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Brain food: Fish oil and the prevention of “cognitive decline”by Dr. John Whitcomb, Medical Director, Aurora Sinai Medical Center Wellness Institute The Hordaland Health Study is a landmark study conducted in Norway in 1997-1999 with the premise that diet and nutrition might have a lot to do with health. The premise has been raised in the nutrition literature that preventing cognitive decline by lifestyle intervention is preferable to treatment once decline has begun. Certainly treatment of dementia has not been wildly successful yet. Being Norwegian, they had a particular interest in fish and fish products and their impact on overall mental health and cognitive abilities. The intent of the study was to answer the following question: Is the intake of fish associated with better cognitive performance? Does seafood help with some or all cognitive functions? Are some types of seafood better? And does it matter how much you eat? Amazing findings. This wasn't looking at folks with dementia to see if they would get better. The study looked at normal adults ages 70-74 and measuring how much they declined during the study period. Those who ate more than 10 grams of seafood a day did significantly better than those who ate less. And it was dose dependent up to 75 grams a day. The more fish they ate, the smarter they remained. Lean fish and fatty fish were the best. “Processed” fish was less helpful. I read the study carefully. Processed did not include Lutefisk. Thank goodness. But many participants in Norway still take cod liver oil in winter. That's a separate part of the Hordaland Study that showed significantly less depression with fish oil intake. Depression and cognitive decline may be linked in that both are brain diseases. And our brain's membranes are some 40 percent DHA, which is the omega-3 fatty acid that's in fish oil. That's probably what makes fish such good brain food. This was an observational study, which means the investigators were looking at populations of folks and observing changes in the population and comparing that to what the folks did. To finally prove any effect by scientific standards, someone is going to have to do a “randomized controlled trial” intervention type study. It's hard to do that for lifestyle interventions. You can find someone to follow a strict research diet for eight weeks at a time. The DASH research went for 24 weeks. That cost some $20 million plus dollars. Cognitive decline takes decades to occur. I haven't got decades to wait from something that is simply the food choices I make. What will work for me?I'm going to stay smart. Well, the more fish I eat, the longer my brain stays healthy. Three ounces a day is 75 grams. That's not easily achievable every day. The rigors of a randomized controlled interventional trial are still pending but it's enough for me to feel confirmed in my “conviction” that those three fish oil tablets I eat every day are good for me. Despite the burps. And the next time I order fish at the restaurant and everyone else orders a juicy steak, I wont feel so sorry for myself. Each of us, every day, one gram of DHA and EPA (Look at your pills and add up the amount of DHA and EPA - most one-gram pills only have a total of 300 plus milligrams of the two, so you need three to get to a gram.). If three makes you burp, eat two, but have at least something, while you can still remember which bottle they were in). Reference: American Journal of Clinical Nutrition, Nov. 2007
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