Concussions, Traumatic Brain Injury, and the Innovative Use of Omega-3s.

Traumatic brain injury (TBI), with its diverse heterogeneity and prolonged secondary pathogenesis, remains a clinical challenge. Clinical studies thus far have failed to identify an effective treatment strategy when a combination of targets controlling aspects of neuroprotection, neuroinflammation, and neuroregeneration is needed. Omega-3 fatty acids (n-3FA) offer the advantage of this approach. Although further clinical trial research is needed, there is a growing body of strong preclinical evidence and clinical experience that suggests that benefits may be possible from aggressively adding substantial amounts of n-3FA to optimize the nutritional foundation of TBI, concussion, and postconcussion syndrome patients. Early and optimal doses of n-3FA, even in a prophylactic setting, have the potential to improve outcomes from this potentially devastating problem. With evidence of unsurpassed safety and tolerability, n-3FA should be considered mainstream, conventional medicine, if conventional medicine can overcome its inherent bias against nutritional, nonpharmacologic therapies.

Low vitamin D status and suicide: a case-control study of active duty military service members.

OBJECTIVE: Considering that epidemiological studies show that suicide rates in many countries are highest in the spring when vitamin D status is lowest, and that low vitamin D status can affect brain function, we sought to evaluate if a low level of 25-hydroxyvitamin D [25(OH)D] could be a predisposing factor for suicide. METHOD: We conducted a prospective, nested, case-control study using serum samples stored in the Department of Defense Serum Repository. Participants were previously deployed active duty US military personnel (2002-2008) who had a recent archived serum sample available for analysis. Vitamin D status was estimated by measuring 25(OH) D levels in serum samples drawn within 24 months of the suicide. Each verified suicide case (n = 495) was matched to a control (n = 495) by rank, age and sex. We calculated odds ratio of suicide associated with categorical levels (octiles) of 25(OH) D, adjusted by season of serum collection. FINDINGS: More than 30% of all subjects had 25(OH)D values below 20 ng/mL. Although mean serum 25(OH)D concentrations did not differ between suicide cases and controls, risk estimates indicated that subjects in the lowest octile of season-adjusted 25(OH)D (<15.5 ng/mL) had the highest risk of suicide, with subjects in the subsequent higher octiles showing approximately the same level of decreased risk (combined odds ratio compared to lowest octile = 0.49; 95% C.I.: 0.315-0.768). CONCLUSIONS: Low vitamin D status is common in active duty service members. The lowest 25(OH)D levels are associated with an increased risk for suicide. Future studies could determine if additional sunlight exposure and vitamin D supplementation might reduce suicide by increasing 25(OH) D levels.

Neuroprotection for the warrior: dietary supplementation with omega-3 fatty acids.

Nutrition has traditionally involved in supplying energy and hydration. An emerging concept developed by the authors is the concept of using omega-3 fatty acids (n-3 FAs) to increase the resilience of the brain. The n-3 FAs have numerous proven benefits including support of cardiovascular and psychiatric health. Docosahexaenoic acid in particular, is found in high concentrations in the brain. N-3 FAs provide benefits by exerting a protective mechanism at the cellular and neuronal levels including the modulation of inflammatory cascade following traumatic brain injury. Promising research and evolving clinical experience now indicate that n-3 FA is useful and effective for recovery following traumatic brain injury. More exciting is that new laboratory research shows the beneficial effects extend to when n-3 FA is given before injury. Given the safety profile, availability, and affordability of n-3 FA, Generally Recognized As Safe amounts of eicosapentaenoic acid and docosahexaenoic acid (up to 3,000 mg daily) should be considered for the athlete and soldier, not only for its general health benefits, but particularly also for those at risk or high exposure to brain impacts. A comprehensive, coordinated research program to evaluate the multiple uses of n-3 FA should be a high priority for the Department of Defense.