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Feeling Anxious? Fish and Fish Oil May Help
3/20/2006
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Israeli studies affirm benefits of omega-3s in social and pre-exam anxiety

by Craig Weatherby


Advertisements for anti-anxiety drugs appear frequently on television and in print, but experts regard this characteristically 21st century condition as stubbornly resistant to consistently safe, effective treatment with pharmaceutical drugs.


  Key Points

  • One Israeli study found a significant correlation between low tissue levels of omega-3s and increased risk of social anxiety disorder.
  • A second Israeli study found that supplements containing the weakest form of omega-3s alleviated pre-exam anxiety significantly more than placebo pills.

  • Evidence from animal studies illuminates the anti-anxiety mechanisms of omega-3s and confirms the ineffectiveness of omega-6s.

While Prozac-type anti-depressants (i.e., selective serotonin reuptake inhibitors) can alleviate symptoms in many patients, they come attached to significant risk of adverse effects, including weight gain, sexual dysfunction, and withdrawal syndrome.


Fortunately, two new research studies out of Israel combine to bolster the hypothesized anti-anxiety benefits of omega-3 fatty acids.

Omega-3 shortage known to undermine psychological health

Omega-3s play key roles in brain health are appear to help alleviate depression, but the typical American diet is grossly imbalanced in favor of omega-6 fatty acids. These inflammatory nutrients are abundant in the cooking oils (corn, soy, safflower, etc.) used most often in households and in processed and restaurant foods.

As a result, most people in Western countries consume about one part omega-3s to 20 or even 40 parts omega-6 fats, rather than the 1:2 or 1:4 ratios recommended by most researchers.


It’s not that omega-6 fatty acids are inherently unhealthful: in fact, they are essential for proper brain and nerve function, among other things.


But the extreme overabundance of omega-6 fats in the Western diet that appears to promote cancer, heart disease, and a variety of inflammatory conditions.


And this nutritional imbalance may also contribute to the growing epidemic of anxiety and depression apparent in modern societies.


Animal study illuminates anti-anxiety effects of omega-3s

Before we get to the intriguing results of the two recently published Israeli studies, it’s useful to understand the mechanisms by which omega-3s may alleviate anxiety, as elucidated by a recent study in rats.


Dr. David Horrobin, M.D., Ph.D., who passed away in April of 2003, was a pioneering researcher in the field of essential fatty acids. Among of the last of his hundreds of influential research studies was one published posthumously in October of 2003, which bears directly on the Israeli findings in people.


Dr. Horrobin’s team at the University of British Columbia’s Department of Psychiatry tested the effects of the omega-3 fatty acid EPA, versus those of two omega-6 fatty acids abundant in the human body—GLA (gamma linoleic acid) and AA (arachidonic acid)—on the behavior of rats in which anxiety had been chemically induced.


The test rodents were administered a body chemical—a cytokine (immune-system agent) called interleukin-1beta—known to raise body levels of cortisol: a hormone that produces inflammation, stress, weight gain, and anxiety.


Dr. Horrobin’s team found that when they fed the rats omega-3 EPA, it prevented any cytokine-induced rise in levels of cortisol, stress, or anxiety.


In contrast, when they fed the rats GLA or AA, neither of these omega-6 fatty acids prevented cytokine-induced increase in levels of cortisol, stress, or anxiety.


In fact, feeding of omega-6 AA only served to further increase the rats’ levels of inflammation, cortisol and anxiety. (Unsurprisingly, feeding of omega-6 GLA—a well-known anti-inflammatory agent—did serve to reduce cytokine-induced inflammation in the rats, but had no other anti-anxiety benefits.)


First Israeli study connects omega-3 deficiency with social anxiety

Last October, an Israeli research team published the results of an investigation designed to discover any correlations between risk of social anxiety and body levels of omega-3s.


Their study involved 27 untreated, non-depressed patients diagnosed with Social Anxiety Disorder (SAD)—a condition characterized by extreme shyness and fear of rejection—and 22 psychologically healthy control subjects.


The researchers found that cell-membrane levels of omega-3s were about one-third lower in the SAD patients: no significant differences in levels of other fatty acids were observed between the 27 SAD patients and the 22 healthy control subjects.


Even more significantly, the Israeli team reported that the SAD patients with the lowest levels of omega-3s also suffered the highest anxiety scores.


These results indicate a possible connection between low omega-3 intake and increased risk of social anxiety.


Second Israeli study finds omega-3s beneficial for school-exam anxiety

Many students suffer anxiety before tests, but, as this second Israeli research team noted, “Conventional treatment [of exam anxiety] by anti-anxiety medications is neither effective nor desirable.”


Accordingly, this Israeli research team, from Bar Ilan University, set out to test the effects in anxiety-prone college students of supplements containing one part omega-3 fatty acids to four parts omega-6 fatty acids (i.e., a 1:4 ratio).


Why did they choose to test this blend of both kinds of essential fatty acid—omega-3 and omega-6—instead of pure omega-3s? It seems odd, since, as they noted, “…the involvement of n-3 [omega-3] fatty acids in [alleviating] anxiety has been suggested in the past …”.


It is likely that they wanted to try this specific regimen for two reasons: 1) it represents a commonly recommended intake ratio of omega-3 to omega-6 fatty acids, and 2) they’d tested it before, with positive results, in Alzheimer’s patients, aged rats, and learning-deficient rats.


Despite the researchers’ decision to test a blend of omega-3 and omega-6 fatty acids, rather than pure omega-3s, one can draw reasonable inferences about the exam-anxiety-alleviating benefits of omega-3s from their results. This is because even supplements containing only one part omega-3s to four parts omega-6 fats would constitute an increase in omega-3 intake, in the context of the average diet in industrialized countries like Israel.


The study began when trained psychologists identified and recruited 126 male undergraduate college students who were diagnosed as suffering from unusual pre-exam anxiety.


Thirty-eight of the diagnosed-anxious students received placebo capsules containing mineral oil, while the remaining 88 received “active” capsules containing the 1:4 omega-3/omega-6 fatty acid mixture.


Seventy other students from the same college classes who did not suffer test anxiety—and who matched the diagnosed-anxious students in age and education level—served as the control group.


Starting one month before a major exam, each student provided morning saliva samples that were tested for cortisol (stress hormone) levels and completed a questionnaire designed to determine their status with regard to six exam-anxiety symptoms:

  1. appetite
  2. overall mood state
  3. concentration during the day
  4. fatigue during the day
  5. ability to organize materials for the exam
  6. quality of sleep

The final results were very positive, with diagnosed-anxious students who took the omega-3/omega-6 supplements showing improvement in all six symptoms of pre-exam anxiety.


And 78 out of the 88 diagnosed-anxious students reported that even after the end of the study they no longer felt anxious.


Even the non-anxious control subjects showed improvement in their ability to concentrate, suffered less daytime fatigue, and slept better.


In contrast, no improvement was observed among the placebo group.


As the authors said, “Test anxiety is an incapacitating academic syndrome. This study shows that administration of a polyunsaturated fatty acid mixture of omega-3 and [omega]-6 can improve the behavioral variables associated with this type of anxiety, i.e. appetite, mood, mental concentration, fatigue, academic organization and poor sleep, as well as lowering elevated cortisol level, with a corresponding reduction of anxiety.”


What is even more remarkable about this study is that the omega-3 fatty acid in the capsules was alpha-linolenic acid (ALA)—the short chain kind found in plant foods—instead of the long-chain marine omega-3s essential to proper brain function. Marine omega-3s are the primary kind used in our cell membranes, and documented to alleviate depression (a condition closely related to anxiety).


In fact, the body converts the vast majority of dietary ALA into EPA and DHA, the prinicipal long-chain omega-3s, which are used in almost all psychological studies of this kind. And most people can convert only two to 10 percent of dietary ALA to EPA and DHA.


It seems reasonable to hypothesize, in light of the rat study cited above, that little or none of the anti-anxiety benefit the students exhibited stemmed from the omega-6 fat in the capsules.

And it also seems reasonable to propose that the diagnosed-anxious students would have enjoyed even more benefit had they taken pure marine omega-3s, rather than much weaker, plant-derived omega-3s.



Sources

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  • Green P, Hermesh H, Monselise A, Marom S, Presburger G, Weizman A. Red cell membrane omega-3 fatty acids are decreased in nondepressed patients with social anxiety disorder. Eur Neuropsychopharmacol. 2006 Feb;16(2):107-13. Epub 2005 Oct 21.
  • Song C, Li X, Leonard BE, Horrobin DF. Effects of dietary n-3 or n-6 fatty acids on interleukin-1beta-induced anxiety, stress, and inflammatory responses in rats. J Lipid Res. 2003 Oct;44(10):1984-91. Epub 2003 Jul 1.
  • Bruce TJ, Saeed SA, American Academy of Family Physicians. Social Anxiety Disorder: A Common, Underrecognized Mental Disorder. Accessed online March 19, 2006 at http://www.aafp.org/afp/991115ap/2311.html.
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