The McCarrison Society - Chairman's Comment Jan 2006

Chairman's Comment Jan 2006

JANUARY 2006
Comments are being made in some quarters that the evidence on the omega 3 fatty acids and the brain is trivial and too recent to be relevant to Government action. The evidence available in the 1960s and early 70s was sufficient to spark FAO and WHO to jointly call an expert consultation to review the evidence and its implications for health, food and agriculture. I explain below.
JANUARY 2006Comments are being made in some quarters that the evidence on the omega 3 fatty acids and the brain is trivial and too recent to be relevant to Government action. The evidence available in the 1960s and early 70s was sufficient to spark FAO and WHO to jointly call an expert consultation to review the evidence and its implications for health, food and agriculture. I explain below. You may also wish to read the Economist (Jan 19th 2006) which reports on the presentation given by Dr. Joseph Hibbeln of the National Institutes of Health in the USA at the conference we organised recently (17th January, 2006) in which he draws attention to the link between fish and sea food consumption during pregnancy and subsequent behaviour, cognition and motor development of the children later at school
http://www.economist.com/science/displaystory.cfm?story_id=5407595
At the Conference, Dr. Hibbeln was presented with the Cleave Award Cup for his outstanding work.
For those interested you could write to the Head, Nutrition Division, FAO, Rome and read what was known in the 1970s and discussed about pregnancy, the brain, infants, children, heart disease and food policy. There is very little new principle since then although the details have been expanded considerably. There is no excuse for the inaction.

Last century nutritionists were mainly interested in protein. Protein is good for body growth as testified by the tests on rat growth rates to determine the quality of different proteins.

Monkeys have two eyes, nose, mouth, two legs and arms and hands like us. The biggest is the gorilla. It only has about 300g brain. The human infant at 4 years of age already has 1.3 Kg of brain. It is the brain that makes us human.

This century the priority needs to be given to the special nutritional requirements of the brain which are dominated by lipid requirements. 60% of the brain's structures are lipid with a high requirement for specific long chain, highly unsaturated fatty acids the evidence for which was presented by Andrew Sinclair and I in 1972 and since then has been robustly confirmed by us and many other research groups.

Comment has recently been made in public that the evidence on omega 3 fatty acids was trivial and the only evidence available is of very recent origin. This type of comment is put up as a defensive excuse to justify the lack of action to correct food policy to reflect the needs of the brain. What is called a balanced diet actually reflects the needs of brain development prenatally and postnatally, and its growth and integrity through to adolescence and into old age. Therefore politicians and industry cannot be blamed for no action.

My reply is that this attitude is falsified if people really read the scientific literature.  We published behvioural abnormalities, liver, kidney and skin pathology in a primate model of too much linoleic and too little omega 3 in 1973 and in the 1980s described the combined omega 3 anti-oxidant deficiency (they go together in foods) inducing massive destruction of the brain followed by death in chicken flocks. The latter studies provided important conclusions regarding the required balance between the omega 6 and 3 fatty acids for the brain.

Andrew Sinclair published detailed isotope data demonstrating the striking preferential use of docosahexaenoic acid (DHA) by the developing rat brain in comparison to the precursor, alpha linolenic acid. There was a 30 fold preferential utilisation of the preformed DHA At last year's Letten Symposium at the Royal Society, Emmanuel Severus reported that they are now finding the same liver pathology in human severe behavioural disorders as we described in the omega 3 deficient primate behavioural pathology in 1973. Again at the beginning of the 1970s, Gene Anderson working at the Cullen Eye Research Institute at Baylor, Houston, reported specific omega 3 deficits in the eye reducing visual function in the rat. A whole host of evidence on the metabolism of the essential fatty acids and nutritional requirement was brought together by Nicholas Bazan at a conference in Sierra de la Ventana, Argentina, publihsed in "Function and Biosynthesis of Lipids" ed Bazan NG, Brenner RR & Gustiusto NM, by New York: Plenum Publishing Co.
About the same time World Health Organisation and Food and Agricultural Organisation of the UN held a joint, international expert consultation on "The Role of Dietary Fats and Oils in Human Nutrition" published by FAO, Rome, 1978. In it there were specific recommendations for the omega 6/3 ratio of 5 to 1 for general diets but the point was made that the target for H. sapiens is the brain, in which the ratio is between 1 and 2 to 1.

The FAO/WHO report specifically drew attention to the requirements during pregnancy, infant feeding, and childhood, with regard to brain and vascular development, the latter in relation to the early development of vascular disease, which leads to heart disease.
Secondly, there were specific recommendations about the need to revise food and agricultural practices, especially with regard to over-fat (technically obese) farmed animals.

So there is no excuse for inaction that has led to the cost of brain disorders
overtaking all other costs of ill health as I predicted would happen based on the evidence available that we and others were publishing in the 1970s.
Nothing was done except in infant formula feeding in response to this, and later evidence from preterm infants fed with formulae more closely reflecting the functional benefits seen in preterm infants by mimicking human milk with regard to arachidonic and DHA as recommended in the FAO/WHO report. However, there was a simple matter of the 1984 Nobel Prize given to Bergstrom, Samuelson and Vane for work on eicosanoids derived from the essential fatty acids that gave rise to the importance of balance between the omega 6 and 3 fatty acids for vascular health.

More recently there have been the three clinical trials with large numbers demonstrating the protective effects of omega 3 fatty acids against sudden death from heart attack (DART, Lyon & GISSI). This evidence is relevant to the brain. Bear in mind that the prediction I published in 1972, that brain disorders would follow in the wake of the rise of mortality from heart disease was based on (i) the evidence of common lipid requirements for the brain and blood vessels, (ii) the fact that the developing brain is better protected than the vascular system and (iii) that the development of the embryonic, placental and fetal vascular system are pre requisites for brain development.

Bear in mind also that there have been several international congresses at regular intervals following Nicholas's one in Argentina that reviewed the advances. So there really is no excuse for inaction.

With the cost of brain disorders now exceeding all other burdens of ill health in the EU, the need for action has to be the highest priority. The audit of ill health costs in the 2005 June issue of the European Journal of Neurology, puts heart disease now relegated to second place at 17% with the rising cost of brain disorders at 25% and a cost to the 25 member states of 386 billion Euros. The implications of inaction are unthinkable.

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