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Can Fish Fat Help Headaches?
First-ever trial finds benefits from diets high in omega-3s and low in omega-6 fats
1/30/2014By Craig Weatherby
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Some 10 million American adults suffer from chronic daily headaches.
 
And headache-related sick days and medical expenses cost billions of dollars every year.
 
Chronic daily headache syndrome (CDH) is defined as having headaches that last four hours or more at least every other day for at least 3 months.
 
CDH encompasses chronic migraine and tension headaches, which afflict about 40 percent of patients seen at headache clinics.
 
Conventional treatment relies heavily on drugs that often provide only partial or transient relief and are associated with significant side effects.
 
Many CDH patients continue to have frequent headaches and impaired quality of life despite taking numerous pain-relief drugs.
 
Omega fatty acids and pain
Omega-3 and omega-6 fatty acids from foods serve as precursors to compounds that tend to reduce (omega-3s) or aggravate (omega-6s) pain.
 
The average American gets far too many omega-6 fatty acids, primarily from the vegetable oils used in home kitchens and in almost all restaurant, take-out, prepared, and packaged foods (corn, soy, safflower, sunflower, cottonseed).
 
Overconsumption of omega-6 fatty acids reduces absorption of omega-3 fatty acids … a double whammy on overall health.
 
As the U.S. National Institutes of Health tells medical doctors, “There is general agreement that individuals should consume more omega-3 and less omega-6 fatty acids to promote good health.”
 
There’s been little research on omega-3s and pain, but a study in rats published last December showed that omega-3s reduced pain related to a spinal injury (Figueroa JD et al. 2013).
 
For the first time, researchers ran a clinical trial to see whether diets higher in omega-3s and lower in omega-6s than usual for Americans would ease the severity or frequency of chronic headaches.
 
Last November, they published the highly encouraging results, which need confirmation in a larger trial, but fit with the known effects of omega-3 and omega-6 fats.
 
Novel clinical trial finds “omega balanced” diets eased chronic headaches
The unprecedented trial was conducted by scientists from the U.S. National Institutes of Health, the University of North Carolina, the UC San Diego, and The University of Western Australia (Ramsden CE et al. 2013).
 
They recruited 67 patients (adult men and women) who’d been under the care of a headache specialist for at least two years.
 
The participants were advised to continue seeing their regular headache physician for usual care throughout the trial.
 
This novel three-month clinical trial was conducted at the University of North Carolina at Chapel Hill (UNC) from April 2009 to November 2011.
 
The researchers wanted to test the effects of two different diets on chronic headaches:
  • Low omega-6 diet (L6 for short)
  • High omega-3 / Low omega-6 diet (H3/L6 for short)
The H3-L6 diet was designed to reduce intake of omega-6 LA from plant foods, and increase intake of omega-3 EPA and DHA from seafood.
 
The L6 diet was designed to reduce intake of omega-6 LA, and maintain the low omega-3 EPA and DHA intakes typical of U.S. diets.
 
The two groups were equivalent with respect to four key factors:
  • Macronutrient and calorie intake
  • The amounts of study foods provided
  • Interactions with the study dietitian and researchers
  • The intensity and breadth of the dietary advice and educational web pages
Foods meeting the nutrient-intake targets – enough for two daily meals and snacks – were provided to all participants, and a registered dietitian provided regular, intensive counseling to help the volunteers stick to their diets.
 
The researchers used three standard measures to judge success or failure:
  • Headache Hours per day
  • Headache Days per month
  • Headache Impact Test (HIT-6)
The biochemical outcomes they measured included the blood levels of omega-6 fatty acids and blood levels of the omega-3 and omega-6 “derivatives” that affect pain and inflammation.
 
Fifty-six (28 in each group) of the 67 patients completed the trial, and both groups (L6 and H3/L6) achieved the desired intakes of omega-3 and omega-6 fatty acids.
 
After three-months, the H3/L6 group showed significantly greater improvements in all measures, compared to the L6 group:
  • HIT-6 score (-7.5 vs -2.1)
  • Headache Days per month (-8.8 vs -4.0)
  • Headache Hours per day (-4.6 vs -1.2)
  • Omega-6 blood level score (-21.0 vs -4.0%
  • Levels of omega-3 derivatives known to reduce pain
As we said, these very good results need confirmation, but fit the known effects of seafood-source omega-3s and plant-source omega-6 fats.
 
 
Sources
  • Coeytaux RR, Linville JC. Chronic daily headache in a primary care population: prevalence and headache impact test scores. Headache 2007;154:477–512.
  • Dodick DW. Chronic daily headache. N Engl J Med 2006;354:158–65.
  • Pryse-Phillips W. Assessment and management of disability in chronic daily headache. Curr Pain Headache Rep 2005;9:53–8.
  • Figueroa JD, Cordero K, Serrano-Illan M, Almeyda A, Baldeosingh K, Almaguel FG, De Leon M. Metabolomics uncovers dietary omega-3 fatty acid-derived metabolites implicated in anti-nociceptive responses after experimental spinal cord injury. Neuroscience. 2013 Dec 26;255:1-18. doi: 10.1016/j.neuroscience.2013.09.012. Epub 2013 Sep 14.
  • Ramsden CE, Faurot KR, Zamora D, Suchindran CM, Macintosh BA, Gaylord S, Ringel A, Hibbeln JR, Feldstein AE, Mori TA, Barden A, Lynch C, Coble R, Mas E, Palsson O, Barrow DA, Mann JD. Targeted alteration of dietary n-3 and n-6 fatty acids for the treatment of chronic headaches: a randomized trial. Pain. 2013 Nov;154(11):2441-51. doi: 10.1016/j.pain.2013.07.028. Epub 2013 Jul 22.
  • Ramsden CE, Mann JD, Faurot KR, Lynch C, Imam ST, MacIntosh BA, Hibbeln JR, Loewke J, Smith S, Coble R, Suchindran C, Gaylord SA. Low omega-6 vs. low omega-6 plus high omega-3 dietary intervention for chronic daily headache: protocol for a randomized clinical trial.
  • Saper JR. Chronic daily headache: transformational migraine, chronic migraine, and related disorders. Curr Neurol Neurosci Rep 2008;8:100–7.
  • Schulman E. Refractory migraine – a review. Headache 2013;53:599–613.
  • Smitherman TA, Burch R, Sheikh H, Loder E. The prevalence, impact, and treatment of migraine and severe headaches in the United States: a review of statistics from national surveillance studies. Headache 2013;53: 427–36. Trials. 2011 Apr 15;12:97. doi: 10.1186/1745-6215-12-97.
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