Asthma

Diet rich in fish may help prevent childhood asthma
SYDNEY, AUSTRALIA. Childhood asthma is now a major health problem in Australia with 31% of West Australian children having been diagnosed with the condition. Chronic inflammation of the airways is also a major problem with 12% of the population reporting wheeze severe enough to disturb sleep. Studies involving Australian school children have shown that those who consume oily fish more than once a week have a significantly reduced risk of asthma.

Australian researchers now suggest that the epidemic of childhood asthma is associated with a change in the omega-6 to omega-3 fatty acid ratio in the Australian diet. It used to be around 5:1, but is now 15:1 or higher. They recently concluded a study of 355 school children of which 166 had been diagnosed with asthma at 6 years of age and the remaining 169 acted as asthma-free controls. A comparison of the two groups showed that the significant risk factors for asthma were:

• Gestational age less than 37 months (OR=2.93)
• Maternal asthma (OR=6.13)
• Breastfeeding for less than 6 months (OR=2.25)
• A high omega-6/omega-3 ratio in the diet (OR=1.93)

After adjustment for other known risk factors the risk of asthma was 2.89 times higher among children with an average dietary omega-6/omega-3 ratio of 18 than among children with a ratio of 8. The researchers believe that the benefits of a diet high in omega-3 fatty acids are due to the inclusion of more EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), the two main components of fish oil.
Oddy, W.H., et al. Ratio of omega-6 to omega-3 fatty acids and childhood asthma. Journal of Asthma, Vol. 41, No. 3, 2005, pp. 319-26

Fish oil benefits children with bronchial asthma
TOKYO, JAPAN. It is now clear that inflammation of the airways is an important factor in asthma. Thus, it would make sense that supplementation with a natural anti-inflammatory could benefit children with the disease. The two main components of fish oil, EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), inhibit the formation of leukotrienes and prostaglandins from arachidonic acid and omega-6 fatty acids and thus reduce the generation of cytokines from inflammatory cells.

Japanese researchers now report that supplementation with fish oil does indeed reduce asthma symptoms in children with long-term bronchial asthma. Their study involved 29 children between the ages of 8 and 14 years who had suffered from asthma for an average of 10 years and were hospitalized for the condition. The children were randomized to receive fish oil capsules or placebo capsules (olive oil) three times daily for a 10-month period. The amount of fish oil given to the children varied from 2.4 grams/day (500 mg EPA + 215 mg DHA) to 4.8 grams/day (1000 mg EPA + 430 mg DHA) depending on body weight. After 10 months of therapy the asthma score (a measure of the severity and frequency of attacks) had dropped from an average of 21 to an average of 6 in the fish oil group with no significant change in the placebo group. The sensitivity to acetylcholine inhalation (a promoter of attacks) also decreased significantly in the fish oil group, but no change was observed in the placebo group.

The researchers conclude that fish oil supplementation for 10 months decreases asthma scores and increases acetylcholine thresholds in children with bronchial asthma. They do add that the conditions of their trial included a strictly controlled environment in terms of diet and the presence of inhalant allergens.
Nagakura, T., et al. Dietary supplementation with fish oil rich in omega-3 polyunsaturated fatty acids in children with bronchial asthma. European Respiratory Journal, Vol. 16, No. 5, November 2000, pp. 861-65

Oily fish protects against childhood asthma
SYDNEY, AUSTRALIA. Researchers at the University of Sydney report that the regular consumption of oily fish is associated with a much reduced risk of developing asthma in childhood. Their study involved 574 children aged 8 to 11 years. The children's parents completed detailed questionnaires about the frequency of the intake of more than 200 foods for a one-year period. The children were evaluated for current asthma as defined by airway hyperresponsiveness and a tendency to wheeze with or without exercise. The researchers found that children who regularly consumed fresh, oily fish (such as mullet, orange roughy, Atlantic salmon or rainbow trout which contains more than two per cent fat) had a four times lower risk of developing asthma than did children who rarely or never ate oily fish. The risk reduction persisted even after adjustment for other risk factors such as parental asthma and smoking, early respiratory infections, race, and place of birth. Consumption of non-oily fish and canned fish was not associated with a reduced asthma risk. Fish oil contains the two omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). The researchers speculate that EPA may prevent the development of asthma or reduce its severity by reducing airway inflammation and responsiveness. A very recent study suggests that long-term fish oil supplementation may reduce asthma severity.
Hodge, Linda, et al. Consumption of oily fish and childhood asthma risk. Medical Journal of Australia, Vol. 164, February 5, 1996, pp. 137-40

Autism

Fish oil may benefit autistic children
VIENNA, AUSTRIA. Autism (autistic spectrum disorder) is characterized by severe tantrums, aggression, self-injurious behaviour, hyperactivity, and repetitive behaviour (stereotypy). The condition is often treated with medications like haloperidol and risperidone, but both of these drugs can have unacceptable adverse effects.

There is increasing clinical evidence that fatty acid deficiencies and imbalances are important contributing factors to childhood neuro-developmental disorders such as dyslexia, dyspraxia, and attention deficit disorders. There is also anecdotal evidence that children with autism may benefit from supplementation with fish oils. Based on these findings researchers at the Medical University of Vienna decided to carry out a clinical trial of fish oil supplementation in autistic children. Their double-blind, placebo-controlled pilot trial included 13 boys (10-15 years of age) who were attending a specialized daycare center for long-term treatment of autistic children. The boys were assigned to receive either 7 grams/day of menhaden fish oil (providing 840 mg/day of EPA [eicosapentaenoic acid] and 700 mg/day of DHA [docosahexaenoic acid]) or 7 grams/day of coconut oil (in capsules) for a 6-week period.

Their scores for irritability, social withdrawal, stereotypy, hyperactivity, and inappropriate speech were evaluated at entry to the study and after 6 weeks of supplementation. Irritability and social withdrawal scores were not affected by the treatment, however, both stereotypy and hyperactivity scores decreased significantly in the fish oil group over the 6-week period. The researchers conclude that their study provides preliminary evidence that fish oils may be an effective treatment for children with autism.
Amminger, G. Paul, et al. Omega-3 fatty acids supplementation in children with autism. Biological Psychiatry, Vol. 64, No. 4, February 15, 2007, pp. 551-53

Fatty acid deficiency linked to autism
GLASGOW, SCOTLAND. The prevalence of autistic spectrum disorders (ASD) such as autism and Asperger’s syndrome (ASP) has increased dramatically over the past 10 years and may now affect as many as 6 out of every 1000 children under the age of 5 years. There is some evidence that ASD may involve a fatty acid imbalance in the neuronal membranes. A group of Scottish researchers has found that a deficiency in EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), the main components of fish oil, is clearly linked to ASD.

As a first step in their study the parents of 104 children with ASD (94 with autism and 10 with ASP) were asked to fill out a questionnaire, which included a checklist of symptoms of impaired fatty acid metabolism (excessive thirst and urination, dry skin and hair, dandruff, and soft and brittle nails). A score greater than 3 on the checklist was deemed to be indicative of an essential fatty acid deficiency (FAD). The FAD score for a group of 71 healthy controls averaged 1.78 as compared to 6.34 in the autism group and 7.64 in the ASP group.

Analyses of blood samples from the study participants showed that children with regressive autism (autism not present at birth, but developing 18-36 months after birth) and ASP had significantly higher levels of tetracosanoic acid (24:0), n-6 docosapentaenoic acid (22:5), and tetracosenoic acid (24:1) in their red blood cell membranes than did the controls. In contrast, levels of n-3 docosapentaenoic acid (22:5) and total n-3 fatty acids were significantly lower in children with ASD. The ratio between arachidonic acid and EPA was also significantly higher in children with ASP and regressive autism. This ratio was reduced by a factor of 5 after 6 months of supplementation with 2-4 grams/day of EPA + DHA. Supplementation with EPA-rich fish oil has been reported to result in improvements in general health, sleep patterns, concentration, and sociability and reductions in irritability, aggression, and hyperactivity among autistic children.
Bell, JG, et al. Essential fatty acids and phospholipase A2 in autistic spectrum disorders. Prostaglandins, Leukotrienes and Essential Fatty Acids, Vol. 71, 2004, pp. 201-04

Autism linked to DHA deficiency
TOURS, FRANCE. Autism is a developmental disorder primarily affecting communication ability and social, cognitive, and imaginative development. Brain development is intimately linked to the structure of neuronal cell membranes and this structure again is dependent on the fatty acid composition making up the phospholipids forming the membrane. It is therefore of interest to investigate possible associations between psychiatric disorders and neuronal membrane phospholipid fatty acid composition. There is already evidence that quite strong associations may exist with regard to schizophrenia, attention-deficient hyperactivity disorder, and bipolar disorder. Now French researchers report that a low level of DHA (docosahexaenoic acid) is characteristic for blood plasma drawn from autistic children.

Their study involved a group of 15 autistic children (4 girls and 11 boys) whose blood plasma levels of long-chain polyunsaturated fatty (PUFA) levels were compared to those of a group of 18 mentally retarded children (who generally have low PUFA levels). The researchers found that autistic children had a 23% lower level of DHA than did mentally retarded children. Autistic children also had a significantly higher ratio of omega-6 to omega-3 fatty acids than did mentally retarded children (18.6 vs 11.0 respectively).

The French researchers speculate that the deficiency of DHA observed in the autistic children may be due to one or more of the following:

• Poorer ability to convert 18-carbon fatty acids to 22-carbon fatty acid (DHA);
• Enhanced breakdown of PUFAs in the phospholipid membrane;
• Abnormality in the mechanism by which PUFAs are incorporated into phospholipids.

Cystic Fibrosis

Fish oils benefit cystic fibrosis patients
NAPOLI, ITALY. Cystic fibrosis (CF) is a serious, inherited childhood disease. The main symptoms are an abnormally thick mucus that clogs the lungs and results in breathing difficulties, failure to gain weight, repeated lung infections, and persistent cough and wheezing. It is estimated that about 1 in 2500 infants are born with the disease. There is ample evidence that it involves a combination of bacterial infection and inflammation. There is also evidence that leukotriene B4 (LTB-4) is involved in the enhanced influx of neutrophils (a special kind of white blood cell) into the lungs. Leukotriene B4, in turn, is synthesized from arachidonic acid. It is well established that the arachidonic acid content of red blood cell membranes can be significantly reduced by supplementation with EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), the main components of fish oil.

Italian researchers decided to see if supplementation with fish oils could reduce the symptoms of CF. Their clinical trial involved 30 CF patients (10 boys and 20 girls with an average age of 12 years). The study participants supplemented with enteric-coated fish oil capsules providing about 1280 mg/day of EPA and about 930 mg/day of DHA as well as about 50 mg/day of vitamin E. They were also encouraged to increase their intake of seafood and continued on their routine supplementation program with multivitamins and pancreatic enzymes. As expected, EPA and DHA levels in red blood cell phospholipids increased significantly during the 8-month supplementation period with a commensurate decrease in arachidonic acid level. The researchers also observed a marked decrease in the level of the inflammatory marker IgG.

Perhaps the most important change resulting from fish oil supplementation was the sharp drop in the need for antibiotic medication. This was needed for an average of 13 days per child during the 8-month supplementation period compared to an average of 24 days per child during the previous 8 months. The researchers conclude that long-term supplementation with EPA + DHA decreases inflammation and the need for antibiotics in children with CF.
De Vizia, Basilio, et al. Effect of an 8-month treatment with omega-3 fatty acids (eicosapentaenoic and docosahexaenoic) in patients with cystic fibrosis. Journal of Parental and Enteral Nutrition, Vol. 27, January-February 2003, pp. 52-57

Intravenous fish oil infusion safe for CF patients
NEW YORK, NY. Seriously ill cystic fibrosis (CF) patients cannot absorb fats and other nutrients properly and therefore often need infusions of essential fatty acids. These infusions are most often based on linoleic acid as many CF patients have been found to have a deficiency of this omega-6 fatty acid. There is now substantial evidence that long-chain omega-3 fatty acids found in fish oils can suppress inflammatory processes such as those involved in CF.

A team of American, Finnish, and German researchers completed a small clinical trial aimed at determining if it would be safe and effective to use a fish oil fortified emulsion in the intravenous feeding of CF patients. The trial involved 12 patients; 6 were given infusions of a lipid emulsion enriched with fish oils while the remaining 6 (control group) were given infusions of the standard linoleic acid-based emulsion. The fish oil emulsion contained 18.3% eicosapentaenoic acid (EPA), 27.6% docosahexaenoic acid (DHA), 12.7% oleic acid, and 2.5% linoleic acid. The standard emulsion contained 54.5% linoleic acid, 22.4% oleic acid, and 0% EPA and DHA. Both emulsions were administered daily (over a 4-hour period) for 1 month at a dose of 150 mg/kg of body weight. The researchers found no adverse effects on liver function or coagulation parameters and no toxic or allergic reactions in the patients receiving the fish oil emulsion. There was a tendency to improved lung function in the fish oil group and a tendency towards a worsening in the control group during the trial; however, these effects were not statistically significant. The researchers conclude that intravenous infusions of lipid emulsions containing fish oils are safe for CF patients. They urge additional, longer-term studies to determine if such infusions would be of clinical benefit.
Katz, David P., et al. The use of an intravenous fish oil emulsion enriched with omega-3 fatty acids in patients with cystic fibrosis. Nutrition, Vol. 12, No. 5, 1996, pp. 334-39

Fish oil helps cystic fibrosis victims
NEW SOUTH WALES, AUSTRALIA. Researchers at the University of Sydney have found that daily supplementation with fish oil capsules alleviates many of the symptoms of cystic fibrosis. Cystic fibrosis is a serious, inherited childhood disease which involves a malfunctioning of the body's mucus glands. An abnormally thick mucus is produced which clogs the lungs and results in breathing difficulties. Other symptoms include persistent cough and wheezing, repeated lung infections, and a failure to gain weight. Sixteen cystic fibrosis patients aged 12 to 26 took part in the experiment. Half the group received fish oil capsules providing 2.7 g of eicosapentaenoic acid (EPA) per day while the other half received identical olive oil capsules as a placebo. After six weeks of treatment the patients receiving EPA coughed up significantly less sputum, were breathing easier (both forced expiatory volume and vital capacity were up) and generally felt better. The Australian researchers believe that the EPA acts by modifying the role of leukotriene B4. Leukotriene B4 is thought to be the main culprit in the excessive inflammatory response to bacteria which characterizes cystic fibrosis.
Lawrence, R. and Sorrell, T. Eicosapentaenoic acid in cystic fibrosis: evidence of a pathogenetic role for leukotriene B4. The Lancet, Vol. 342, August 21, 1993, pp. 465-69

Cystic fibrosis and fish oils
GENT, BELGIUM. There is evidence that cystic fibrosis patients with high plasma phospholipid levels of omega-3 fatty acids have better lung function than patients with lower levels. Cystic fibrosis (CF) is, unfortunately, often accompanied by fat malabsorption so it is not clear whether oral fat supplementation with omega-3 fatty acids would benefit CF patients.

Researchers at the State University of Gent set up an experiment to see if CF patients are able to absorb omega-3s effectively by mouth. The trial involved 9 CF patients (4 females and 5 males) ranging in age from 7 to 20 years. All had been diagnosed with pancreatic insufficiency and had poor fat absorption despite supplementing with pancreatic enzyme preparations. The patients were assigned to receive either 6 fish oil capsules per day for a month followed by 6 placebo capsules for a month or 6 placebo capsules daily for a month followed by 6 fish oil capsules daily for a month. Each fish oil capsule contained 335 mg of salmon oil and 165 mg of commercial soy lecithin and provided 152 mg of omega-3 fatty acids. The placebo capsules contained 500 mg of pharmaceutical-grade liquid paraffin.

The researchers found that the CF patients who took fish oil showed a marked increase in their phospholipid levels of eicosapentaenoic acid [EPA] (increase of 327%) and docosahexaenoic acid [DHA] (increase of 215%). The levels of EPA and DHA returned to baseline 2 weeks after discontinuing supplementation. The researchers also noted that patients with low initial levels of EPA showed the greatest increase in EPA levels after supplementation. They conclude that oral supplementation with fish oil and lecithin is effective in increasing the levels of omega-3 fatty acids especially EPA and DHA in cystic fibrosis patients.
Christophe, Armand, et al. Increase of long chain omega-3 fatty acids in the major serum lipid classes of patients with cystic fibrosis. Ann Nutr Metab, Vol. 36, 1992, pp. 304-12

Depression

Fish oil helps combat childhood depression
BEER-SHEVA, ISRAEL. It is estimated that 2-4% of children suffer from major depressive disorder sometimes leading to substance abuse or suicide. Israeli researchers now report that fish oils are effective in relieving childhood depression. Their randomized, placebo-controlled clinical trial involved 20 children (15 boys and 5 girls) between the ages of 8 and 12 years. The study participants were assigned to receive capsules containing either fish oil (providing 400 mg/day of EPA [eicosapentaenoic acid] and 200 mg/day of DHA [docosahexaenoic acid]) or a placebo (olive or safflower oil) for a total of 16 weeks.

After the first 4 weeks of supplementation the researchers noted that the children on fish oil had significantly improved their rating on the Childhood Depression Rating Scale (CDRS) with 7 out of 10 showing an improvement of greater than 50%. None of the children in the placebo group experienced a 50% or better improvement. Four of the 10 children in the fish oil group were classified as being no longer depressed whereas none of the children in the placebo group achieved this goal. The researchers conclude that fish oils may have therapeutic benefits in childhood depression.
Nemets, Hanah, et al. Omega-3 treatment of childhood depression. American Journal of Psychiatry, Vol. 163, June 2006, pp. 1098-1100

Dyslexia and Aggressive Behaviour

Fish oils may help dyslexic children
GUILDFORD, UNITED KINGDOM. Dyslexia is a fairly common condition which involves difficulties in learning to read and write, mirror reversals of letters and words, and poor short-term memory. Dyslexia is closely related to dyspraxia (problems with coordination and muscle control) and attention-deficit hyperactivity disorder. It is estimated that about 10% of the populations of the United States and the United Kingdom suffer from dyslexia and 4% are severely affected. There was a 3-fold increase in the prevalence of learning disorders in the USA over the period 1976 to 1993 and 80% of the new cases involved dyslexia.

Dr. Jacqueline Stordy of the University of Surrey believes that dyslexia, dyspraxia, and attention-deficit hyperactivity disorder have one common denominator - a deficiency of long-chain fatty acids. She points to a study which found improved dark adaptation (a problem among dyslexics) after supplementation with 480 mg/day of docosahexaenoic acid (a main constituent of fish oil) for a month. Another study involving 15 dyspractic children found that supplementation with a proprietary mixture of tuna oil, evening primrose oil, thyme oil, and vitamin E for 4 months markedly improved their motor skills. The mixture provided 480 mg of docosahexaenoic acid, 35 mg of arachidonic acid, 96 mg of alpha-linolenic acid, 80 mg of vitamin E, and 24 mg of thyme oil daily. Dr. Stordy concludes that long-chain polyunsaturated fatty acid supplements may benefit children with dyslexia, dyspraxia, and attention-deficit hyperactivity disorder and notes that large, double-blind, placebo-controlled studies are already underway to verify this hypothesis.
Stordy, B. Jacqueline. Dark adaptation, motor skills, docosahexaenoic acid, and dyslexia. American Journal of Clinical Nutrition, Vol. 71 (suppl), January 2000, pp. 323S-26S

DHA helps control aggressive behaviour
TOYAMA, JAPAN. DHA (docosahexaenoic acid), a major component of fish oil, is the most abundant fatty acid in the brain. It is becoming increasingly clear that a deficiency of this important nutrient can have far-ranging negative effects from fetus to old age.

Japanese researchers now add to the evidence of the importance of DHA by their discovery that supplementation with DHA-rich fish oil eliminates stress-induced aggressive behaviour among university students. Their trial involved 41 medical students who were randomized to receive fish oil capsules providing 1.5 – 1.8 grams/day of DHA or soybean oil based placebo capsules. The trial was started during the last days of summer vacation in September and was completed during the highly stressful exam time in December. Administration of the P-F (picture-frustration) test in December revealed that students who had taken the placebo capsules for the 3-month trial period showed a substantial increase in aggression whereas those who had supplemented with DHA actually exhibited less aggression than they had at the end of their summer vacation.

The researchers conclude that DHA supplementation prevents an increase in aggressive behaviour during times of mental stress. They further speculate that this aggression-reducing effect may translate into a reduced risk of coronary heart disease.
Hamazaki, Tomohito, et al. The effect of docosahexaenoic acid on aggression in young adults. Journal of Clinical Investigation, Vol. 97, No. 4, February 1996, pp. 1129-34

Obesity, Diabetes and Heart Disease

Omega-3 polyunsaturated fatty acids and risk of type 1 diabetes in children
DENVER, COLORADO. Dietary factors have been implicated in the etiology of type 1 diabetes, a disease that frequently occurs during childhood. In a study from Norway, cod liver oil was implicated in preventing this type of diabetes, but it was unclear whether the effect was due to the omega-3 fatty acids, vitamin D or some other constituent. In a study just reported, Norris et al report on an observational study of dietary intake of omega-3 fatty acids and the incidence of pancreatic islet autoimmunity (IA) in a group of children judged at high risk of type 1 diabetes because of family history or the presence of an identified genetic predisposition. One group studied consisted of children recruited between birth and 8 years of age who had strong family history of type 1 diabetes. A second group consisted of newborns who tested positive for genetic markers of susceptibility. The association between intake of omega-3 and omega-6 fatty acids and the incidence of IA was examined during the follow-up. It was found that higher intake of omega-3 fatty acids was associated with a significant decrease in the risk of IA in the group identified by family history. For the newborn group, the risk of IA was inversely associated with the omega-3 status assessed by a blood test. These associations were relatively strong and statistically significant. Omega-6 fatty acids were not found to beneficial or harmful in this context. The authors comment that that if these results are confirmed in an ongoing intervention study involving supplementation with DHA in utero and in infancy, then omega-3 fatty acids could become a mainstay for early intervention to safely prevent the development of type 1 diabetes in this high-risk group of children.
Norris, J.M. Omega-3 Polyunsaturated Fatty Acid Intake and Islet Autoimmunity in Children at Increased Risk for Type 1 Diabetes. Journal of the American Medical Association, 2007, Vol. 298, No. 12, pp. 1420-28

DHA deficiency linked to obesity
STRASBOURG, FRANCE. Obesity is a growing problem among adolescents and is often accompanied by metabolic syndrome (MS). Metabolic syndrome involves a cluster of several metabolic abnormalities including overweight (specifically abdominal adiposity), insulin resistance, high triglycerides and low HDL (high-density lipoprotein) levels, and is associated with an increased risk of cardiovascular disease.

Researchers at the Louis Pasteur University of Strasbourg now report that overweight adolescents and overweight adolescents with MS exhibit significant differences in the fatty acid content of plasma phospholipids when compared to their non-overweight peers. Their study involved 60 12-year-olds (30 boys and 30 girls) with normal weight and 60 12-year-olds who were overweight. Twenty-five per cent of the overweight children had been diagnosed with MS as well (none of the normal weight children had MS). Analyses of the phospholipid phase of the blood plasma revealed several important differences between the overweight and normal-weight groups. There was a highly significant difference in DHA (docosahexaenoic acid) concentration with normal-weight subjects having a substantially higher level. Normal-weight participants also had a significantly higher ratio of polyunsaturated fatty acids (PUFAs) to standard fatty acid (SFAs). Furthermore, overweight adolescents with MS had even lower levels of DHA and lower PUFA/SFA ratios than did those who were merely overweight.

The researchers conclude that a diet providing a high ratio of PUFAs to SFAs and, more specifically, a high intake of long-chain PUFAs such as DHA may protect obese persons against the development of metabolic syndrome.
Klein-Platat, Carine, et al. Plasma fatty acid composition is associated with the metabolic syndrome and low-grad inflammation in overweight adolescents. American Journal of Clinical Nutrition, Vol. 82, 2005, pp. 1178-84
Phinney, Stephen D. Fatty acids, inflammation, and the metabolic syndrome. American Journal of Clinical Nutrition, Vol. 82, 2005, pp. 1151-52 (editorial)

DHA helps prevent heart disease in children
BOSTON, MASSACHUSETTS. Children with inherited hypercholesterolemia (high cholesterol levels) or hyperlipidemia (high cholesterol and triglyceride levels) are at a substantially increased risk for coronary heart disease. It is believed that the main reason for this is that the children have impaired endothelial function resulting in a slowdown in blood flow and a commensurate increase in the risk of atherosclerosis. The quality of endothelial function is determined by measuring endothelium-dependent flow-mediated dilation (FMD) of the brachial artery using high-resolution ultrasound. A normal value for healthy children would be about 8%.

A team of American and Austrian cardiologists has evaluated the effect of supplementation with DHA (docosahexaenoic acid) on FMD in children with hypercholesterolemia or hyperlipidemia. Their double-blind, placebo-controlled, randomized clinical trial involved 20 patients (ages 9-19 years) who were assigned to receive 1.2 grams/day of DHA or a placebo for 2 separate 6-week periods. All participants followed the National Cholesterol Education Program Step II diet throughout the study. At baseline the average FMD was 5.9%. Just following the NCEP-II diet increased the FMD to 6.3%, while adding 1.2 grams/day of DHA increased it by 34% to a normal level of 7.9%. The average total cholesterol level was 282 mg/dL at baseline and this increased to 297 mg/dL after 6 weeks of DHA supplementation. However, triglycerides decreased from an average of 139 mg/dL to 119 mg/dL (a drop of 14%). Very low-density lipoprotein concentration also decreased by about 23%, while both low-density lipoprotein and high-density lipoprotein increased by 8% and 6% respectively.

The researchers speculate that the change in cholesterol concentrations may represent a beneficial shift in lipoprotein particle size from the atherogenic, small, dense type to the less atherogenic, large, buoyant type. They also suggest that the observed increase in FMD may be due to increased availability of nitric oxide (NO), which promotes dilation of blood vessels resulting in improved flow. They conclude that supplementation with DHA has the potential to delay early coronary atherosclerosis in hyperlipidemic children.
Engler, M.M., et al. Docosahexaenoic acid restores endothelial function in children with hyperlipemia. International Journal of Clinical Pharmacology and Therapeutics, Vol. 42, No. 12, 2004, pp. 672-79

Headaches and Migraines

Fish and olive oils prevent migraines in adolescents
PROVIDENCE, RHODE ISLAND. Recurrent migraine headaches are a frequent complaint among teenagers and so far no really effective treatment has been developed. This may now be about to change. Researchers at Brown University have discovered that supplementation with either fish oil or olive oil results in a very substantial decrease in both headache frequency and severity. Twenty-seven adolescents (19 girls and 8 boys with a mean age of 15 years) who had been suffering from frequent migraines for 3 years or more were randomly assigned to receive either 2 capsules of fish oil /day (providing 750 mg/day of EPA and 500 mg/day of DHA) or 2 capsules of olive oil a day for two 2-month period separated by a 1-month washout period.

At the end of the 2-month periods the participants reported the number of headaches they had experienced and rated their severity on a 7-point pain scale. Prior to the supplementation the participants experienced an average of 31 migraine episodes per 2 months and rated their severity at an average 5.0 on the pain scale. After 2 months of supplementation, the frequency of episodes had declined dramatically from 31 to 4 episodes/2 months in both the fish oil and olive oil groups. This clearly is a very significant improvement. Headache severity also declined substantially from an average of 5.0 to 2.9 in the fish oil group and to 3.5 in the olive oil group. About 72% of participants also experienced a significant shortening of their migraine episodes when taking either fish oil or olive oil. At the end of the trial, 91% of participants said that they would recommend fish or olive oils to friends suffering from recurrent migraine headaches.
Harel, Zeev, et al. Supplementation with omega-3 polyunsaturated fatty acids in the management of recurrent migraines in adolescents. Journal of Adolescent Health, Vol. 31, No. 2, August 2002, pp. 154-61