A change in pace from the typical Fresh Beet postings I know, but with all the Veteran appreciation happenings this month, I thought that highlighting this current study would be fitting.

What is the BRAVO study?

A study seeking to determine if Omega-3 supplementation (fish oil) reduces the risk for serious suicidal behaviors, suicidal thinking, negative emotions, and symptoms associated with suicide risk, in a Veteran population that is at risk for suicidal behaviors. Participants are asked to drink 3 omega-3 fortified fruit juice smoothies per day for 6 months. Blood tests, computer questionnaires and fMRI (functional MRI) are used to evaluate changes in nutrition status and cognitive processes, and ultimately, whether or not fish oil reduces suicidality. Participants are randomized to one of two groups: either the experimental group where they receive the juice with fish oil, or the placebo group where they receive juice with macadamia nut oil.

Why Fish Oil?

Cold water fatty fish contain Omega-3 fatty acids which have shown to reduce inflammation, improve cognitive processes and provide a host of cardiovascular benefits. This study is specifically focusing on EPA (eicosapentanaenoic acid )and DHA (docosahexaenoic acid), two omega-3 fats believed to confer the majority of these benefits. Our body can synthesize a small amount of EPA and DHA from ALA (alpha-linolenic acid) which is found in plant foods such as flax, hemp seeds, pumpkin seeds and walnuts. However, the conversion of ALA to EPA and DHA is very limited, especially in men. Like many other nutrients, animal sources of EPA and DHA (such as seafood) are much more bio-available to the body. This conversion also requires zinc, iron and vitamin B6, so if these nutrients are lacking in someones diet, chances are that their conversion rates are even lower.

What’s in the juice?

The juice is made by Smart Fish, a company in Norway, and consists of a blend of 100% juices, whey protein isolate, fish oil, pectin, rosemary extract and is fortified with several vitamins and minerals. These juices are currently sold over the counter in Norway and in parts of Europe, but are not yet available in the US. Participants in the experimental group drinking 3 of these per day receive a total of 3000 mg of highly concentrated omega-3’s. This is typically much more than what over the counter supplements provide (which is usually 1000 grams); fingers crossed that we see some changes!

What does 3000 mg of Omega-3 from food look like?

0.6 oz of chia seeds (a little over 1 TBSP)

6 oz wild herring, farmed Atlantic salmon, wild king salmon or wild mackeral

9 oz canned pink salmon, wild blue-fin tuna

9-12 oz canned albacore tuna, canned sardines, wild swordfish, wild sockeye salmon, farmed trout, oysters and mussels

Farm raised fish typically have omega-3 supplements added to their feed which is why some consider them as top sources of omega-3’s. However, wild fish obtain their omega-3 levels from feeding off of seaweed. Needless to say, it would be quite difficult to get our participants to acquire 3000 mg of omega-3 through food only, which is why the Smart Fish juice is being used. So far, participants love the stuff.

Why Suicide? Since 2000, rates of suicide in America have steadily increased yet suicide remains a topic of minimal conversation. For those who have lost someone dear to them, it’s a very touchy subject. For others, it’s taboo to speak about it. It’s the elephant in the room that people refuse to address. Now is the time to start talking about suicide and to raise awareness. There were many diseases - HIV/AIDS for example - that were considered taboo at first. But with the help of intelligent and hard working people, the diseases are now curable or at the very least, manageable. This will be the first study of its kind to attempt to address suicide and the possibility of fish oil as part of a treatment plan.

Being a part of this study has really opened my eyes to the prevalence of suicide in the United States; it is the 10th leading cause of death with approximately 30,000 civilian deaths annually. It has continued to increase in the military and the prevalence is particularly high among veterans. After interviewing some of our participants and hearing about the traumatic events they have experienced, it’s no wonder why there is such a high depression rate among this population. Events of a traumatic nature really change these people; they view life completely different than you and I. The same goes for non-veterans and we are currently in the process of opening up our study to non-veterans.

I have noticed that diets of our participants are far from nutritious; consuming a healthy diet just isn’t at the top of someone’s priority list when they’re depressed. Of particular importance is their lack of consumption of omega-3’s. Several studies have shown a link between low omega-3 levels and depression. One of the Principle Investigators on the BRAVO study, Joseph Hibbeln, has done a lot of work in this area. Many high quality studies show that DHA, a specific fatty acid found in cold water fatty fish, provides tremendous protection against developing depression and more interestingly, treating depression.

fMRI. One of the most exciting aspects of our study is the fMRI sub-study led by Dr. Mark George. The fMRI in this study is meant to capture brain images of our participants during different points in time, and to see if supplementation with omega-3’s alters the physiology of their brains. DHA is found concentrated in neural tissues and is essential for neural function, neruodevelopment, and neurotransmitter function. I’m pretty excited to see these results at the end of the study.

Due to the intricate nature of this study, I could go into much greater detail but I think I’ll stop here for now. Help us spread the word about this study by liking our Facebook page. And if you know of anyone who might be fit for this study and who lives within 60 miles of Charleston, SC (we deliver the juices and can only deliver within this radius), please send them our way.

Cheers