Will fish oil decrease Alzheimer's risk?

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    Will fish oil decrease Alzheimer's risk?

    NIH-funded research looking at effects of nutrients on Alzheimer's-associated blood proteins was published this month in a scientific journal. [ Y. Gu, N. Schupf, S.A. Cosentino, J.A. Luchsinger and N. Scarmeas, Nutrient intake and plasma beta-amyloid, Neurology, DOI: 10.1212/WNL on-line May 2, 2012, abstract at http://www.neurology.org/content/early/2012/05/02/WNL.0b013e318258f7c2.abstract ]

    Although results have been noted in the health section of the NY Times, a French trade journal, published on-line in English, has a more informative description. [ Nathan Gray, Study finds omega-3 may reduce risk of Alzheimer's, Nutra Ingredients, May 7, 2012, at http://www.nutraingredients.com/Research/Omega-3-may-reduce-risk-of-Alzheimer-s-Study ]

    The research organized at Columbia University in New York examined associations between ten nutrients and levels of two Alzheimer's-associated proteins in blood samples, involving more than 1,000 healthy volunteers aged 65 years and older. Their diets were followed for an average of 14 months before collecting and testing a single blood sample from each. Nutrients tracked included A, B, C and D vitamins and precursors, plus saturated, monounsaturated and omega-3 and omega-6 polyunsaturated fats.

    Strong associations were found only for omega-3s. Statistical significance with blood protein amyloid-beta-42 levels remained strong after adjustment for age, sex, ethnicity, education, caloric intake and other factors. The magnitude of the effect appears substantial. Dietary supplementation with about one gram per day of omega-3s reduced blood protein levels by 20 to 30 percent, according to the trade journal's description. That is the typical strength of commonly used, high-potency fish-oil-extract capsules. The amount of potential risk-reduction has not been described in the research or in the reviews of it so far.

    In view of results published after the report by Gu et al. was accepted for publication, data obtained in that research should be re-analyzed. The key predictor of risk for Alzheimer's and dementia is not the blood concentration of amyloid-beta-42 or amyloid-beta-40, the two proteins measured by Gu et al., but their ratio. [ A. Koyama, O.I. Okereke, T. Yang, D. Blacker, D.J. Selkoe and F. Grodstein, Plasma amyloid-beta as a predictor of dementia and cognitive decline, Archives of Neurolology (DOI:10.1001/archneurol on-line March 26, 2012), abstract at http://archneur.ama-assn.org/cgi/content/short/archneurol.2011.1841 ]

    Koyama et al. found, "Lower [42:40] ratios were significantly associated with development of [Alzheimer's] and dementia," whereas "levels of [42 and 40] alone were not significantly associated with either outcome." The risk ratios they report suggest that supplementation with a gram a day of omega-3s could associate with Alzheimer's risk reduction as great as a factor of two, but the effect could also be much less. An updated report from Gu et al. ought to reduce the uncertainty.

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    Re: Will fish oil decrease Alzheimer's risk?

    Fish Oil is good stuff. Unfortunately it is not considered medication, it is a food supplement...therefore Medicare/Medicaid, Private Insurance often will not pay for it.  Therefore if you have a loved one in a Nursing Home or Institution and you would like them to receive Fish Oil you may have to buy it yourself, bring it in and see if the dr will prescribe it, assuming it doesn't conflict with other medications the patient is on.
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    No clear answers yet

    The effects of fish oil began to be investigated decades ago, after it was noticed that populations of Sami in Norway and Eskimo in Canada, whose diet was mainly fish, had low incidences of heart problems. Research in the 1980s showed that omega-3 fatty acids were the main agents and free acids were as effective as the natural triglyceride esters. Over the last 25 years, technology has provided refined oils that concentrate omega-3 fatty acids and remove residues of organomercury and pesticides from fish oil base.

    Possible benefits in reducing neurological disorders are a much newer topic, surfacing only in the past few years. Research has yet to provide clear answers. The recent results from Gu et al. are interesting but not yet very useful. They didn't take into account the even more recent finding that a ratio of trace protein concentrations in blood, associated with Alzheimer's, appears to be an effective predictor while individual protein concentrations do not. They also don't consider the possibility that omega-3s might be only a bystander, altering transport of proteins across the blood-brain barrier but not affecting neurology.

    Re-analysis of the data from Gu et al. should show whether omega-3 intake will correlate with the key ratio of beta-amyloid proteins. If it does, keep in mind that the correlation might go either way--that is, fish oil might look harmful for this purpose rather than beneficial. If a solid correlation turns up, then some controlled studies--probably first in animals--will be needed to see if there is a clear cause-and-effect relationship. With luck, we might be five to ten years away from getting useful results.

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    Fish oils as blood thinners

    Many of us have been using fish oil supplements for years, sometimes on physician recommendations, as a low-risk measure to reduce the likelihood of heart attacks and strokes. Although their omega-3 fatty acids may have several effects, the most noticeable one provides a blood thinner. Interactions with other blood thinners are suspected but not yet well documented.


    Reposted from "Blood thinners: old and new" which vanished from the Health page--

    Anticoagulants--blood thinners--reduce chances of harmful blood clots. Behaviors of the classic drugs, aspirin and precursors of warfarin, were discovered by accident. Aspirin was developed as an analgesic. Its effects at blood thinning were noticed in the 1930s; it was never a prescription drug. Warfarin was patented as rat poison in 1948; Endo obtained FDA approval in 1954 as a prescription drug named Coumadin. Since then, several similar brand-name drugs have been introduced, all minor variations.

    The main hazard of anticoagulants is not a "side effect." It is the main effect: increased risk of harmful bleeding--such as unchecked gastrointestinal, menstrual and wound blood flows. While anticoagulants reduce risk of ischemic stroke--from a clot--they increase risk of hemorrhagic stroke--from unchecked blood flow. Treatments usually include frequent measurement of clot formation to maintain a balance, most often the "prothrombin time" blood test at weekly to monthly intervals. [ Warfarin, U.S. National Library of Medicine, 2010, at http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000634/ ]

    A critical element in arresting health hazards from anticoagulant overdose is prompt administration of an antidote. For warfarin, the normal antidote is vitamin K. It can restore clot formation in minutes and check harmful bleeding. The frequency of hemorrhagic stroke is many times the frequency of ischemic stroke, and availability of an antidote can be literally life-saving.

    Typical obsession of U.S. physicians with prescription drugs led to neglect of aspirin as an anticoagulant. A recent, large, fully controlled clinical trial showed that aspirin is as effective as warfarin for treating congestive heart failure--the most common use of warfarin. [ Nicholas Bakalar, Aspirin seen to be as effective as warfarin, New York Times, May 7, 2012, at http://well.blogs.nytimes.com/2012/05/07/aspirin-prevents-blood-clots-in-heart-failure/ ]

    The last two years have seen a new generation of prescription anticoagulants. While they may provide some improvements over aspirin and warfarin, the improvements are modest in scale, and the new anticoagulants are turning out to carry hazards similar to the old ones. An additional hazard is that, unlike warfarin, none of the new anticoagulants has a known antidote. Typical costs are about 20 times warfarin, whose cost is at least 20 times aspirin:

    * Pradaxa, FDA approval 2010, Boehringer Ingelheim
    * Xarelto, FDA approval 2011, J&J and Bayer
    * Eliquis, pending, Pfizer and Bristol-Myers Squibb