Omega-3: An Intelligent Decision for Brain Nutrition (book chapter) April 2018

in book: Preventing Health and Environmental Risks in Latin America pp 59-70
First Online: 18 April 2018, Part of the The Anthropocene: Politik—Economics—Society—Science book series (APESS, volume 23)
Socorro Herrera Meza. Grecia Herrera Meza

• Dr. Socorro Herrera Meza, Researcher, Institute of Psychological Research at Universidad Veracruzana. Email: soherrera at uv.mx.
• Dr. Grecia Herrera Meza, Researcher, Food Development and Research Unit at Instituto Tecnológico de Veracruz. Email: greehem at gmail.com.

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Abstract

Chronic degenerative diseases put the health of the general population at risk. However, the information given to the population to prevent or decrease the incidence of illness does not always reach its intended audience or is inaccurate, as in the case of information regarding polyunsaturated fatty acids such as ω-3, found in aquatic animals and some seeds. It has been observed that supplementation with ω-3

• prevents cardiovascular diseases and strokes;
• reduces triglycerides, blood pressure, formation of thrombi and arrhythmia;
• alleviates cutaneous lesions resulting from psoriasis, rheumatoid arthritis, nephropathy and asthma; and
• decreases the metastasis of prostate, breast and colon cancer.

Decrease in ω-3 levels, on the other hand, is associated with

• dementia, migraines, post-partum depression bipolarity, symptoms of depression and aggression, and neurological disorders relating to memory, attention and information processing.

If the information on ω-3 were widely available, people would be able to choose what they eat and create a culture of prevention, thus decreasing the risk factors.

5.1 Introduction

Despite major technological and scientific advances, chronic degenerative diseases, such as diabetes mellitus, cardiovascular diseases and cancer, are on the rise and putting the health of the general population at risk. These serious illnesses have been associated with risk factors, such as: obesity, poor eating habits, sedentary lifestyles, ignoring medical indications and the absence of a culture of prevention in Mexico. These factors have led to an increase in health risks affecting the general public.

Furthermore, information regarding how to prevent or decrease the incidence of some of these risk factors never reaches its intended audience or is inaccurate, as in the case of information that has been created regarding the consumption of certain foods, specifically fats.

Fats, better known as fatty acids (FA), are compounds that play a fundamental role in human nutrition, given that, depending on the type of fatty acid, they can accelerate or reverse diseases that are caused by their consumption.

FAs not only play a major role in foods, such as giving them flavour or texture, they also have important functions in the body, such as, for example, acting as our main energy reserve, transporting a range of nutrients, regulating our metabolism, forming vitamins and hormones (Badui 2006) and creating cell membranes and neuron structures, i.e. they create a layer that divides the cell, the strength of which is determined mainly by the proportion and types of fatty acids from which they are composed. This function is fundamentally important in our bodies as this membrane maintains the balance between the interior and exterior of the cells, regulating the flow of substances or nutrients (Flores et al. 2007), in addition to improving contact among cells and promoting the transmission of nerve impulses, leading to better memory and learning processes (Valenzuela et al. 2011).

There are two types of fatty acids in cell membranes: saturated fatty acids (those fats that we know to be bad or harmful) and polyunsaturated fatty acids (PUFAs) (those fats that help keep us healthy). PUFAs include omega-3 and 6 (ω3 and ω6) fatty acids, which have been classified as essential, i.e. these should be obtained as part of our daily diet and cannot be substituted by any other nutrient, nor can the body produce them naturally. On the other hand, there are non-essential fatty acids, which our bodies can get from what we eat or can synthesize, i.e. produce from the carbohydrates we ingest (Muriana 2004).

Once the digestion, absorption and transportation of the fats have been completed, the ω-6 and ω-3 are introduced into the adipose cells and form fatty compounds that have a range of different functions in the body. When these cells receive specific stimuli, different enzymes are activated, i.e. proteins that regulate and favour chemical reactions in human beings are activated (Muriana 2004).

The omega-3 and 6 compete for these enzymes, each of them generating different compounds. The consumption of ω-6 fatty acids generates, through reactions within the body, compounds called eicosanoids, which can lead to platelet aggregation (the formation of thrombi), the formation of blood clots and vasoconstriction (the thinning of the blood vessels). In contrast, ω-3 fatty acids favour the production of another type of eicosanoid that has the opposite effect, i.e. they prevent the formation of clots and cause vasodilation (the expansion of the blood vessels) (Krummel 2001). As such, it is extremely important to ensure a balance between the intake of ω-6 and ω-3 fatty acids in order to avoid any imbalance leading to the creation of undesirable compounds that pose a risk to our health.

Omega-6 is generally found in seeds, such as sunflower, corn, safflower and peanuts. Omega-3 is found in aquatic animals and some seeds. In this chapter, we focus specifically on ω-3: what foods it is found in, what functions it has in the body, what benefits it provides as part of our diet, and what illnesses are associated with a lack of ω-3, at a metabolic, cerebral and cognitive level.

We reflect on our eating habits and compare a Mediterranean diet to Western eating habits. The Mediterranean diet, rich in polyunsaturated fatty acids, is based on the combination of a high intake of vegetables, fruits, nuts, whole grains, olive oil, fish, cheese and moderate wine consumption with lower quantities of milk and meat. On the other hand, the Western diet consists of high quantities of trans-fatty acids, saturated fats, sugars, flour, meat and a large amount of industrialized food, which can be easily acquired on the market (Haast/Kiliaan 2014).

The Western diet has a number of deficiencies (and also excesses) with regard to its nutritional properties. The most fundamental deficiency, and perhaps the most relevant, is that of omega-3 (Valenzuela 2005). ω-3 fatty acids are composed of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), which are mainly found in fish oil, tuna, salmon, cod and some seeds, such as flax and olive, among others. The bullet-pointed list at the end of this section provides a detailed overview of omega-3 content in a variety of foods (Muriana 2004; Flores et al. 2007).

Despite the fact that food rich in omega-3 is widely available to the general public, it is sad to see that, in Mexico, the consumption of seafood is extremely low, compared to that in eastern countries. For example, annual per capita consumption of fish in an eastern country, such as Japan, is 61 kg per capita per year; however, in Mexico, consumption stands at 10 kg per capita per year (FAO 2009). It is important to highlight the fact that both countries have the same access to seafood; however, sociocultural and marketing factors play an important role in promoting unhealthy eating habits among the general population (Flores et al. 2007), mainly diets rich in sugars and meat but low in omega-3.

The nutritional importance of these fatty acids has led health authorities to establish a daily recommended dose of ω-3. Although there is no exact dosage, the World Health Organization (WHO) recommends that adults consume between 1.2 and 1.5 g per day (Valenzuela 2005). Other authors recommend a dose of 2–4 g per day (Pirillo/Catapano 2013), while some experts recommend eating fish or food with a high omega-3 content at least once or twice a week.

The health benefits of DHA are numerous, and including them in our daily diets is an easy task. We can find them in what we eat on a daily basis, which is a practical, tasty and pleasurable way of incorporating them into our diets, and also as food supplements. The food sources richest in omega-3 are the following (in g/100 g):
Flaxseed oil (55.3)
Salmon oil (35.30)
Cod liver oil (19.75)
Herring oil (11.86)
Walnut (11.50)
Soybean (7.30)
Soybean oil (7.60)
Wheat germ (5.30)
Caviar (3.74)
Sardine (3.0)

Other foods that contain omega-3, although in less quantity, are: herring, fish from the Pacific, salmon, fish from the Atlantic, anchovy, butter, fresh tuna, crab, trout (rainbow), olive oil, corn oil, sunflower oil, parmesan cheese, hen’s egg (white), prickly pear fruit, strawberry, canned tuna, cow’s milk (Flores et al. 2007).

5.2 Omega-3 and Chronic Degenerative Diseases

It has been proven that genetic and environmental factors determine how susceptible an individual is to becoming ill; therefore, nutrition is a determining environmental factor and one that has a major impact on us as human beings. Studies of the evolution of diets indicate that the major changes to our eating habits have occurred mainly in the type and amount of essential fatty acids and antioxidants found in foods. The changes that have taken place over the past hundred years are major catalysts in some of the most prevalent chronic diseases in our society, such as cancer, diabetes mellitus, obesity, metabolic syndrome and cardiovascular diseases (Mata et al. 2004).

Cardiovascular diseases (CVDs) represent a serious global public health issue as they are the leading cause of death around the world. Unfortunately, CVDs are becoming more and more prevalent among the younger generations (Alwan 2011). According to the World Health Organization (WHO), some 17.5 million people died as a result of CVDs in 2012. In Mexico, according to the National Social Security Institute (IMSS), 283,732 Mexicans died of CVDs in the same year (De la Peña 2012).

CVDs are strongly associated with a number of risk factors, including: increases in levels of serum total cholesterol (TC), triglycerides (TG), hypertension, strokes, diabetes and obesity (Carrero et al. 2005). Many of these risk factors are associated with diet, and they can be modified through proper eating habits. The consumption of ω-3 polyunsaturated acids can have a positive effect on cardiovascular health; even eating a small amount of fish (once a week) can reduce any type of risk relating to this disease (Carrero et al. 2005).

There are a number of studies that recommend the consumption of DHA to help prevent cardiovascular problems and strokes (Pirillo/Catapano 2013). In fact, since 1990, these fatty acids have been used in Japan to treat arteriosclerosis and hyperlipidaemia (Arab-Tehrany et al. 2012).

Carrero et al. (2005) discuss a study entitled ‘The Seven Countries’, in which, over a period of 20 years, they observed how men who ate 30 g of fish per day reduced their risk of death from coronary disease by 50% compared to volunteers who did not eat any fish.

Recent research has shown that omega-3 reduces the level of triglycerides in the bloodstream among patients suffering from hypertriglyceridemia (an increase in the level of triglycerides in the blood), with a daily intake of 2 g, as well as increasing high density lipoproteins (HDL, good fats). Other studies highlight a decrease in triglycerides of between 25 and 35% with high doses of between 3 and 4 g/day, in addition to a 36% decrease in low-density lipoproteins (VLDL), which cause damage to arteries (Hartweg et al. 2007; Pirillo/Catapano 2013).

Increase in blood pressure or hypertension (HTN) is the cause of 13% of deaths around the world (Alwan 2011). A number of studies have shown that consuming ω-3 from fish on a daily basis is associated with a decrease in blood pressure (Mata et al. 2004). Some studies suggest that supplementing a dose of 2–3 g/day decreases blood pressure among individuals suffering from hypertension (Arab-Tehrany et al. 2012).

Thrombosis (which drives the formation of clots in blood vessels and can cause acute myocardial infarctions) and arrhythmia (the alteration in cardiac rhythm) are key factors in the development of clinical manifestations of coronary heart disease. It has been shown that consuming omega-3 reduces platelet aggregation, the formation of thrombi and arrhythmia (Mata et al. 2004).

It has also been shown that groups with a high fish intake have seen decreases in the incidence of Type 2 diabetes (T2D) as well as positive impacts on the effect of insulin (Pirillo/Catapano 2013). However, this is still controversial; there are a number of studies that prove a positive direct association between omega-3 intake and a decrease in T2D, while others refute this association (Kaushik et al. 2009; Wu et al. 2012; Zhou et al. 2012).

The supplementation of DHA has also been studied in a wide range of other diseases. For example, it has been shown that consuming these fatty acids helps to alleviate cutaneous lesions resulting from psoriasis (a chronic skin disease stemming from autoimmune complications) (Rahman et al. 2013), in addition to having a positive effect on the treatment of rheumatoid arthritis (Arab-Tehrany et al. 2012), nephropathy (kidney damage or disease) (Bell et al. 2012) and asthma (D’Auria et al. 2014). Some researchers have studied the positive effects of omega-3 on Crohn’s disease, but the information available remains contradictory: some studies show that consumption of omega-3 can help mitigate the symptoms of the disease, while other maintain that the administration of omega-3 aggravates the problem (Swan/Allen 2013).

Mexico is ranked first in the world for childhood obesity (ENSANUT 2012). Obesity is a complex disorder with a number of different causes, the most significant of which is inadequate diet. Obesity and overweight involve the chronic inflammation of cells. i.e. adipose tissue (fat that accumulates in the body), as a result of body weight, producing substances known as cytokines, which are directly related to the occurrence of cardiovascular diseases, diabetes, hypertension and dyslipidaemias. It has been shown that supplementing DHA can reduce the production of cytokines, and, as such, the risk of suffering from the aforementioned diseases (Jalbert 2013; Lee et al. 2013; Legrand-Poels et al. 2014).

Scientific evidence highlights the association between omega-3 intake and a protective effect from a range of different cancers. More specifically, delays in tumour growth, reductions in tumour size and a decrease in the metastasis of prostate, breast and colon cancer have been observed (Valenzuela et al. 2011a; Ballesteros-Vásquez et al. 2012; Merendino et al. 2013; Vasudevan et al. 2014).

5.3 Omega-3 and the Brain

Our brain tissue is composed mainly of fatty acids, and it has been estimated that between 50 and 60% is comprised of different types of fat, 35% of which are omega-3 fatty acids (Flores et al. 2007).

Brain development occurs mainly during the last trimester of pregnancy, finalizing at the age of 3. Omega-3 plays a fundamental and specific role in brain structure and function, given that it is the major component of the brain membranes. DHA is found in neuron membranes, creating greater fluidity within the cell and driving the increased synapsis and transmission of nerve impulses among neurons, which, in turn, favours learning processes (Valenzuela et al. 2011b).

The omega-3 fatty acids present in the neuronal membranes also regulate and increase the expression (creation) of important proteins, which help to improve neuroplasticity, neuronal protection, memory, learning and the prevention of illnesses, such as Alzheimer’s and Parkinson’s (Pasinettia et al. 2014; Porqueta et al. 2014).

There are specific stages of human development during which DHA is needed by the body in significant quantities: pregnancy, breastfeeding and childhood. How does DHA reach us when we are in our mother’s womb? ω-3 is provided by the mother from her own reserves and her diet (Innis 2008). These fatty acids pass through the placenta and accumulate in the brain of the foetus (Dutta-Roy et al. 2004; Muriana 2004) prior to birth. After birth, omega-3 is delivered via breast milk (Das 2003).

During pregnancy, the nervous and visual systems are created. DHA accumulates mainly in the retina cells, called rods and cones, helping ensure visual acuity (Muriana 2004).

During the formation of the nervous system, which begins between the third and fourth week of pregnancy (Lagercrantz/Ringstedt 2001), the amount of omega-3 increases; however, these requirements increase even further during the tenth week of pregnancy, when the brain hemispheres are formed. It is during this period when brain cells called neurons and glial cells are actively created, with around 200,000 neurons being formed every minute (Sanhueza et al. 2004).

In order to maintain a balance of the amount of omega-3 between the foetus and the mother, the latter must ingest around 100 mg/day of these fatty acids during the last trimester of pregnancy (Das 2003), as it is during this stage when the mother’s ω-3 levels are particularly depleted as she transfers these fatty acids to the foetus and the breastfeeding child (Montgomery et al. 2003).

As such, studies into humans and animals show that a lack of DHA during the perinatal period, which comprises the period encompassing the 22nd week of gestation until 7 days after birth, has an impact on visual acuity (Muriana 2004), capacity for learning, concentration and the child’s IQ, alterations that do not become evident until they reach adulthood (Innis 2008; Levan et al. 2004).

It has been shown that DHA is not only needed during the first stage of life. An unbalanced diet, specifically a lack of omega-3, has negative effects on neural functions (the formation of the neural tube and of the nervous system), both during infancy and adulthood (Flores et al. 2007). Studies conducted with infant rats show that a deficit of DHA leads to an increase in locomotive activity and induced cataleptic states (muscular immobility) (Ikemoto et al. 2001; Haubner et al. 2002).

Furthermore, over the past three decades, psychiatric and neurodegenerative illnesses, such as bipolar disorders, depression (Valenzuela et al. 2009), Alzheimer’s (Nussbaum/Ellis 2003; Sontrop/Campbell 2006) and Parkinson’s, have grown significantly (Tiemeier et al. 2003). Epidemiological studies indicate a close association between the incidence and development of these illnesses and factors such as: age, physical activity, family history and poor diets, such as a lack or low levels of ω-3 (Tiemeier et al. 2003; Sontrop/Campbell 2006; Shinto et al. 2009).

A decrease in omega-3 levels in the blood is associated with neurological disorders (McCann/Ames 2005; McNamara/Carlson 2006), such as cognitive impairment (loss of functions, such as memory, attention and information processing), dementia (Ikemoto et al. 2001; Morris et al. 2003), migraines (Tanskanen et al. 2001a, b; Shinto et al. 2009) and post-partum depression (Valenzuela et al. 2009). Omega-3 deficiency has also been related to behavioural disorders, such as bipolarity, symptoms of depression and aggression (Zanarini/Frankenburg 2003).

Other studies propose that omega-3 should be used to treat illnesses such as depression, schizophrenia (Hui-Min 2010), bipolar disorders (McNamara/Carlson 2006), dementia and psychiatric disorders prevalent during pregnancy and breastfeeding (Carlson 2001). Furthermore, it has been observed that neurodegenerative diseases, such as Parkinson’s and Alzheimer’s, are associated with a major loss of DHA in the neuronal membranes. With regard to Alzheimer’s, the ω-3 in the membranes is replaced by saturated fatty acids (Sanhueza et al. 2004).

As such, research conducted on mice (Carrié et al. 2000) and humans (Helland et al. 2006), associates higher levels of DHA in brain tissue with a greater capacity for learning, through memorization, intelligence (Helland et al. 2006) and motor development tests. Furthermore, it has been shown that the presence of omega-3 is associated with a neuroprotective state, i.e. one that protects the brain (Bazan 2005; Ikemoto et al. 2001; Takeuchi et al. 2002). Other studies conducted on rats show that the consumption of omega-3 during pregnancy and the first days of breastfeeding produces greater resistance among their offspring to the severity and occurrence of convulsions stemming from increasing their body temperature (experimental hyperthermia) (Flores et al. 2007).

These findings, with regard to the health benefits of omega-3, have led to increased interest among the scientific community in studying what the benefits of omega-3 intake are and how it helps to improve mental and physical health; however, the significant changes in human diets have created major alterations in metabolic processes and general health. The scales have shifted towards excessive consumption of sugars, flour, saturated fats and omega-6, and reduced consumption, or lack thereof, of whole grains, fruits, vegetables and omega-3. If we add the lack of awareness of the general public regarding the nutritional value of foods and the influence of media outlets in promoting the consumption of low-quality or junk foods, the outcome is discouraging given that these illnesses continue to increase.

The restructuring of our eating habits towards a healthier diet, rich in ω-3, would lead to improved protection, prevention and treatment of chronic degenerative, psychiatric and behavioural disorders. As such, the creation of a range of healthcare and prevention strategies, such as promoting a balanced diet rich in DHA and a healthier lifestyle that encompasses physical activity and appropriate body weight, could lead to a significant reduction in risk factors among the general population.

Furthermore, if the information created surrounding fatty acids is accurate and widely available, people will be able to choose what they eat carefully and take advantage of the benefits that omega-3 offers. It is important to highlight that the food industry, which extracts ω-3 from fish and some algae, offers a wide range of supplement options for the whole family (capsules, oil). Special supplements have also been created for children, using attractive and tasty options (gummy bears), which are easy to find and economical. These fatty acids have also been added to infant formula, and in some countries omega-3 is being used in infant foods, as it is deemed to be a fundamental element in the development of the central nervous system, in addition to promoting optimal mental and visual development among children.

However, learning more about the nutritional composition and the effect that foods have on our bodies is not enough. Creating a culture of prevention and decreasing risk factors to our health will, without a doubt, reduce the incidence of these illnesses and improve the health of future generations. We need to overcome nutritional problems not only through choosing what food we eat or what supplements we take, but also by finding preventive measures. Our first-aid boxes should be found in the food we keep in the kitchen rather than in our medicine cabinets.

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