James Loewke

Suicide deaths of active-duty US military and omega-3 fatty-acid status: a case-control comparison.

BACKGROUND The recent escalation of US military suicide deaths to record numbers has been a sentinel for impaired force efficacy and has accelerated the search for reversible risk factors. OBJECTIVE To determine whether deficiencies of neuroactive, highly unsaturated omega-3 essential fatty acids (n-3 HUFAs), in particular docosahexaenoic acid (DHA), are associated with increased risk of suicide death among a large random sample of active-duty US military. METHOD In this retrospective case-control study, serum fatty acids were quantified as a percentage of total fatty acids among US military suicide deaths (n = 800) and controls (n = 800) matched for age, date of collection of sera, sex, rank, and year of incident. Participants were active-duty US military personnel (2002-2008). For cases, age at death ranged from 17-59 years (mean = 27.3 years, SD = 7.3 years). Outcome measures included death by suicide, postdeployment health assessment questionnaire (Department of Defense Form 2796), and ICD-9 mental health diagnosis data. RESULTS Risk of suicide death was 14% higher per SD of lower DHA percentage (OR = 1.14; 95% CI, 1.02-1.27; P < .03) in adjusted logistic regressions. Among men, risk of suicide death was 62% greater with low serum DHA status (adjusted OR = 1.62; 95% CI, 1.12-2.34; P < .01, comparing DHA below 1.75% [n = 1,389] to DHA of 1.75% and above [n = 141]). Risk of suicide death was 52% greater in those who reported having seen wounded, dead, or killed coalition personnel (OR = 1.52; 95% CI, 1.11-2.09; P < .01). CONCLUSION This US military population had a very low and narrow range of n-3 HUFA status. Although these data suggest that low serum DHA may be a risk factor for suicide, well-designed intervention trials are needed to evaluate causality.

Low omega-6 vs. low omega-6 plus high omega- 3 dietary intervention for Chronic Daily Headache: Protocol for a randomized clinical trial

BackgroundTargeted analgesic dietary interventions are a promising strategy for alleviating pain and improving quality of life in patients with persistent pain syndromes, such as chronic daily headache (CDH). High intakes of the omega-6 (n-6) polyunsaturated fatty acids (PUFAs), linoleic acid (LA) and arachidonic acid (AA) may promote physical pain by increasing the abundance, and subsequent metabolism, of LA and AA in immune and nervous system tissues. Here we describe methodology for an ongoing randomized clinical trial comparing the metabolic and clinical effects of a low n-6, average n-3 PUFA diet, to the effects of a low n-6 plus high n-3 PUFA diet, in patients with CDH. Our primary aim is to determine if: A) both diets reduce n-6 PUFAs in plasma and erythrocyte lipid pools, compared to baseline; and B) the low n-6 plus high n-3 diet produces a greater decline in n-6 PUFAs, compared to the low n-6 diet alone. Secondary clinical outcomes include headache-specific quality-of-life, and headache frequency and intensity.MethodsAdults meeting the International Classification of Headache Disorders criteria for CDH are included. After a 6-week baseline phase, participants are randomized to a low n-6 diet, or a low n-6 plus high n-3 diet, for 12 weeks. Foods meeting nutrient intake targets are provided for 2 meals and 2 snacks per day. A research dietitian provides intensive dietary counseling at 2-week intervals. Web-based intervention materials complement dietitian advice. Blood and clinical outcome data are collected every 4 weeks.ResultsSubject recruitment and retention has been excellent; 35 of 40 randomized participants completed the 12-week intervention. Preliminary blinded analysis of composite data from the first 20 participants found significant reductions in erythrocyte n-6 LA, AA and %n-6 in HUFA, and increases in n-3 EPA, DHA and the omega-3 index, indicating adherence.Trial RegistrationClinicalTrials.gov (NCT01157208)

Preferential effect of lead exposure during lactation on non-essential fatty acids in maternal organs

This study determined the effects of lead exposure during the lactational period on maternal organ FA compositions in rat dams that were fed either an n−3 adequate (n−3 Adq) or deficient (n−3 Def) diet prior to conception. On giving birth, dams were subdivided into four groups in a 2×2 design with n−3 FA supply and Pb exposure as the dependent variables. Pb acetate (0.2 wt%) was administered in the drinking water from the time they gave birth to weaning 3 wk later. Following weaning, the dams were decapitated. and the liver, plasma, kidney, brain, and retina analyzed for FA composition. The n−3 deficient diets markedly decreased the percentages of total n−3 FA, including docosahexaenoic acid (DHA), and increased total n−6 FA including both arachidonic (AA) and n−6 docosapentaenoic acids in all tissues (P<0.05). The principal effects of Pb occurred in the liver and plasma, where 20–32% losses in total FA concentration concurrent with increased relative percentages of AA (P<0.05) were observed. In kidney, the percentages of AA and DHA also increased after Pb exposure (P<0.05) with lesser effects in the nervous system. There was a diet x Pb interaction for liver, plasma, and retinal 20-C n−6 PUFA (P<0.05). Generally, shorter-chain saturated and monounsaturated FA concentrations were decreased after Pb exposure. An analysis of the changes in the tissue concentrations induced by Pb indicated that the increases in the percentages of PUFA likely reflected a preferential loss of non-EFA. The mechanisms by which Pb affects saturated and monounsaturated FA concentration are unknown.