A just-published study seems to suggest a synergistic relationship between omega-3s and B-vitamins in brain health. Jererén et al. were able to show that B vitamin supplementation was successful in reducing brain atrophy in elderly people with mild cognitive impairment only if their omega-3 levels were high. Those with high omega-3 levels at the start of the trial experienced 40% less brain atrophy after daily B vitamin supplementation than those with high omega-3 levels taking placebo. There was no significant effect of B vitamin intake on those with ‘low’ omega-3 levels at baseline, suggesting the benefits were not associated with omega-3 status alone.
Omega-3s and B vitamins have dominated brain health headlines in recent months but there still seems to be little conclusive evidence as to whether they can be of benefit to those already showing signs of cognitive impairment. Jererén et al. are among the minority to consider that the benefits of nutritional intervention could be related to the levels of the components of the tissue being targeted. Since omega-3 levels are vital for the structure and function of the brain and the levels of EPA plus DHA (known as the omega-3 index) are strong predictors of later life brain atrophy, it makes sense to measure the ‘current’ state of the brain tissue in order to determine whether a targeted intervention might be of benefit.
In their study, Jererén et al. specifically sought to identify whether plasma omega-3 levels could modify the beneficial effects of the homocysteine-lowering B vitamins, knowing that both nutrient groups are associated with brain atrophy rates. They took 168 elderly patients with existing cognitive impairment and measured their omega-3 levels. They were then randomised to receive daily either 0.8mg folic acid, 20mg B6 and 0.5mg B12 – the key B vitamins necessary for recycling homocysteine – or a placebo. The subjects had their brains scanned by MRI and were followed up two years later with another MRI scan.
The patients were split into three groups according to their baseline omega-3 levels and analysed according to the changes in their brain structure. The researchers found that those with the highest baseline omega-3 levels (>590umol/L) who were also taking the B vitamins had a 40% reduction in brain shrinkage versus those taking placebo. Those subjects with the lowest omega-3 levels (<390umol/L) experienced no significant reduction in brain atrophy over the two year period regardless of B vitamin intake. The study clearly shows a significant interaction between omega-3 EPA and DHA levels with the B vitamin intervention on the rate of brain atrophy. The authors conclude that “The beneficial effect of B vitamin treatment on brain atrophy was observed only in subjects with high plasma ω-3 fatty acids. It is also suggested that the beneficial effect of ω-3 fatty acids on brain atrophy may be confined to subjects with good B vitamin status. The results highlight the importance of identifying subgroups likely to benefit in clinical trials.”
These findings highlight the importance of considering the underlying mechanisms of a targeted intervention, and that taking into consideration the interactions that occur between the nutrients and the targeted tissue is necessary to fully understand and determine the true effect of any isolated nutrient intervention. This study also demonstrates the need to recruit subjects according to their baseline nutrient levels, since clinical benefits are usually most pronounced in those groups with either the lowest baseline levels or, as this study shows, the greatest potential for the nutrient of interest to ‘interact’ within the effector systems.
Since the benefits of B vitamin use on brain structure appear to be related to omega-3 status in elderly adults, it is necessary to measure omega-3 levels and optimise EPA and DHA status according to personalised dosing, to ensure full clinical benefits are achieved.
Find out more about our Opti-O-3 test and how to determine your clients’ ideal omega-3 levels together with why our Pharmepa Restore and Maintain Protocol is the most targeted and effective way to personalise your approach to managing their omega-3 status.