Omega 3 supplements.. Is it the biggest medical myth in the twenty-first century?!

Morgan Crabtree, 8, from Bradford, England.

A bright elementary school student, she was doing well in subjects she enjoyed such as reading, but was easily distracted.

Her mother told The Independent in June 2006 that her daughter could easily find excuses for not doing her homework, had frequent tantrums and got bored quickly.

Morgan's mother was particularly worried about leaving her daughter at home with her siblings for fear of misbehaving, but the mother confirmed that these problems had disappeared, and even her daughter's academic abilities had improved after 6 months of eating a daily tablespoon of a food supplement called "Smart Omega-3". Omega 3)” in her school, during an experiment conducted on students (1).

In Bradford, pupils at Newhall Park Primary School got omega-3s, and 81% of them showed an improvement in reading, while 67% showed an improvement in writing, and 74% showed an improvement in mathematics.” This is the good news that some press reports gave to parents(2 During the report in which she presented the case of Morgan and her mother, The Independent stated that school children should be given fish oil supplements to enhance their brain power, improve their behavior, and their ability to focus.

The report added that health professionals fear that young people do not get enough omega-3s through their daily diet, which is dominated by modern convenience foods, noting that this omega deficiency may expose them to risks of poor learning ability and violence in school settings. 1), but is that really so?

Widespread trade

Purvis explained that the reason behind the huge amount of spending on these supplements is the belief that the omega-3 fats in fish oil enhance children's intelligence.

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Meanwhile, taking omega-3 supplements was becoming a widespread culture.

In 2007, via The Guardian newspaper, Andrew Purvis investigated the omega-3 supplement industry in Britain, which was valued at about £116m at the time.

Purvis explained that the reason behind this huge amount of spending on these supplements is the belief that the omega-3 fats in fish oil enhance children's intelligence (2).

The popularity of omegas was not limited to Britain only. A report published by Time in 2018 stated that it can be considered that omega-3 is the most popular supplement in America, and that nearly 8% of adults, or about 19 million people, take some kind of omega-3 supplement. fatty acids, according to figures from the National Institutes of Health (3).

According to Harvard TH Chan, Harvard School of Public Health, the human body can make most of the types of fats it needs, but it cannot do so with omega-3 fatty acids.

These are essential fats, which belong to the category of essential unsaturated fats, although the body cannot create them from scratch, but must be obtained from food.

EPA and DHA come primarily from fish, while ALA is found in vegetable oils and nuts.

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There are 3 main types of omega-3: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) come primarily from fish, while alpha-linolenic acid (ALA) is found in vegetable oils and nuts, especially walnuts and flaxseeds, leafy greens and some animal fats (4).

Simon Dale, chair of nutrition at Bournemouth University in the UK, confirms to TIME the importance of omega-3s: "Omega-3s are involved in many different essential brain processes," he says.

According to Dayal, omega-3 polyunsaturated fatty acids and their receptors positively influence gene expression, oxidative stress, cerebral blood flow, levels of neurotransmitters, and other brain-related processes such as the production of new neurons.

DHA in particular can be considered an essential building block for brain cell membranes, based on this, a brain without omega-3 fatty acids can be thought of as a house without bricks or walls (3).

What is uncertain, unclear, or not sufficiently scientifically proven is not how important omega-3s are, but rather whether swallowing a fish oil pill or any other type of omega-3 supplement can improve cognitive function or protect brain health.

Uncontrolled experiments

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Over 15 years ago, Durham County Council approached Equazen, the manufacturer of its own fish oil supplements, to ask them to donate £1m worth of capsules to 5,000 school-aged children, who would be benchmarked against children who had not. They take omega-3 supplements, but the problem is that this large trial was done without a control group, no placebo, and no double-blind studies.

Double-blind trials are those in which neither the participants nor the experimenters know who is receiving a real treatment and who is receiving a placebo.

The goal here is to eliminate subjective bias that subjects may have toward a specific outcome.

During double-blind trials, even the researchers studying the effects of a new drug, who interact with the participants, don't know who was receiving the actual drug and who was receiving the placebo (5).

Despite these flaws and lack of research discipline, the results of these trials were widely reported, and fish oil was heralded as a wonderful supplement and of great importance, "but it is not science," says Dr Tom Sanders, a nutritionist at King's College London. The Guardian commented on these studies.

Sanders points out that these unsupervised studies undermine research that is properly done, yet hardly a month goes by without another "experiment" making headlines.

The link between these multiple trials is that they are without appropriate controls, and their results are based on anecdotal evidence (2).

Omega-3 polyunsaturated fatty acid supplementation is used as an adjunctive treatment of ADHD.

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In turn, Dr. Alex Richardson, a researcher at the University of Oxford and an expert in nutrition and the brain, responds to the belief in the magical effect of omega supplements on mental abilities, saying: “The studies conducted on the benefits of fish oil focused on children with specific difficulties,” such as children People with ADHD, dyslexia, and developmental coordination disorder, a disorder that affects motor coordination, learning, and social or psychological adjustment.

Some of these groups showed a slight improvement when taking fish oil, while others did not show any amount of improvement (2).

A study published in 2019 showed that long-chain omega-3 polyunsaturated fatty acids play a key role in the growth of neurons and the development of the human brain, and a deficiency in these substances has been reported in children with attention deficit hyperactivity disorder.

Therefore, polyunsaturated omega-3 fatty acid supplementation is used as an adjunctive treatment for ADHD (6).

On the other hand, a review of 52 studies showed that some were looking at whether symptoms of ADHD could be improved by avoiding certain nutrients, and others were looking at whether certain nutrients might reduce symptoms of ADHD. Movement and attention deficit, she explained that fish oil supplements were among the most promising nutritional interventions in studies to reduce symptoms of ADHD in children, but the results of the same review added that the studies that were conducted had some shortcomings, and that more comprehensive studies are necessary. To determine if fish oil supplementation is recommended as part of treatment for ADHD (7).

Misleading ads

About 17 years ago, Dairy Crest campaign ads claimed that omega-3 fatty acids in milk could enhance a child's learning abilities, but the Advertising Standards Authority ruled that this claim was "misleading".

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But despite the scientific implications of the studies on which they are based, the omega-3 supplement business has continued to thrive, driven by huge profits.

About 17 years ago, Dairy Crest announced that sales of its new omega-3-rich milk were performing strongly, despite the controversy surrounding the multimillion-pound advertising campaign for its so-called "smart milk".

The campaign ads claimed that the omega-3 fatty acids found in milk could enhance a child's learning abilities, but the Advertising Standards Authority ruled that this claim was "misleading". A company spokesperson then announced that the ads would be amended, but sales had already reached 15 million liters. annually, at a value of about 12 million pounds sterling, sales that later continued to grow (9).

Premier Foods may have learned the lesson of the smart milk advertising campaign. When it launched its brand of baked beans called Branstein, its slogan was that it was the "smart" choice for parents keen to get more omega-3s for their children. However, the company was careful not to make explicit claims about the effect of the product on intelligence(10)(2).

And it's not just children. Companies have often promoted omega-3 supplements to adults as improving cognitive function and memory.

In this regard, "Aaron Barbie", associate professor and director of the Center for Brain Plasticity at the University of Illinois, tells Time that his research has linked higher levels of omega-3 in the blood with improved cognitive function, as well as increased volume in some brain structures, but "Barbie" He added that these results do not mean that eating omega-3s in food or supplements alone can produce these benefits.

Barbie explains that there are not yet randomized controlled trials that prove that dietary omega-3s will cause positive changes in the way a person's brain works or improve cognitive function as they age(3).

One study conducted over two years in healthy older adults found that taking a daily supplement containing 500 mg of DHA

"For brain health, it is better to eat a nutritious diet and exercise than to take omega-3 fatty acid supplements or fish oil pills. Supplements cannot replace a healthy diet," says Frank Hu, professor of nutrition and science. Epidemiology at Harvard University.

Frank was commenting on a 2015 National Eye Institute study that showed little benefit of omega-3 supplementation on memory.

The previous trial was conducted on a group of 3,073 elderly people. Participants were randomly assigned to take omega-3 pills or a placebo for 5 years.

Frank stresses that if a person follows a healthy diet that contains large amounts of fruits, vegetables, and marine fish, they probably will not need to take fish oil supplements (12).

What about anxiety and depression?

When monitoring the results of one study, researchers found that omega supplements had little or no effect in preventing symptoms of depression or anxiety.

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Omega-3 supplements are also touted to help improve mood and reduce symptoms of anxiety and depression, but this claim is no less controversial than its predecessors.

A systematic review published in the British Journal of Psychiatry in 2019 was titled: “Fish oil supplementation has no effect on anxiety and depression,” stating that omega-3 fats had little or no effect on anxiety and depression (13).

Because depression appears to be less common in countries where people eat more fish, which contains omega-3 fatty acids, the researchers thought that fish oils might prevent and/or treat depression and other mood disorders.

Two of the omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are thought to be more beneficial to people with mood disorders.

The researchers show that using omega-3s to treat depression can work through different mechanisms. For example, omega-3s can easily travel across the brain cell membrane and interact with molecules associated with mood within the brain.

These substances also have anti-inflammatory effects that may help relieve symptoms of depression.

According to the Harvard website, there are more than 30 clinical trials that tested different omega-3 preparations in people with depression, but most studies used omega-3 as an additional treatment for people taking prescription antidepressants, while fewer studies used omega-3 as a single treatment.

Harvard Health Publishing, which is affiliated with Harvard Medical School, states that meta-analyses, which is research that combines and analyzes the results of multiple studies, generally indicates that omega-3s may be effective, but that the results are insufficiently unanimous (14). ).

This is confirmed by another review published in the Cambridge University Press.

During the review, the team looked at 31 trials of adults with depression or anxiety, and adults without these disorders.

Over 41,000 participants were randomly assigned to consume more long-chain omega-3 fats, or maintain their usual intake, for at least 6 months.

When monitoring the results, the researchers found that the omega supplements had little or no effect in preventing symptoms of depression or anxiety.

Experts recommend eating healthy food sources of omega-3, rather than swallowing pills.

Fatty fish, such as salmon and sardines, are among the highest natural food sources.

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Lead author Dr Lee Hooper, from UEA's Norwich Medical School, says: "Our previous research has shown that long-chain omega-3 supplements, including fish oils, do not protect against diseases such as heart disease, stroke or diabetes. Now comes this large, informative systematic review based on data collected from many thousands of people over long periods of time to confirm that there are no protective effects that omega-3s can achieve in relation to anxiety disorders and depression."

Hooper adds that previous, more reliable studies have consistently shown that there is little or no effect of long-chain omega-3 fats on depression or anxiety, and that these supplements should not be treated as an effective treatment for these disorders (13).

Also, the Royal College of Psychiatrists stated in 2015 that there was insufficient evidence to recommend omega-3 fatty acids as an alternative to antidepressants or mood stabilizers.

While the British Dietetic Association clarified in 2017 that the use of omega-3 dietary supplements is not currently recommended for healthy adults and children (15).

In the same vein, Dr. Matthew Muldoon, professor of medicine at the University of Pittsburgh, says it is still possible, and perhaps likely, that long-term consumption of omega-3 dietary acids could have a beneficial effect on brain health and function, but he adds that all the details are murky. No one knows how much or what kinds of omega-3s a person needs or how long it takes for these acids to achieve the desired benefits or positive results, or even the best possible way to take omegas to achieve the benefits.

For all these reasons, experts advise people to eat healthy food sources of omega-3s, rather than swallowing pills.

Fatty fish, such as salmon, trout, and sardines, are among the highest natural dietary sources of omega-3s (3).

The bottom line, then, is that omega-3 supplementation can be beneficial at times, but it is by no means a magic cure for some disorders, nor is it an opportunity to improve the mental abilities of ordinary people, as it has long been promoted.

Scientists in this range tell us that, in contrast to the medical companies' announcements, there is still some area of ​​ambiguity in this range.

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