Orsome Omegas, Vibrant Vitamin D!
We had a great turn up for our first workshop of the year. Matt focused on helping you understand the evidence base for omega 3 and Vitamin D supplementation. We use best evidence based practices to help optimise your health outcome from your chiropractic care. The most important key we help you with for your spinal health is the chiropractic adjustment. Your home care responsibility is to make sure you’re sufficient with essential nutrients to help your care. An essential nutrient is one that is required for normal cellular and body function, and our genes cannot make, so must be consumed. These are omega 3s and vitamin D. Together these help decrease inflammation, and move you towards less pain and better health. The guidelines for appropriate supplementation are around 1g omega 3 per 20kg bodyweight, and similarly, 1000iu Vitamin D per 20kg bodyweight. Omega 3 has a blood thinning effect, so if you’re on any blood thinning medications such as Warfarin, discuss your best approach with your GP first! Taking a sufficient level of omega 3 and Vitamin D, in combination with your chiropractic care, helps you get the best out of your spinal health.
Below is a summary of the research literature supporting omega 3 and vitamin D sufficiency/supplementation by Dr James Chestnut (Chiropractor) DC MSc. Have a read and share the knowledge with your friends and family!
Omega-3 Fatty Acids:
“The agent best documented by hundreds of references in the literature for its anti-inflammatory effects is omega-3 essential fatty acids (EFAs) found in fish and in pharmaceutical-grade fish oil supplements.” (Maroon JC, Bost JW. Omega-3 fatty acids (fish oil) as an anti-inflammatory: an alternative to nonsteroidal anti-inflammatory drugs for discogenic pain. Surgical Neurology. 2006;65(3):326-331).
“There is extensive documentation in the rheumatology, ophthalmology, and cardiovascular literature on the beneficial anti-inflammatory effects of high-dose fish oil in the reduction of joint pain from rheumatoid and osteoarthritis, and also major positive effects on … coronary artherosclerosis, which is now considered an inflammatory disease.” “In an editorial published in the same issue of Surgical Neurology, J.I. Ausman, MD, PhD, states “the importance of this work to neurosurgeons is that now there is an analgesic agent that can take the place of the COX-2 inhibitors and be used with no side effects.” (Maroon JC, Bost JW. Omega-3 fatty acids (fish oil) as an anti-inflammatory: an alternative to nonsteroidal anti-inflammatory drugs for discogenic pain. Surgical Neurology. 2006;65(3):326-331).
“Omega-3 fatty polyunsaturated fatty acids (PUFAs) have been shown to decrease the production of inflammatory eicosanoids, cytokines, and reactive oxygen species; have immunomodulatory effects; and attenuate inflammatory diseases.” (Mickleborough,T.D. Omega-3 polyunsaturated fatty acids in physical performance optimization. Int J Sport Nutr. Exerc. Metab. 2013; 23: 83-96).
“A meta-analysis of 16 studies at 3-4 months showed significant effects for four of six pain outcomes: patient assessed pain, morning stiffness, number of painful and/or tender joints, and NSAID consumption [significantly reduced NSAID consumption].” (Goldberg RJ, Katz J. A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain. Pain 129 (2007) 210-233).
By affecting cell membrane composition, metabolism, signal pathways, and by direct control of gene expression, sufficient omega 3 essential fatty acid levels play a key role in the prevention of human diseases such as obesity, diabetes, cancer, neurological and brain disorders, and heart disease. (Ntambi, J.M. & Bene, H. Polyunsaturated fatty acid regulation of gene expression. J Mol Neuroscience 2001 Apr-Jun; 16 (2-3): 273-8).
Fish oil supplementation reduces exercise-induced inflammation, decreases delayed onset muscle soreness, increases the rate of recovery, and reduces the risk for infection due to immunodeficiency. Fish oil supplementation is associated with improved cognitive abilities including reaction time, decision making, and stabilizing mood. (Mickleborough, T.D. Omega-3 polyunsaturated fatty acids in physical performance optimization. Int J Sport Nutr. Exerc. Metab. 2013; 23: 83-96).
“A Purdue University study showed that kids low in Omega-3 essential fatty acids are significantly more likely to be hyperactive, have learning disorders, and to display behavioural problems.” (Stevens, LJ et. al. Omega-3 fatty acids in boys with behavior, learning, and health problems. Physiol Behav. 1996 59(4/5) 915-920).
“Omega-3 fatty acids lower the risk of cancer through their suppressing effect on the biosynthesis of eicosanoids [molecules from omega-6 fatty acids that promote inflammation, suppress the immune cells that eliminate cancer cells, and stimulate cancer cell growth].” (Larsson, SC, et.al. Dietary long-chain n-3 fatty acids for the prevention of cancer: a review of potential mechanisms. Am J Clin Nutr 2004;79:935-45) .
Due to the overwhelming evidence of benefit, the American Heart Association now recommends the use of omega-3 fatty acid supplements for the primary and secondary prevention of coronary heart disease. (Bronsna, U. & Dengel, D. Influence of vascular oxidative stress and inflammation on the development and progression of atherosclerosis. Am J Lifestyle Med. 4 (6) 521-34).
“Some researchers have found this (vitamin D deficiency) to occur in up to 85% of chronic musculoskeletal pain cases, especially those involving the lower back.” (Stewart Leavitt, Ph.D. Vitamin D – A Neglected ‘Analgesic’ for Chronic Musculoskeletal Pain. Pain Treatment Topics June 2008).
“In the research investigations to date, patients found to have deficient 25(OH)D (Vitamin D) concentrations had been variously diagnosed with fibromyalgia syndrome, hyperesthesia, rheumatic disorders, osteoarthritis, back pain, bone and joint pain, muscle weakness, and other chronic somatic complaints.” (Stewart Leavitt, Ph.D. Vitamin D – A Neglected ‘Analgesic’ for Chronic Musculoskeletal Pain. Pain Treatment Topics June 2008).
“The active 1,25(OH)2D form of vitamin D is a potent modulator of inflammation, and may play a role in shutting off chronic inflammatory responses.” (Pedersen LB, et al. 1,25-dihydroxyvitamin D3 reverses experimental autoimmune encephalomyelitis by inhibiting chemokine synthesis and monocyte trafficking. J Neurosci Res 2007;85:2480-2490).
Research indicates that vitamin D supplementation modulates or decreases pro-inflammatory cytokines (e.g. C-reactive protein, interleukin 6 and 12, and tumor necrosis factor-alpha) while increasing anti-inflammatory cytokines (e.g. interleukin-10). Clinical investigators have further suggested that vitamin D may help to moderate painful chronic inflammatory autoimmune conditions that are influenced by excessive cytokine activity, such as inflammatory bowel disease and Crohn’s disease. (Boxer RS, Dauser RA, Walsh SJ, et al. The association between vitamin D and inflammation with the 6-minute walk and frailty in patients with heart failure. J Am Geriatr Soc. 2008;56:454-461) .
Subjects were treated for 3 months with 5000 IU/day to 10,000 IU/day of vitamin D3 (patients >50 kg received the larger dose). There were no episodes of hypercalcemia reported, and pain symptoms were relieved in 95% of the patients. (Al Faraj S, Al Mutairi K. Vitamin D deficiency and chronic low back pain in Saudi Arabia. Spine 2003;28:177-179) .
Supplementation of Vit D in subjects with deficient Vit D levels resulted in a 50% increase in muscle force and reaction time. A similar change was seen in the ability to relax the muscle – in other words the muscle responds quicker to the brain signal both to contract and relax. Vit D regulates calcium metabolism and calcium is responsible for muscle contraction. (Glerup H., Mikkelsen K, Poulsen L, et al. Hypovitaminosis D myopathy without biochemical signs of osteomalacic bone involvement. Calcif Tissue Int. 2000; 66:419-424) .
Vitamin D levels are correlated with muscle efficiency and muscle mitochondrial activity and phosphocreatine recovery significantly improved with vitamin D supplementation. In a parallel study the researchers showed that low vitamin D levels were associated with reduced muscle function and recovery. (Akash Sinha, et al. Improving the vitamin D status of vitamin D deficient adults is associated with improved mitochondrial oxidative function in skeletal muscle. Endocrine Abstracts, 2013; DOI: 10.1530/endoabs.31.OC1.6).
“Birge and Haddad found that supplementation with vit D acts directly on muscle to increase protein synthesis.” “Several cross-sectional studies have assessed associations between Vit D levels and various parameters of neuromuscular performance, finding direct associations between Vit D levels and physical performance. Correlations were more frequent and strongest for reaction time, balance, and timed tests of physical performance.” (Cannelletal.(2009) Athletic Performance and Vitamin D. Medicine and Science in Sports and Exercise. 41 (5) 1102-1110) .
“Several randomized controlled trials in older adults found that vitamin D improves various parameters of neuromuscular functioning, including balance, muscle strength, and reaction time… .” “Another test of the theory are interventional studies in reducing falls, assuming falls are failures of athletic performance. Bischoff-Ferrari et al. recently reviewed that literature and concluded that vitamin D, even in relatively low doses (800 IU/day), reduces falls in the elderly.” (Cannell et al. (2009) Athletic Performance and Vitamin D. Medicine and Science in Sports and Exercise. 41 (5) 1102-1110) .
“Vitamin D dramatically up-regulates the genetic expression of antimicrobial proteins (AMPs) in immune cells of the innate immune system [the part of the immune system that immediately attacks and kills viruses, bacteria, and fungi – the branch of the immune system responsible for fighting colds and flu].” “Also, macrophages use vitamin D to enable the synthesis of the bactericidal peptides needed to deal with bacterial invaders.” (Nature Immunology, (Vitamin D controls T cell antigen receptor signaling and activation of human T cells ) 10.1038/ni.1851).
In a 3 year trial taking 800 IU/day of Vitamin D reduced the incidence of colds and flu by 70%. In the group taking 2000 IU/day the incidence of colds and flu was reduced by almost 100% (only 1 of 104 subjects developed cold or flu). (Alogia, J. et al. Epidemic Influenza and Vitamin D. Epidemiology and Infection 2007, Vol 135 (7) pp. 1095-1098).
A group of Type 2 diabetic subjects with chronic, painful neuropathy were supplemented with 2000 IU/day of Vitamin D for 3 months. Symptoms improved from an average of “distressing” to an average of “mild”. Overall results were a nearly 50% reduction in pain scores. (Lee P, Chen R. Vitamin D as an analgesic for patients with type 2 diabetes and neuropathic pain. Arch Intern Med. 2008;168(7):771-772) .
Vitamin D-sensitive cancers are responsible for 257,000 deaths (46% of all cancer deaths in U.S. in 2007). (Jemal A, et al. Cancer statistics, 2007. CA Cancer J Clin. 2007 Jan-Feb;57(1):43-66) .
A four-year study on vitamin D supplementation showed a 77% reduction in all invasive breast cancers in women who received vitamin D supplementation versus those who did not supplement. (Lappe, J.M. et al. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J of Clin Nutr 2007;85:1586-1591) .
Women who maintained sufficient vitamin D levels had an 80% reduction in breast cancer incidence compared to those who had deficient vitamin D levels. (Lowe, LC et al. Plasma 25-hydroxy vitamin D concentrations, vitamin D receptor genotype and breast cancer risk in a UK Caucasian population. Eur J Cancer. 2005;41:1164-9) ..
“High serum vitamin D was associated with lower mortality from breast cancer.” “Patients with the highest concentration of Vitamin D had approximately half the fatality rate compared to those with the lowest concentration.” (Mohr SB et al. Meta-analysis of Vitamin D sufficiency for improving survival of patients with breast cancer. Anticancer
Research. 2014;34:1163-1166) .
“In an earlier study, patients with clinical depression were randomized to receive vitamin D3 supplementation or placebo. Those patients administered vitamin D had significantly enhanced mood and a reduction in negative-affect symptoms.” (Stewart Leavitt, Ph.D. Vitamin D – A Neglected ‘Analgesic’ for Chronic Musculoskeletal Pain. Pain Treatment Topics June 2008).