Omega-3 Fatty Acid Plasma Levels Before and After Supplementation: Correlations with Mood and Clinical Outcomes in the Omega-3 and Therapy Studies.
OBJECTIVE
To examine fatty acid profiles, their response to omega-3 fatty acid (Ω3) supplementation, and associations with clinical status and treatment response in youth with mood disorders.


METHODS
In a placebo-controlled 2X2 design, 7-14 year-olds (N = 95) in parallel pilot trials (depression N = 72; bipolar N = 23) were randomly assigned to 12 weeks of Ω3 supplementation (1.4 g eicosapentaenoic acid [EPA], 0.2 g docosahexaenoic acid [DHA], and 0.27 g other Ω3 per day); psychoeducational psychotherapy (PEP); their combination; or placebo (mainly oleic and linoleic acid) alone. Blood was drawn at baseline (N = 90) and endpoint (n = 65). Fatty acid levels were expressed as percent of total plasma fatty acids. Correlational and moderator/mediator analyses were done with SPSS Statistics 23.


RESULTS
At baseline: (1) DHA correlated negatively with alpha-linolenic acid (ALA) (r = -0.23, p = 0.029); (2) Arachidonic acid (AA, Ω6) correlated negatively with global functioning (r = -0.24, p = 0.022); (3) Total Ω3 correlated negatively with age (r = -0.22, p = 0.036) and diastolic blood pressure (r = -0.31, p = 0.006). Moderation: Baseline ALA moderated response to Ω3 supplementation: ALA levels above the sample mean (lower DHA) predicted significantly better placebo-controlled response (p = 0.04). Supplementation effects: Compared to placebo, 2 g Ω3 per day increased EPA blood levels sevenfold and DHA levels by half (both p < 0.001). Body weight correlated inversely with increased EPA (r = -0.52, p = 0.004) and DHA (r = -0.54, p = 0.003) and positively with clinical mood response. Mediation: EPA increase baseline-to-endpoint mediated placebo-controlled global function and depression improvement: the greater the EPA increase, the less the placebo-controlled Ω3 improvement.


CONCLUSIONS
Ω3 supplementation at 2 g/day increases blood levels substantially, more so in smaller children. A possible U-shaped response curve should be explored.
1 Department of Psychiatry and Behavioral Health, The Ohio State University , Columbus, Ohio.
L Eugene
LE
Arnold
2 Department of Psychiatry, Johns Hopkins University , Baltimore, Maryland.
Andrea S
AS
Young
1 Department of Psychiatry and Behavioral Health, The Ohio State University , Columbus, Ohio.|3 Department of Human Sciences, The Ohio State University , Columbus, Ohio.
Martha A
MA
Belury
1 Department of Psychiatry and Behavioral Health, The Ohio State University , Columbus, Ohio.|2 Department of Psychiatry, Johns Hopkins University , Baltimore, Maryland.
Rachel M
RM
Cole
1 Department of Psychiatry and Behavioral Health, The Ohio State University , Columbus, Ohio.|4 Nationwide Children's Hospital , Columbus, Ohio.
Barbara
B
Gracious
5 Department of Psychological and Brain Sciences, University of Delaware , Newark, Delaware.
Adina M
AM
Seidenfeld
1 Department of Psychiatry and Behavioral Health, The Ohio State University , Columbus, Ohio.
Hannah
H
Wolfson
1 Department of Psychiatry and Behavioral Health, The Ohio State University , Columbus, Ohio.
Mary A
MA
Fristad
D000293:Adolescent; D016718:Arachidonic Acid / Q000097:blood; D002648:Child; D019587:Dietary Supplements; D004281:Docosahexaenoic Acids / Q000097:blood; D015118:Eicosapentaenoic Acid / Q000097:blood; D005227:Fatty Acids / Q000097:blood; D015525:Fatty Acids, Omega-3 / Q000097:blood* / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000188:drug therapy* / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy; D016896:Treatment Outcome; D017962:alpha-Linolenic Acid / Q000097:blood
D005227:Fatty Acids; D015525:Fatty Acids, Omega-3; D017962:alpha-Linolenic Acid; D004281:Docosahexaenoic Acids; D016718:Arachidonic Acid; D015118:Eicosapentaenoic Acid
mediation; moderation; mood disorders; omega-3 fatty acids; plasma levels; supplementation as treatment