Fish oils and psychosis

Recent evidence published in Archives of General Psychiatry suggests that fish oil supplementation may reduce the risk of transition to psychotic illness in people at very high risk of these disorders.

The use of antipsychotic medication for the prevention of psychotic disorders is controversial. Long-chain omega-3 polyunsaturated fatty acids may be beneficial in a range of psychiatric conditions, including schizophrenia. Given that omega-3 polyunsaturated fatty acids are generally beneficial to health and without clinically relevant adverse effects, their preventive use in psychosis is of considerable interest.

Previous studies have found low levels of omega-3 and omega-6 polyunsaturated fatty acids in people with schizophrenia, and some scientists have suggested that problems with fatty acid metabolism could play a role in the development of the disorder. However, studies looking at the effects of omega-3 polyunsaturated fatty acid supplementation in people with schizophrenia have so far been inconclusive. Types of omega-3 fatty acids are found in oily fish, certain vegetable oils and in fish oil capsules.

A randomized, double-blind, placebo-controlled trial was conducted between 2004 and 2007 in the psychosis detection unit of a large public hospital in Vienna, Austria.

The aim was to determine whether omega-3 polyunsaturated fatty acids reduce the rate of progression to first-episode psychotic disorder in adolescents and young adults aged 13 to 25 years with subthreshold psychosis.

Eighty-one individuals at ultra-high risk of psychotic disorder participated in the trial. These participants had at least one of the following risk factors for psychosis:

• low levels of psychotic symptoms (delusions, hallucinations, suspiciousness, or conceptual disorganisation measured on a standard scale),

• transient psychosis, i.e. lasted less than a week and resolved without antipsychotic medication, or

• having either a schizotypal personality disorder or a first-degree relative (such as a mother, father, sister or brother) who had psychosis, plus the participant experienced a significant reduction in ability to function in the last year.

A 12-week intervention period of 1.2 g per day omega-3 polyunsaturated fatty acids or placebo was followed by a 40-week monitoring period; the total study period was 12 months.

Researchers monitored how much of their supplements the participants took by monitoring the number of pills they had left and by taking blood samples. The placebo pill contained coconut oil (which does not contain omega-3 polyunsaturated fatty acids) and an equivalent amount of vitamin E to the fish oil capsules, plus 1% fish oil to make the taste of the capsules similar.

Seventy-six of 81 participants (93.8%) completed the intervention. By the end of the study (12 months), 2 of 41 individuals (4.9%) in the omega-3 group and 11 of 40 (27.5%) in the placebo group had transitioned to psychotic disorder (P = .007). The difference between the groups in the cumulative risk of progression to full-threshold psychosis was 22.6% (95% confidence interval, 4.8-40.4).

Omega-3 polyunsaturated fatty acids also significantly reduced positive symptoms (P = .01), negative symptoms (P = .02), and general symptoms (P = .01) and improved functioning (P = .002) compared with placebo.

The incidence of adverse effects did not differ between the treatment groups.

The researchers concluded that:

a 12-week intervention with omega-3 significantly reduced the transition rate to psychosis and led to significant symptomatic and functional improvements during the entire follow-up period (12 months)

This small study does seem to suggest that, at least in the short term, fish oil supplementation could prevent young people at high risk from progressing to psychotic illness. However, while the study was robust in its design it was too short to say whether the illnesses were prevented completely or just delayed.

Psychotic illnesses are serious conditions and if fish oils can be confirmed to prevent or delay their development in susceptible individuals this would be a very important finding. However, it will require larger, long-term studies to know if this is the case.

To learn more about the effects of what we eat on our mental health, why not come along to a Cooking for Health course on “Food and Emotions“, taught by nutrition consultant Dr Jane Philpott.


Cook your way to a healthier life

Ancient wisdom and modern science teach us that the quality of the food we eat is intrinsically linked with our level of health and well being.


The development of agriculture 10,000 years ago and the radical changes in the production and processing of food  which have occurred in the last 200 years, have led to our diet moving further and further away from the natural foods which sustained our earliest ancestors 2.5 million years ago.  From an evolutionary perspective, these changes have taken place too rapidly for the human genome to adjust.  Biochemically and physiologically, we are virtually identical to the hunter-gatherers who roamed the earth 20,000 years ago[i],[ii].




There is growing scientific evidence that the evolutionary collision of our ancient genome with the nutritional qualities of recently introduced foods may underlie many of the chronic diseases of Western civilization, such as obesity, diabetes, heart disease and cancer[iii], as well as problems such as depression, mood swings, PMS, hot flushes, chronic fatigue, inability to cope with stress, allergies and susceptibility to illness and infection.


In particular, food staples and food-processing procedures introduced during the Neolithic and Industrial Periods have fundamentally altered seven crucial nutritional characteristics of the ancestral hominin diets of the Paleolithic era: 1) glycaemic load (or the impact of food on blood glucose levels), 2) fatty acid composition (the balance between good fats and bad fats), 3) macronutrient composition (the proportion of energy coming from carbohydrates, proteins and fats), 4) micronutrient density (the amount of vitamins and minerals per calorie), 5) acid-base balance, 6) sodium-potassium ratio, and 7) fibre content.




Today, a few societies in the world are noted for their healthy longevity, including Okinawans in Japan, Hunzans in Pakistan and Vilcabambans in Ecuador[iv].  Scientific studies have shown that these people consume a predominantly plant-based diet high in whole grains, locally grown vegetables, beans, fruits, nuts and seeds, with small amounts of animal foods, sea vegetables, natural sweeteners and condiments.  In other words, natural, unprocessed foods similar to those consumed by the earliest human beings.


We too can be full of energy, in excellent physical health and with minds as sharp as razors into advanced old age if we move away from eating refined, processed foods and return to a more natural diet.


You can learn how to cook with these natural ingredients at Cooking For Health courses held throughout the year in Somerset, UK.   The classes cover the basics of healthy eating and focus on different aspects of the link between nutrition and optimum health and well being.  Topics include Managing Your Weight Naturally, Food and Emotions, Balancing Your Hormones, Beating Stress and Fatigue and Boosting Your Immune System.


The classes not only include cooking healthy and appetising recipes, but also slowly unfold a fascinating and comprehensive study of the healing power of food.


Whether you are young or old, male or female, vegan, vegetarian or omnivorous, a novice or an experienced cook, if you are seeking a natural approach to health and well being, you will find these classes valuable, interesting and potentially life-changing.

[i] Cohen MN (1989): Health and the Rise of Civilization. New Haven: Yale Univ. Press

[ii] Eaton, SB; Eaton SB III and Konner, MJ (1997).  Paleolithic nutrition revisited: A twelve-year retrospective on its nature and implications.  European Journal of Clinical Nutrition (1997) 51, 207-216

[iii] Cordain L.; Eaton,SB; Sebastian A.; Mann,N.; Lindeberg,S; Watkins,B.A.; O’Keefe,JH; Brand-Miller, J. (2005).  Origins and evolution of the Western diet: health implications for the 21st century American Journal of Clinical Nutrition (2005), 81, 341–54.

[iv] Robbins, J. (2007).  Healthy at 100.  Ballantine Books.

New Research Shows Novel Benefits of Omega 3 Oils in Arteries

Fish are generally rich in omega-3 fatty acids, which have shown benefit in many health areas such as helping to prevent mental illness and delaying some of the disabilities associated with ageing.  Eating tuna, mackerel, sardines, salmon and other so-called cold water fish appears to protect people against clogged arteries.  Omega-3 fatty acids can also lower triglycerides, a type of fat often found in the bloodstream.


Now, a research team led by Richard J. Deckelbaum, M.D., Director of the Columbia Institute of Human Nutrition, has found that a diet rich in fish oils can prevent the accumulation of fat in the aorta, the main artery leaving the heart. The beneficial actions of fish oil that block cholesterol buildup in arteries are even found at high fat intakes.

The study was conducted in three separate populations of mice: one that was fed a balanced diet, one that was fed a diet resembling a “Western” diet high in saturated fat, and a third that was fed a high fish fat diet rich in omega-3 fatty acids.

Researchers in Dr. Deckelbaum’s laboratory, including Chuchun Liz Chang, a Ph.D. student in nutritional and metabolic biology, found that the fatty acids contained in fish oil markedly inhibit the entry of “bad,” or LDL, cholesterol into arteries and, as a result, much less cholesterol collects in these vessels.

They found that this is related to the ability of those fatty acids to markedly decrease lipoprotein lipase, a molecule that traps LDL in the arterial wall. This will likely prove to be important as a new mechanism which helps explain benefits of omega-3 fatty acids on heart health.

Dr. Deckelbaum advises those interested in increasing omega-3 intakes do so by either increasing fish intake or by using supplements that contain the “long-chain” fatty acids, EPA and DHA, which are found in cold water fish.

The research was published February 5, 2009 by the American Heart Association’s Arteriolosclerosis, Thrombosis and Vascular Biology.

Jane Philpott

Some fats are important for health

Reducing fat intake in the diet has been a key message of the government and health professionals for the last few decades but, in fact, some fats are essential for the proper functioning of the body.  Fats provide vital energy for cells.  They make up adipose tissue, which stores energy, cushions and protects vital organs, and provides insulation.  Cholesterol which, technically, is not a fat, is needed to make cell membranes and the critically important sheaths around nerve cells and is the raw material from which the body makes many important hormones, such as oestrogen, progesterone and cortisol.


To enable these things to happen, fat must somehow get from your digestive system to your cells.  This is not as easy as it sounds.  Like oil and water, fats and blood do not mix.  If digested fats were just dumped by the liver and intestines straight into the blood, they would congeal in oily blobs and be unusable.  So the body has devised a way of packaging fats into particles coated with proteins, which are able to dissolve in the blood and flow with it.  These tiny particles are called lipoproteins (lipid plus protein) and contain some cholesterol to help stabilise the particles.


Like a busy motorway, your bloodstream carries many sizes and shapes of fat-transporting particles.  Lipoproteins are generally classified by the balance of fat and protein they contain.  Those with a little fat and a lot of protein are heavier and denser than the lighter, fluffier and less dense particles that are more fat than protein.  In addition to coating the particles and helping them to move in the bloodstream, the proteins also act like address labels that help the body direct fat-filled particles to particular destinations.

Some of these lipoproteins influence the risk of developing heart disease.  The most important lipoproteins in this regard are high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very-low-density lipoprotein, which is composed of triglycerides.

LDL is often referred to as ‘bad cholesterol’.  When your bloodstream carries too many of these particles, they end up inside the cells that line the blood vessels.  Once there, LDL is attacked by highly reactive free radicals and transformed into oxidised LDL.  Oxidised LDL can damage the artery lining and set off a cascade of reactions that result in clogging of the artery and increase the risk of artery-blocking blood clots.

In contrast, HDL particles sponge up excess cholesterol from the lining of blood vessels and elsewhere and carry it off to the liver for disposal.  They also help the liver to recycle other lipoprotein particles.


Triglycerides make up most of the fat you eat and most of the fat that circulates in your bloodstream.  Triglycerides are essential for good health as your tissues rely on them for energy.  Like cholesterol, though, too much triglycerides may be bad for the arteries and the heart.

If you have your blood tested for cholesterol levels, results will often be shown as total cholesterol and as the ratio between total cholesterol and HDL.

The levels of cholesterol fall into the following categories:

  • Ideal level: cholesterol in the blood <5mmol/l
  • Mildly high cholesterol level: 5 to 6.4 mmol/l
  • Moderately high cholesterol level: 6.5 to 7.8 mmol/l
  • Very high cholesterol level: above 7.8 mmol/l

In the UK the average total blood cholesterol level is 5.7 mmol/l compared with 3.3 mmol/l in rural China.

The ideal ratio of total cholesterol/HDL is below 3.5:1.


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Willett, W.C. (2005).  Eat, Drink and Be Healthy – the Harvard Medical School Guide to Healthy Eating, Free Press, New York.

Posted by: Jane Philpott MA (Oxon), MSc, PhD