High Omega-3 Polyunsaturated Fatty Acid Intake May Reduce Risk for Amyotrophic Lateral Sclerosis CME

[Guest guest]

I hope this makes it to the list, I've been having trouble lately getting my

posts to show up (on both crcommunity & )

Al

May 1, 2006 - A diet high in omega-3 polyunsaturated fatty acids (PUFAs) and

vitamin E reduces the risk for amyotrophic lateral sclerosis (ALS),

according to the results of a case-control study reported in the April 28

Online First issue of the Journal of Neurology, Neurosurgery, and

Psychiatry.

" Despite several studies that investigated environmental exposures in

relation to ALS, age, gender and smoking are the only established risk

factors, " write J. H. Veldink, MD, from the University Medical Center

Utrecht in The Netherlands, and colleagues. " Several, not mutually

exclusive, pathological processes may contribute to motor neurone death in

ALS in a so-called convergence model, including oxidative stress,

mitochondrial dysfunction, protein misfolding, axonal strangulation,

apoptosis, inflammation, glutamate excitotoxicity and defects in

neurotrophin biology. Nutrients are factors that could influence these

processes and thereby the risk of developing ALS or its clinical

expression. "

During 2001-2002, 132 patients referred to the authors' clinic with

definite, probable, or possible ALS according to El Escorial criteria, but

without a familial history of ALS, were enrolled in a case-control study and

matched with 220 healthy controls. All subjects completed a food frequency

questionnaire, and multivariate logistic regression analysis was performed

with adjustment for confounding factors, including sex, age, level of

education, energy intake, body mass index, and smoking.

High PUFA and vitamin E intake was associated with a reduced risk of

developing ALS (PUFA: odds ratio [OR], 0.4; 95% confidence interval [CI],

0.2 - 0.7; P = .001; vitamin E: OR, 0.4; 95% CI, 0.2 - 0.7; P = .001). PUFA

and vitamin E appeared to act synergistically. In a combined analysis, the

trend OR for vitamin E was further reduced from 0.67 to 0.37 (P = .02) and

PUFA from 0.60 to 0.26 (P = .005), with a significant interaction term (P =

..03). The intake of flavonols, lycopene, vitamin C, vitamin B2, glutamate,

calcium, or phytoestrogens did not affect the risk of developing ALS.

" A high intake of PUFAs and vitamin E is associated with a 50-60% decreased

risk of developing ALS, and these nutrients appear to act synergistically, "

the authors write. " Vitamin E may act directly to reduce the risk of ALS as

a known inhibitor of lipid peroxidation, but it could also act indirectly

through inhibition of peroxidation of nutritional PUFAs. "

Study limitations include the possible influence of overmatching of

controls, recall bias, and the non-population-based design.

" Importantly, this case-control study took into account the possible

influence of preclinical disease in assessing dietary intake and adjusted

for important confounders, including total energy intake, according to the

residual method, " the authors write. " A population-based case-control study

is presently being conducted to generate class I evidence. "

ZonMw, The Netherlands Organization for Health Research and Development,

supported this study. The authors have disclosed no relevant financial

disclosures.

J Neurol Neurosurg Psychiatr. Posted online April 28, 2006.