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August 30, 2011

Omega-3 fatty acid protects brain from severe stroke damage

Omega-3 fatty acid protects brain from severe stroke damage

In an article published online on August 18, 2011 in the journal Stroke, researchers at Université Laval Quebec report that the administration of the omega-3 fatty acid docosahexaenoic acid (DHA), which occurs in fish oil and algae, reduces damage caused by stroke in an animal model.

"Large prospective cohort studies and randomized trials have shown that fish oil intake decreases the risk of death from coronary heart disease," Jasna Kriz and colleagues write. "Several lines of epidemiological evidence also indicate that consumption of fish is associated with reduced risk of ischemic stroke, although this association is not consistently detected. Because fish is a major source of docosahexaenoic acid, it can be hypothesized that DHA is a potential nutraceutical candidate for treatment of ischemic stroke."

The team gave male mice a diet supplemented with DHA, a diet deficient in omega-3 polyunsaturated fatty acids, or a control diet for three months. Stroke was induced by middle cerebral artery occlusion and the animals were examined for early neurologic defects. The size of the stroke-damaged areas was assessed at 48 hours and at seven days following the event, and blood samples were analyzed for markers of inflammation and other factors.

Mice that were treated with DHA had areas of ischemic damage that were 25 percent smaller and higher levels of a molecule known as Bcl-2, which prevents apoptosis (programmed cell death), compared with the other groups. The DHA-treated animals also had lower levels of the inflammatory markers COX2 and interleukin-1, as well as a higher ratio of omega-3 to omega-6 fatty acid levels in their brains.

"The consumption of omega-3s creates an anti-inflammatory and neuroprotective environment in the brain that mitigates damage following a stroke," explained Dr Kriz, who is a member of the Université Laval's Faculty of Medicine. "It prevents an acute inflammatory response that, if not controlled, is harmful to brain tissue."

"This is the first convincing demonstration of the powerful anti-inflammatory effect of DHA in the brain," added Frédéric Calon of Université Laval's Faculty of Pharmacy. "Since DHA is readily available, inexpensive, and reduces the risk of a number of health problems without causing significant side effects, the risk–benefit ratio tends to favor the regular consumption of fish or DHA."

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Stroke and cerebrovascular disease

There are two main kinds of stroke. The most common, an ischemic stroke, occurs when an artery in the brain is blocked by a blood clot, usually because of atherosclerosis (the deposition of plaque on the inside of artery walls). Alternatively, a hemorrhagic stroke can occur when a portion of the arterial wall weakens and bursts. A stroke is a serious medical emergency that requires immediate medical attention. Time is a critical factor in stroke management: some experts now refer to strokes as "brain attacks" to stress the need for emergency treatment.

Nutritional therapy in cerebrovascular disease associated with atherosclerosis has several interrelated goals. These include reversing endothelial dysfunction with nutrients that stimulate endothelial nitric oxide production, reducing inflammation, enhancing and restoring cerebral blood flow, and providing antioxidant support to reduce the level of damaging free radicals.

Omega-3 fatty acids are another important nutrient for stroke victims and those at risk of stroke because of their ability to reduce inflammation. They are found in the oil of cold-water fish and in flaxseed oil. Most people get too much pro-inflammatory omega-6 fatty acids in their diet but not enough omega-3 fatty acids to balance the omega-6. The balance is essential in regulating blood pressure and also in reducing inappropriate platelet aggregation, inflammation, LDL, and other atherosclerosis risk factors (Knapp HR et al 1989; DeBusk RM 2000).

Randomized clinical trials have found that patients with high omega-3 fatty acid intake experienced decreased incidence of stroke (He K et al 2002; Jeerakathil TJ et al 2001). Omega-3 intake may also slow the progression of atherosclerosis (Kris-Etherton PM et al 2005). One study found that eating coldwater fish as little as once per month reduced risk of ischemic stroke (He K et al 2002). American Stroke Association data indicate that individuals may not get enough omega-3 fatty acids through diet alone; the association suggests that individuals who don't should consider taking a supplement. Those who have high levels of triglyceride (blood fat) may need larger doses of fish oil supplements (more than 4 g daily) than normally recommended for general prevention purposes (Kris-Etherton PM et al 2005).

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