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New Publications – What’s Good for Your Brain is Good for Your Heart

Michael F. Roizen, MD

November 21, 2019

Two recent articles that buttress each other, but were completed independently by first authors and groups largely located on the other side of the world—Western Southern University in Australia and Harvard in Massachusetts USA – hit my reading stack this past month. These studies reinforce the notion that what is good for your brain, is also good for your heart. These articles include: 

  • The efficacy and safety of nutrient supplements in the treatment of mental disorders: a meta-review of meta-analyses of randomized controlled trials published recently in World Psychiatry 20191
  • Marine Omega-3 Supplementation and Cardiovascular Disease: An Updated Meta-Analysis of 13 Randomized Controlled Trials Involving 127,477 Participants published online in JAHA in September 20192.

Mental health

The first publication is a review by a large group of investigators examining in meta-analysis form all of the potential vitamins and mineral combos and other supplements to better understand what supports mental function.  It took a large group – 15 co-authors in fact – as they specifically did analyses and meta-analyses on at least 33 meta-analysis of largely or only randomized controlled trials involving supplement choices, including vitamins, minerals, antioxidants, polyunsaturated fatty acids (PUFAs), amino acids, and pre/probiotics for common and severe mental disorders.  

This review found the strongest evidence for polyunsaturated fatty acids (PUFAs). The researchers found that PUFAs were effective as an adjunctive therapy for depression and potentially for attention deficit hyperactivity disorders (ADHD). The beneficial effects were largely with preparations of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) with lesser evidence for methylfolate in major depressive disorders and emergent evidence for N-aceylcysteine as a useful adjunctive therapy in mood disorders and schizophrenia. The omega-3 preparations with greater than 50 percent EPA had the largest effect and higher doses (>1.3 g/d) had larger effects. No meta-analyses of randomized studies were found for pre or probiotics. 

Therefore, the fact that large doses of EPA and DHA had beneficial effects on depression and potentially on ADHD, triggered my interest in reading the second article.  

Heart health

The second article, which was conducted by three researchers from Harvard, reexamined the data on omega-3 supplements and cardiovascular disease in several meta-analyses. This group even did the analyses without the study with the largest effect size as they didn’t want one or two studies with large effects to overwhelm the analyses. Their results for omega-3s again showed approximately an 8 percent reduction in heart attacks and cardiovascular deaths, increasing to over 20 percent reduction when 840 or more mg of EPA/DHA were taken daily.   

What is good for the brain in these studies also is good for the heart   

It is no surprise that DHA and EPA support brain health. The human brain is made up of more than 60 percent fat, and half of that fat is DHA omega‑3. A 2010 randomized controlled study showed that 900 mg of DHA omega3 daily supported brain health3. Supplements from plant sources like algae or 18 ounces of wild salmon or ocean trout (the only fish species in the USA with predictable omega‑3) weekly are good sources of DHA and EPA omega-3s.

I regularly recommend to my irregular-fish-eating patients or non-fish eaters that they get what I take, 900 mg of DHA and EPA per day.

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References

  1. Firth J, Teasdale SB, Allott K, et al: The efficacy and safety of nutrient supplements in the treatment of mental disorders: a meta-review of meta-analyses of randomized controlled trials. World Psychiatry 2019;18:308–324.
  2. Hu Y, Hu FB, Manson JE: Marine Omega-3 Supplementation and Cardiovascular Disease: An Updated Meta-Analysis of 13 Randomized Controlled Trials Involving 127,477 Participants, JAHA, online Sept. 30, 2019, doi: 10.1161/JAHA.119.013543.
  3. Yurko-Mauro K, McCarthy D, RomD , et al, on behalf of the MIDAS Investigator. Beneficial effects of docosahexaenoic acid on cognition in age-related cognitive decline. Alzheimer's & Dementia: The Journal of the Alzheimer's Association 2010; 6: 456–464.