Kristin Kirkpatrick, registered dietitian

Murphy added that the study had a particularly narrow focus and didn’t consider lifestyle modifications that could also affect autoimmune disease.

“The main population was older adults, which means that the results might not be generalizable to a younger population. The study only looked at one dose and formulation of each supplement, which could impact future outcomes,” Murphy said.

“A more comprehensive study should look at a more diverse population base with a younger subsect of participants, as well as varying dosages. It should also consider finding ways to control external impacts like diet, lifestyle, and stress factors,” she added.

Preventing Autoimmune Diseases: New Findings on Vitamin D, Omega-3 Supplements

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Two years after the end of a randomized trial that showed a benefit of daily vitamin D and omega-3 fatty acid (n-3 FA) supplementation for reducing risk for autoimmune diseases, the salubrious effects of daily vitamin D appear to have waned after the supplement was discontinued, while the protection from n-3 lived on for at least 2 additional years.

As previously reported, the randomized VITAL, which was designed primarily to study the effects of vitamin D and n-3 supplementation on incident cancer and cardiovascular disease, also showed that 5 years of vitamin D supplementation was associated with a 22% reduction in risk for confirmed autoimmune diseases, and 5 years of n-3 FA supplementation was associated with an 18% reduction in confirmed and probable incident autoimmune diseases.

Now, investigators Karen H. Costenbader, MD, MPH, of Brigham & Women’s Hospital in Boston, Massachusetts, and colleagues reported that among 21,592 participants in VITAL who agreed to be followed for an additional 2 years after discontinuation, the protection against autoimmune diseases from daily vitamin D (cholecalciferol; 2000 IU/d) was no longer statistically significant, but the benefits of daily marine n-3 FAs (1 g/d as a fish-oil capsule containing 460 mg of eicosapentaenoic acid and 380 mg of docosahexaenoic acid) remained significant.

“VITAL observational extension results suggest that vitamin D supplementation should be given on a continuous basis for long-term prevention of [autoimmune diseases]. The beneficial effects of n-3 fatty acids, however, may be prolonged for at least 2 years after discontinuation,” they wrote in an article published on January 25 in Arthritis & Rheumatology.

Costenbader told Medscape Medical News that the results of the observational extension study suggest that the benefits of vitamin D “wear off more quickly, and it should be continued for a longer period of time or indefinitely, rather than only for 5 years.”

In addition to the disparity in the duration of the protective effect, the investigators also saw differences in the effects across different autoimmune diseases.

“The protective effect of vitamin D seemed strongest for psoriasis, while for omega-3 fatty acids, the protective effects were strongest for rheumatoid arthritis and inflammatory bowel disease,” she said.

Mixed Effects

In an interview with Medscape Medical News, Janet Funk, MD, MS, vice chair of research in the Department of Medicine and professor in the School of Nutritional Science and Wellness at the University of Arizona, Tucson, Arizona, who was not involved in the study, saidthat the results suggest that while each supplement may offer protection against autoimmune diseases, the effects are inconsistent and may not apply to all patients.

“I think the VITAL extension results suggest that either supplement (or both together) may have benefits in reducing risk of autoimmune diseases, including possible persistent effects posttreatment, but that these effects are nuanced (ie, only in normal weight post-vitamin D treatment) and possibly not uniform across all autoimmune diseases (including possible adverse effects for some — eg, inverse association between prior omega-3 and psoriasis and tendency for increased autoimmune thyroid disease for vitamin D), although the study was not powered sufficiently to draw disease-specific conclusions,” she said.

In an editorial accompanying the study, rheumatologist Joel M. Kremer, MD, of Albany Medical College and the Corrona Research Foundation in Delray Beach, Florida, wrote that “[T]he studies by Costenbader, et al. have shed new light on the possibility that dietary supplements of n-3 FA [fatty acid] may prevent the onset of [autoimmune disease]. The sustained benefits they describe for as long as 2 years after the supplements are discontinued are consistent with the chronicity of FA species in cellular plasma membranes where they serve as substrates for a diverse array of salient metabolic and inflammatory pathways.”

VITAL Then

To test whether vitamin D or marine-derived long-chain n-3 FA supplementation could protect against autoimmune disease over time, Costenbader and colleagues piggybacked an ancillary study onto the VITAL trial, which had primary outcomes of cancer and cardiovascular disease incidence.

A total of 25,871 participants were enrolled, including 12,786 men aged 50 and older and 13,085 women aged 55 and older. The study had a 2 × 2 factorial design, with patients randomly assigned to vitamin D 2000 IU/d or placebo and then further randomized to either 1 g/d n-3 FAs or placebo in both the vitamin D and placebo primary randomization arms.

In multivariate analysis adjusted for age, sex, race, and other supplement arm, vitamin D alone was associated with a hazard ratio (HR) of 0.68 (P = .02) for incident autoimmune disease, n-3 alone was associated with a nonsignificant HR of 0.74, and the combination was associated with an HR of 0.69 (P = .03). However, when probable incident autoimmune disease cases were included, the effect of n-3 became significant, with an HR of 0.82.

VITAL Now

In the current analysis, Costenbader and colleagues reported observational data on 21,592 VITAL participants, a sample representing 83.5% of those who were initially randomized, and 87.9% of those who were alive and could be contacted at the end of the study.

As in the initial trial, the investigators used annual questionnaires to assess incident autoimmune diseases during the randomized follow-up. Participants were asked about new-onset, doctor-diagnosed rheumatoid arthritis, polymyalgia rheumatica, psoriasis, autoimmune thyroid disease, and inflammatory bowel disease. Participants could also write in any other new autoimmune disease diagnoses.

There were 236 new cases of confirmed autoimmune disease that occurred since the initial publication of the trial results, as well as 65 probable cases identified during the median 5.3 years of the randomized portion, and 42 probable cases diagnosed during the 2-year observational phase.

The investigators found that after the 2-year observation period, 255 participants initially randomized to receive vitamin D had a newly developed confirmed autoimmune disease, compared with 259 of those initially randomized to a vitamin D placebo. This translated into a nonsignificant HR of 0.98.

Adding probable autoimmune cases to the confirmed cases made little difference, resulting in a nonsignificant adjusted HR of 0.95.

In contrast, there were 234 confirmed autoimmune disease cases among patients initially assigned to n-3, compared with 280 among patients randomized to the n-3 placebo, translating into a statistically significant HR of 0.83 for new-onset autoimmune disease with n-3.

Costenbader and colleagues acknowledged that the study was limited by the use of doses intended to prevent cancer or cardiovascular disease and that higher doses intended for high-risk or nutritionally deficient populations might reveal larger effects of supplementation. In addition, they noted the difficulty of identifying the timing and onset of incident disease, and that the small number of cases that occurred during the 2-year observational period precluded detailed analyses of individual autoimmune diseases.

Omega-3 Supplements do not have CVD benefits : JAMA

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https://speciality.medicaldialogues.in/omega-3-supplements-do-not-have-cvd-benefits-jama/

Omega-3 supplements continue to prevent psychological disorders up to 7 years after patients stop taking them.

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The psychiatric benefits of short-term omega-3 supplementation could last for years afterward. This is the suggestion made by a study conducted by researchers from the University of Melbourne and the Medical University of Vienna and published in the journal Nature Communications on August 11.

The researchers followed up on a study in which young people at ultra-high risk of schizophrenia were given omega-3 supplements for 12 weeks. The original study found that people in the omega-3 group who developed schizophrenia did so an average of a year later than people who had been given a placebo.

In the new study, researchers found that even seven years later, the people in the omega-3 group were significantly less likely to have developed schizophrenia than those in the placebo group.

Cuts schizophrenia rate 75 percent

Omega-3s are a family of essential fatty acids that are known to play an important role in the development and function of the nervous system, including the brain. Prior studies have linked omega-3 deficiencies to a variety of mental health problems. Omega-3s have also showed promise as a treatment for anxiety and depression, and low levels have been linked with an increased risk of schizophrenia. People with schizophrenia have been shown to have low levels of both omega-3s and omega-6s in their cell membranes.

In the new study, the researchers found that only 10 percent of the people who had participated in the 12-week omega-3 trial developed schizophrenia over the following seven years. In contrast, nearly 40 percent of those in the placebo group developed schizophrenia in that time.

“We show that omega-3 significantly reduced the risk of progression to psychotic disorder during the entire follow-up period,” the researchers wrote.

Omega-3s help the brain develop

The researchers could not explain exactly how omega-3 supplementation might prevent schizophrenia seven years later, but they did discuss several possibilities. They noted that the brain’s neural circuitry has “several critical periods of development” during which interventions such as omega-3 supplementation might influence the way in which the brain’s connections are formed. Adolescence might be such a “critical period” for the development of schizophrenia, and providing a boost of omega-3s at this time might stop the processes that lead to the development of psychosis, instead shunting the brain onto a healthier developmental path.

Two recent studies in animals provide some support for this hypothesis. One study found that when rats with brain lesions were treated with an antioxidant during adolescence, they did not develop the structural brain defects seen in untreated adult rats. In addition to the brain defects, the untreated adult rats developed behavioral and electrophysiological changes comparable to those seen in schizophrenia.

“Adolescence may therefore be a critical developmental stage in which pathophysiological conditions (for example, oxidative stress) can affect the developing brain, but at the same time it may also provide a window of opportunity for preventive intervention,” the Melbourne and Vienna researchers wrote.

The second study found that when rats were deprived of dietary omega-3s, levels of the neurotransmitter dopamine changed in their brains. Among adolescent rats, dopamine levels dropped. Among adult rats, however, the levels actually increased.

Humans at ultra-high risk of schizophrenia have elevated dopamine levels in the brain. The findings suggest that omega-3 supplementation during adolescence might prevent dopamine levels from becoming elevated, thereby halting one of the processes that leads to the development of schizophrenia in adulthood.

Although the study was too small to recommend omega-3 supplementation for schizophrenia prevention, the researchers noted that omega-3-rich fish oil “has no clinically relevant side effects” and that greater intake is therefore unlikely to cause any harm.

Approximately one percent of the population suffers from schizophrenia, which is characterized by hallucinations and delusions. The disease has a very strong genetic component, but it is also known to be influenced by environmental factors. It currently has no cure.

Learn more: http://www.naturalnews.com/051017_Omega-3_oils_schizophrenia_dopamine.html#ixzz3kgvtbqXl