Clinical Applications of Essential Fatty Acids In Psychiatric Disorders

Fats, Essential Fatty Acids & Mental Health

Confusion and misconceptions about fat are very common. Although much attention has been focussed on the need to reduce dietary fat, the body does need fat. While avoiding a high saturated fat diet can be beneficial, there are some essential fats that are extremely important for healing and maintaining good health. These are "good" fats that are as necessary for mental health as vitamins or minerals.

To understand how fat intake is related to psychiatric disorders, it is necessary to understand the different types of fats available and the ways in which these fats act within the body and their influence on mental health....

01.-Saturated Fatty Acids are found primarily in animal and dairy products such as whole milk, cheese and cream, and fatty meats like beef, veal, ham, lamb and pork. Some vegetable products including palm kernel oil or coconut oil are also high in saturated fatty acids. The liver uses saturated fats to manufacture cholesterol.

02.-Monounsaturated Fatty Acids are found in vegetable and nut oils such as olive, canola and peanut. These fats appear to reduce blood levels of LDLs without affecting HDLs in any way.

03.-Polyunsaturated Fatty Acids (Essential Fatty Acids) are found in greatest abundance in soybean, safflower, corn and sunflower oils. Certain fish oils are also high in polyunsaturated fats. Unlike the saturated fats, polyunsaturated fats may actually lower our total blood cholesterol level. There are two basic categories of Essential Fatty Acids, Omega-3 and Omega-6...

3.1.-Omega-3's are Essential Fatty Acids that our bodies cannot create without first obtaining them from food. The omega-3 fatty acids include alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA).Fish oils and plant products are the primary dietary source of Omega-3 Fatty Acids. EPA and DHA are found in cold-water fish such as salmon, mackerel, halibut or herring, and in animals that feed on these fish. ALA is found in nonhydrogenated oils, such as rapeseed (canola), flaxseed, and soybean oil, and in margarines and other fats containing such oils. After consumption, ALA is converted in the human body to EPA and DHA.

3.2.-Gamma-Linolenic Acid (an Omega-6 Fatty Acid) is the other major category of Essential Fatty Acids. Omega-6 Fatty Acids are found in the plant seed oils of evening primrose, borage, black currant, and fungal oils. Arachidonic acid of the omega-6 series is found in egg yolk, organ meats and other animal-based foods.

The balance of Omega-6 Essential Fatty Acid and Omega-3 Essential Fatty Acid should be four or five Omega 6 to each Omega-3 for a good balance. We get ample amounts of Omega-6 in the typical Western diet. The ratio in this diet is between 10 and 20 to 1 in favor of Omega 6, far too high in Omega-6.This imbalance leads to many serious physical and mental problems. To help achieve the healthier balance, a person eating a typical western diet should reduce consumption of saturated fats and increase consumption of Omega-3 Polyunsaturated Essential Fatty Acids.

The Role of Essential Fatty Acids in Psychiatric Disorders

There is an increasing body of evidence that indicates that fish oils, in particular those with high EPA to DHA ratios, have a major role to play in helping people maintain good mental health and to avoid the mood swings, mild depression and general fatigue many people experience on a regular basis. According to researchers at an international conference sponsored by the National Institutes of Health there is evidence which suggests that higher consumption of Essential Fatty Acids in fish, particularly Omega-3, appear to be linked to a lower risk for Depression and better treatment of Manic Depression and Schizophrenia.

For years, investigators have been exploring the link between depression and diet, especially the association between the incidence of depression and fish consumption. Fish and some land-based foods are rich in Omega-3,a nutritional building block critical for the healthy development and functioning of the brain and nervous system.

According to Horrobin "The level of prostaglandin E1 (which are made in the brain from Omega 3 and 6 Essential Fatty Acids) is of crucial importance to the body. A fall in the level of PGE in the brain will lead to a potentially catastrophic series of untoward consequences including increased vascular reactivity, elevated cholesterol production, diabetic-like changes in insulin release, enhanced risk of auto-immune disease, enhanced risk of inflammatory disorders, and susceptibility to depression."

Clinical Applications of Essential Fatty Acids : Scientific Evidences

Here are some basic facts about Essential Fatty Acids and Mental Health.

01.-Epidemiological studies in various countries suggest that decreased n-3 fatty acid consumption correlates with the increasing rates of depression. Long chain –3 polyunsaturated deficiency may also contribute to depressive symptoms in alcoholism, multiple sclerosis and post-partum depression just as n-3 polyunsaturated fatty acid may reduce coronary artery disease (Hibbeln & Salem,1995).

02.-It has been hypothesized that depletion of cell membrane n3 polyunsaturated fatty acids (PUFA), particularly docosahexanoic acid (DHA), may be of etiological importance in depression. They measured the fatty acid composition of phospholipid in cell membranes from red blood cells (RBC) of 15 depressive patients and 15 healthy control subjects. Depressive patients showed significant depletions of total n3 PUFA and particularly DHA. Incubation of RBC from control subjects with hydrogen peroxide abolished all significant differences between patients and controls these findings suggest that red blood cells membranes in depressive patients show evidence of oxidative damage (Peet et al.,1998).

03.-Researchers at the University of Guelph now report that they have found low levels of long-chain polyunsaturated fatty acids, notably DHA (docosahexaenoic acid) in people suffering from dementia and Alzheimer’s disease. The study involved 84 people -aged 80 years or older- who were given a thorough clinical evaluation. 19 of the people were diagnosed as having AD, 10 as having non-AD dementia, 36 were characterized as non-demented but cognitively impaired, and 19 had normal cognitive functioning. Blood samples were obtained from all participants and analyzed for fatty acids in the phospholipid phases of the plasma.

The researchers observed significantly lower levels of EPA (by about 42%), DHA (by 17-33%) and total Omega-3 Fatty Acids (by 23-28%) in the plasma phospholipids phase of the patients with Alzheimer’s disease, other dementia and cognitive impairment (non-demented) than in the normal controls. Other research has confirmed the association between low DHA and EPA levels and impaired cognitive function. Other studies have found that fish oil supplementation improves sleep, mood, appetite, cooperation and short-term memory in AD patients. The Guelph researchers conclude that an effort should be made to increase the intake of fish or fish oils in the population at large and the elderly in particular (Conquer et al.,2000).

04.-Epidemiologic studies have found a clear correlation between a low intake of EPA and DHA and the prevalence of depression. In two studies of population groups in the USA the incidence of depression was found to be 3.7% and 2.9%. Average intake of EPA and DHA in the USA is estimated to be about 0.1 gram per day. In two Japanese studies, on the other hand, the incidence of depression was only 0.9% and 0% and the intake of EPA plus DHA was 1.5 grams per day and 4.2 grams/day respectively. Other studies have shown that on-off dieting can produce a serious imbalance in the ratio of fatty acids and may lead to depression. The researchers conclude that an extremely low-fat diet may be counter-productive and have deleterious psychological ramifications. They stress that dietary advice regarding cholesterol reduction, weight loss, and cancer prevention should emphasize the importance of an adequate intake of omega-3 fatty acids. (Bruinsma & Taren,2000)

05.-Researchers at the University of Kuopio report that regular fish consumption reduces the risk of depression and suicide. Their study involved 1767 Finnish men and women who were evaluated for depression and suicidal tendencies using the 21-item Beck Depression Inventory. They were also asked about their fish consumption. The researchers conclude that people who consume fish twice a week or more have a 37 per cent lower risk of being depressed and a 43 per cent lower risk of having thoughts of harming themselves -suicidal tendencies- (Tanskanen et al.,2001).

Conclusion

The epidemiological studies and scientific research so far indicate that Essential Fatty Acids are necessary for our mental and physical health. Scientific studies suggest that by increasing our consumption of certain ‘good’ fats found in fish, walnuts and flaxseed oil, we may improve the symptoms of a number of psychiatric disorders, including Depression, Schizophrenia and Manic-Depressive Illness.

Canadian researchers like Dr. Allan Logan says that in societies where fish is the primary protein consumed, the incidence of Depression and Bipolar Disorders is considerably lower than in cultures where bovine protein is a core staple. Recent studies, according to Dr. Logan, draw links to Alzheimer's disease, ADD, Autism, Schizophrenia, Hostility, Anxiety and Bipolar Disorder.

According to Haag (2003) "The ratio of membrane omega-3 to omega-6 PUFAs can be modulated by dietary intake. This ratio influences neurotransmission and prostaglandin formation, processes that are vital in the maintenance of normal brain function. (...) The ratio of dietary omega-3 to omega-6 polyunsaturated fatty acids (PUFAs) in the average Western diet needs to be increased for optimal mental health. Eicosapentanoic acid (EPA) and docosahexanoic acid (DPA) have potential in the treatment of psychiatric disease.(...).It is important that the public, dieticians, the medical profession, and policy-makers in charge of nutrition programs be conscious of this recommendation and work toward ensuring an adequate daily DHA-plus-EPA intake by the population."

Epidemiological data and scientific evidences suggesting significant efficacy of Omega-3 Fatty Acids in the prevention and treatment of numerous psychiatric disorders has been emerging worldwide. Several important clinical studies with Omega-3 Fatty Acids on psychiatric disorders like Bipolar Disorder, Schizophrenia, Alzheimer’s Disease or Depression are ongoing and the results of these studies may add new modalities and therapeutic options to the present treatment of these devastating mental diseases.

References

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Conquer,M. ; Julie,A. et al.(2000).Fatty acid analysis of blood plasma of patients with Alzheimer's disease, other types of dementia, and cognitive impairment. Lipids , 35 1305-1312.

Edwards,R. ; Peet,M. ; Shay,J. & Horrobin,D. (1998).Omega-3 polyunsaturated fatty acid levels in the diet and in red blood cell membranes of depressed patients.Journal of Affective Disorders , 48 (2-3) , 149-155.

Haag,M.(2003).Essential Fatty Acids & the Brain.Canadian Journal of Psychiatry , 48 (3) , 195-203.

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Horrobin,D. & Bennett,C.(1999).Depression and bipolar disorder: relationships to impaired fatty acid and phospholipid metabolism and to diabetes, cardiovascular disease, immunological abnormalities, cancer, ageing and osteoporosis. Possible candidate genes. Prostaglandins Leukot Essent Fatty Acids. , 60 (4) , 217-234.

Peet,M. ; Murphy,B. ; Shay,J. & Horrobin,D. (1998).Depletion of omega-3 fatty acid levels in red blood cell membranes of depressive patients.Biological Psychiatry,143 (5), 315-319.

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Tanskanen,A. et al. (2001). Fish consumption,depression and suicidality in a general population. Archives of General Psychiatry , 58 , 512-513

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Article written by David Puchol Esparza
Psychologist and Naturopath

Author: David Puchol Esparza
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