Health for life

The omega 3 fatty acids in fish oil have long been thought to protect against cardiovascular disease—so much so that the American Heart Association currently recommends eating at least two servings of fish a week, particularly fatty varieties rich in omega 3s. However, the mechanism behind this protective effect still remains a mystery.

In a new study, scientists led by Jason R. Carter of Michigan Technological University shed light on this phenomenon by providing evidence that fish oil might specifically counteract the detrimental effects of mental stress on the heart. Their findings show that volunteers who took fish oil supplements for several weeks had a blunted response to mental stress in several measurements of cardiovascular health, including heart rate and muscle sympathetic nerve activity (MSNA), part of the "fight or flight" response, compared to volunteers who took olive oil instead. The results may explain why taking fish oil could be beneficial to the heart and might eventually help doctors prevent heart disease in select populations.

The article is entitled "Fish Oil and Neurovascular Reactivity to Mental Stress in Humans." It appears in the May edition of the American Journal of Physiology – Regulatory, Integrative, and Comparative Physiology, published by the American Physiological Society. It is available online at http://bit.ly/10j0CSS

Methodology

Carter and his colleagues worked with 67 adult volunteers. At the beginning of the study, each volunteer underwent a battery of tests to assess cardiovascular function, including heart rate, blood pressure, MSNA, and blood flow through the forearm and calf. These tests were performed first when the volunteers were at rest, and then again while they were performing a mental arithmetic test while the investigator encouraged them to hurry, a situation designed to induce acute mental stress. The study subjects were then nearly equally assigned to take either 9 grams of fish oil per day or 9 grams of olive oil, a placebo that hasnt been shown to have the same beneficial cardiovascular effects as fish oil. None of the volunteers were aware of which supplement they were taking. After 8 weeks of this intervention, the study subjects underwent the same tests again.

Results

The researchers found that test results didnt change between the two groups of study subjects when they were at rest. However, results for the volunteers who took fish oil and those who received the placebo differed significantly for some of the tests during the mental stress. Those in the fish oil group showed blunted heart rate reactivity while they were stressed compared to those who took olive oil. Similarly, the total MSNA reactivity to mental stress was also blunted in the fish oil group.

Importance of the Findings

These results show that fish oil could have a protective effect on cardiovascular function during mental stress, a finding that adds a piece to the puzzle on why taking fish oil helps the heart stay healthy, the authors suggest. Future studies might focus on the effects of taking fish oil for longer time periods and examining this effect on older populations or people with cardiovascular disease.

"Overall," the study authors say, "the data support and extend the growing evidence that fish oil may have positive health benefits regarding neural cardiovascular control in humans and suggest important physiological interactions between fish oil and psychological stress that may contribute to disease etiology."

There may be a way for older people to prevent natural aging of their minds, and it could be as simple as playing a video game.

Thats according to a study from the University of Iowa, which found that elderly people who played just ten hours of a game priming their mental processing speed and skills delayed declines by as many as seven years in a range of cognitive skills.

"We know that we can stop this decline and actually restore cognitive processing speed to people," says Fredric Wolinsky, professor in the UI College of Public Health and lead author on the paper published May 1 in the journal PLOS One. "So, if we know that, shouldnt we be helping people? Its fairly easy, and older folks can go get the training game and play it."

The study comes amidst a burst of research examining why, as we age, our minds gradually lose "executive function," generally considered mission control for critical mental activities, such as memory, attention, perception and problem solving. Studies show loss of executive function occurs as people reach middle age; other studies say our cognitive decline begins as soon as 28 years of age. Either way, our mental capacities do diminish, and medical and public health experts are keen to understand why in an effort to stem the inexorable tide as much as possible.

Wolinsky and colleagues separated 681 generally healthy medical patients in Iowa into four groups—each further separated into those 50 to 64 years of age and those over age 65. One group was given computerized crossword puzzles, while three other groups were exposed to a video game called "Road Tour." Briefly, the game revolves around identifying a type of vehicle (displayed fleetingly on a license plate) and then reidentifying the vehicle type and matching it with a road sign displayed from a circular array of possibilities, all but one of them false icons. The player must succeed at least three out of every four tries to advance to the next level, which speeds up the vehicle identification and adds more distractions, up to 47 in all.

The goal, naturally, is to increase the users mental speed and agility at identifying the vehicle symbol and picking out the road sign from the constellation of distractors (which are rabbits, by the way).

"The game starts off with an assessment to determine your current speed of processing. Whatever it is, the training can help you get about 70 percent faster," says Wolinsky, who has no financial stake in the game.

The groups that played the game at least 10 hours, either at home or in a lab at the university, gained at least three years of cognitive improvement when tested after one year, according to a formula developed by the researchers. A group that got four additional hours of training with the game did even better, improving their cognitive abilities by four years, according to the study.

"We not only prevented the decline; we actually sped them up," Wolinsky says.

Improving peoples processing speed is considered important for a host of reasons. One widely accepted benefit is widening a persons field of view. "As we get older, our visual field collapses on us," Wolinsky explains. "We get tunnel vision. Its a normal functioning of aging. This helps to explain why most accidents happen at intersections because older folks are looking straight ahead and are less aware of peripherals."

Recognizing this, the National Institutes of Health in the late 1990s commissioned the largest cognitive training study of its kind, called ACTIVE. The national, multi-site trial, in which Wolinsky was involved, showed the elderlys memory, reasoning and visual processing speed could be improved with interventions, thus slowing the aging of their minds. But the ACTIVE study had its limitations: Among them, the control group didnt get any training and the primary goal was to assess the effects on seniors field-of-view vision.

Wolinskys team added an active control group—those doing the crossword puzzles. The researchers found those who played the "Road Tour" game also scored far better than the crossword puzzle group on tests involving executive function beyond field-of-view vision, such as concentration, nimbleness with shifting from one mental task to another and the speed at which new information is processed. The improvement ranged from 1.5 years to nearly seven years in cognitive improvement, the study found.

"Its the use it or lose it phenomenon," Wolinsky says. "Age-related cognitive decline is real, its happening, and it starts earlier and then continues steadily. The good news is we can do something about it. The question is will we?"

It thought the fundamental purpose of teachers was to teach. Yet, when it considers that the hours that a child spends in school is an opportunity to catch problems that may be missed by parents and docs alike, the idea that schools can be a first line of defense in the early detection of mental illness has some merit.

 For your consideration when youre grappling with your local school taxes:

Tim is the son of Paul Gionfriddo, who is a former Connecticut politician and current mental health advocate.  As the parent of a child with schizophrenia, he knows what hes writing about.

When Mr. Gionfriddo was starting out as a legislator, he was only just becoming aware of Tims difficulties in school. What followed was heartbreaking tale of inflexible school officials arranging for the wrong evaluations, wrong diagnoses, inadequate care and wasted attempts to help a deeply troubled child. Teachers were unable to cope, the parents were often blamed and Tim got shuffled around an unresponsive school system.  Despite "good" insurance, coverage fell short and many services involved onerous co-pays and limitations. And once he reached adulthood, an unwillingness to accept services moved Tim to the margins of society, leading to repeated hospitalizations and incarcerations. He now lives in squalor somewhere in San Francisco.

Tims story is not unique. According to Mr. Gionfriddo, a well meaning policy that moved hundreds of thousands of mentally ill out of decaying inpatient psychiatric hospitals in the 1980s was followed by

1) schools being unable to handle children with mental illness,

2) underfunding of community agencies, and

3) the siloing of the resources that did exist, resulting in little collaboration among physicians, law enforcement, community services or the mental health community.

Among Mr. Gionfriddos recommendations?  In addition to better screening by pediatricians during the well child visit, insurance orm and better housing options, state legislators should support the following:
 
1. The U.S. public school system should be prepared to offer mental health services in addition to basic education;

2. Every teacher should receive training in recognizing mental illness and how to handle it;

4. Once mental illness is  discovered, meaningful support should be included in a childs individualized education planning.

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