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Soldiers' Suicide Risk Linked to Omega-3 Lack
8/25/2011
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The U.S. military is getting serious about omega-3 fish-fats’ potential to protect combat-zone soldiers’ mental health.
 
The research charge has been largely led by psychiatrist Captain Joseph R. Hibbeln, M.D. of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) … a renowned researcher into omega-3s’ effects on mental health and child development.
 
We attended the 2009 Department of Defense-hosted Nutritional Armor gathering, which was organized by Dr. Hibbeln to inform military health pros about the benefits of omega-3 fish fats (see “Soldiers and Omega-3s: Pentagon Pitched on Benefits”).
 
As Dr. Hibbeln told Eating Well magazine last year (click here for our summary), post-traumatic stress disorder (PTSD) and depression in the U.S. military affect 20 percent of deployed personnel:
“They’re building new treatment facilities to capture this flood of psychiatric distress. If I can get the military to change their diet, show that it works to reduce depression and suicide there, then there’s a great potential for societal change.” (Gorman RM 2010)
 
Clinical trial tested omega-3s in soldiers … results eagerly awaited
Last January, we reported that the U.S. Army was undertaking the first-ever trial testing omega-3 fish oil among combat-zone troops. See “Soldiers' Omega-3 Test Targets Suicide Risk”.
 
The three-month study involved U.S. Army personnel at bases in northern Iraq, who’d served there for various lengths of time performing functions from infantry to aviation.
 
The goal was to test various measures of brain health and the effects, if any, of omega-3 fish oil on signs of depression, anxiety, and post traumatic stress disorder (PTSD)… overlapping conditions that seriously damage many soldiers and raise suicide risks.
 
This clinical trial – called “Effects of Omega-3 EPA/DHA for Soldiers at Risk for Mood Disorders” – will also include military-specific tests such as the Post-Deployment Health Assessment.
 
It’s being led by Brigade Surgeon Lt. Colonel Daniel Johnston, M.D., the Medical Director for the US Army Comprehensive Soldier Fitness (CSF) Program.
 
This clinical trial ended in February, 2011, and the eagerly awaited results were to be published in May, 2011 but have not yet appeared.
So we’re very pleased to report the encouraging outcomes of a “case-control” omega-3s-and-suicide study performed by Dr. Hibbeln and his colleagues.
 
Dr. Hibbeln remarked on the study’s value in a press release: “The findings add to an extensive body of research that points to a fundamental role for DHA and other omega-3 fatty acids in protecting against mental health problems and suicide risks.” (NIAAA 2011)
 
And he hopes the results will influence military menus:
“This study presents new information on the potential usefulness of omega-3 fats in reducing risk for suicide and optimizing mental health, which can be taken into account when designing U.S. military diets.” (NIAAA 2011)
 
This seems especially likely to happen if Dr. Hibbeln’s new findings are supported by positive outcomes from a completed but unpublished clinical trial that measured the mental effects of omega-3s among combat-zone troops in Iraq (see our sidebar, “Clinical trial tested omega-3s in soldiers”).
 
Findings support wisdom of filling military kits and mess halls with omega-3s
NIAAA scientists led by Dr. Hibbeln teamed with researchers at the Uniformed Services University of the Health Sciences (USUHS) to analyze a sample of suicide deaths among U.S. military personnel on active duty between 2002 and 2008.
 
Dr. Hibbeln’s team compared blood levels of omega-3 fatty acids in 800 troops who’d committed suicide with those of 800 randomly selected service members who were matched with the suicide cases by age, sex, and rank (Lewis MD, Hibbeln JR, et al. 2011).
 
All 1,600 service members had low omega-3 levels, but the lowest levels of omega-3 DHA were more likely to be found among the 800 who’d taken their own lives.
 
The risk of suicide death was 14 percent higher for every “standard deviation” of lower DHA percentage.
 
Among men, the risk of suicide death was 62 percent greater in those with low blood DHA levels.
 
Sadly, but not surprisingly, the risk of suicide death was 52 percent greater in those who reported having seen a soldier killed, or seeing wounded or dead soldiers.
 
As Dr. Hibbeln’s team wrote, “This US military population had a very low and narrow range of n-3 HUFA [omega-3] status.” 
 
They sounded a note of caution: “Although these data suggest that low serum [blood] DHA [levels] may be a risk factor for suicide, well-designed intervention [clinical] trials are needed to evaluate causality.”
 
Still as Dr. Hibbeln said, “The identification of low DHA status as a significant risk factor for suicide deaths should complement ongoing efforts in the U.S. military to study modifiable risk and protective factors related to mental health and suicide among U.S. military personnel.” (NIAAA 2011)
 
Omega-3 DHA matters to mood
DHA is the most abundant fatty acid in the human brain, and is clearly critical to mood, memory, and other mental functions.
 
Accordingly, this outcome was not unexpected. As Dr. Hibbeln said, “… a previous placebo-controlled trial demonstrated that 2 grams of omega-3 fatty acids per day reduced suicidal thinking by 45 percent as well as depression and anxiety scores among individuals with recurrent self-harm.” (NIAAA 2011)
 
“In a prior study we found that low blood levels of DHA correlated with hyperactivity of brain regions in a pattern that closely resembles the pathology of major depression and suicide risk”, he added. (NIAAA 2011)
 
Omega-3s are recommended by the American Psychiatric Association as an adjunct therapy for mood disorders, thanks in part to the results of a 2006 evidence review by an expert APA panel that included Dr. Hibbeln (see “Top Psych Panel Says Omega-3s Deter Depression, Bipolar Disorder”).
 
 
Sources
  • Gorman RM. Captain of the Happier Meal. Eating Well. May/June 2010. Accessed at http://www.eatingwell.com/nutrition_health/nutrition_news_information/new_science_links_food_and_happiness
  • Hale R. Nutrient may enhance Soldiers' performance. WWW.ARMY.MIL. Sept, 28, 2010. Accessed at http://www.army.mil/-news/2010/09/28/45806-nutrient-may-enhance-soldiers-performance/
  • Hallahan B, Hibbeln JR, Davis JM, Garland MR. Omega-3 fatty acid supplementation in patients with recurrent self-harm. Single-centre double-blind randomised controlled trial. Br J Psychiatry. 2007 Feb;190:118-22.
  • Hibbeln JR. Depression, suicide and deficiencies of omega-3 essential fatty acids in modern diets. World Rev Nutr Diet. 2009;99:17-30. Epub 2009 Jan 9. Review. No abstract available.
  • Hibbeln JR. Depression, suicide and deficiencies of omega-3 essential fatty acids in modern diets. World Rev Nutr Diet. 2009;99:17-30. Epub 2009 Jan 9. Review. No abstract available.
  • Hibbeln JR. From homicide to happiness--a commentary on omega-3 fatty acids in human society. Cleave Award Lecture. Nutr Health. 2007;19(1-2):9-19.
  • Huan M, Hamazaki K, Sun Y, Itomura M, Liu H, Kang W, Watanabe S, Terasawa K, Hamazaki T. Suicide attempt and n-3 fatty acid levels in red blood cells: a case control study in China. Biol Psychiatry. 2004 Oct 1;56(7):490-6.
  • Lewis MD, Hibbeln JR, et al. Suicide Deaths of Active-Duty US Military and Omega-3 Fatty-Acid Status: A Case-Control Comparison. Journal of Clinical Psychiatry. 2011 August 23. [Epub ahead of print]
  • National Institute on Alcohol Abuse and Alcoholism (NIAAA). Study links low DHA levels to suicide risk among U.S. military personnel. Tuesday, August 23, 2011. Accessed at http://www.nih.gov/news/health/aug2011/niaaa-23.htm
  • Patton M. Army doctor studies benefits of fish oil. Stars and Stripes. December 3, 2010. Accessed at http://www.stripes.com/news/army-doctor-studies-benefits-of-fish-oil-1.127338
  • Sublette ME, Hibbeln JR, Galfalvy H, Oquendo MA, Mann JJ. Omega-3 polyunsaturated essential fatty acid status as a predictor of future suicide risk. Am J Psychiatry. 2006 Jun;163(6):1100-2.
  • Sublette ME, Hibbeln JR, Galfalvy H, Oquendo MA, Mann JJ. Omega-3 polyunsaturated essential fatty acid status as a predictor of future suicide risk. Am J Psychiatry. 2006 Jun;163(6):1100-2.
  • Tanskanen A, Hibbeln JR, Hintikka J, Haatainen K, Honkalampi K, Viinamäki H. Fish consumption, depression, and suicidality in a general population. Arch Gen Psychiatry. 2001 May;58(5):512-3.
  • Tanskanen A, Hibbeln JR, Hintikka J, Haatainen K, Honkalampi K, Viinamäki H. Fish consumption, depression, and suicidality in a general population. Arch Gen Psychiatry. 2001 May;58(5):512-3. No abstract available.
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