Omega-3 and perinatal depression: Nutritional strategies can help combat “under effective” treatment

Academics from Taiwan and Singapore said omega-3 (n-3) polyunsaturated fatty acids (PUFAs) were promising antidepressant treatments for perinatal depression (PND) due to their safety, anti-inflammatory and neuroplastic effects.

However, they said although several observational studies have shown n-3 PUFA deficits in women with PND, clinical trials have showed inconsistent antidepressant effects of omega-3 PUFAs.

The meta-analysis included 12 eligible studies available as of December 2016.

Key findings included the fact there were significantly lower levels of total n-3 PUFAs and significantly increased n-6/n-3 ratios in PND patients.

In the subgroup analyses, there were significantly lower levels of  eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in women with prenatal depression.

Meanwhile, the n-6/n-3 ratio was significantly increased in both prenatal and postnatal depression subgroups.

“Taken together, both meta-analyses highlight the importance of PUFAs in clinical depression. The brain is highly enriched with n-3 PUFAs and their derivatives, which regulate several biological processes, such as neurotransmission, neuroplasticity, and neuroinflammation, and thereby mood and cognitive function,”​ the researchers wrote in the journal Biological Psychiatry​.

Profound imbalance

“The other primary finding is that PND is associated with a higher n-6/n-3 PUFA ratio, which is in line with the evidence suggesting an association between high dietary ratios of n-6 to n-3 PUFAs in PND. Anthropological and epidemiological studies suggest that human beings evolved on a diet with a ratio of n-6/n-3 PUFAs of about 1:1, and modern diets have a ratio of 10–20:1, indicating that modern diets are in a profound imbalance in PUFA composition.”​

Although the beneficial effects of EPA and DHA in the treatment of depression have long been recognised, the importance of imbalance between total n-3 and total n-6 should be further examined as a possible role in the prediction of mental health in women during and after pregnancy, the paper noted.

The researchers concluded nutritional intervention should play a significant role in treatment.

“Our meta-analysis supports the important role of PUFAs in PND and further consolidates the phospholipid hypothesis of depression…nutritional medicine is a promising strategy for the crisis of undereffectiveness in depression treatment. Our findings provide a strong rationale to conduct clinical trials to test the therapeutic and prophylactic effects of n-3 PUFAs in PND.”​

Source: Biological Psychiatry​

http://doi.org/10.1016/j.biopsych.2017.02.1182​

“Polyunsaturated Fatty Acids in Perinatal Depression: A Systematic Review and Meta-analysis”​

Austhors: Pao-Yen Lin, ​ ​​et al​