Concussion Management, Science, and Omega 3s

Discussion in 'SoCalScene' started by MWN, May 2, 2018.

  1. MWN

    MWN Silver

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    Public Service Announcement (PSA)

    We all know concussions are a concern for soccer players. The other day, I came across this article: http://goalnation.com/action-armor-is-it-body-armor-for-your-brain/

    I read the article and cringed at the lack of any actual critical thinking (i.e. challenge or verification by the author to the claims), no cites to scientific journals, research, etc. The article was nothing more than a puff piece for a company called Action Armor. So I visited the website and discovered it read very similar to the article. To their credit, they do include "references" to some articles, but also cite mostly to general articles that makes the body of evidence appear more than it is, which can be misleading to many consumers that don't actually take the time to research and read.

    What initially struck me about the Action Armor sales pitch/packaging is they represent DHA as unique and different from an "Omega 3" fatty acid. Their packaging states: "Made with 3 essential vitamins (and lists Lutein, DHA and Omega 3)." WTF? Omega 3 includes EPA, DHA and ALA. The claim really should be "Made with 2 essential vitamins." See, https://ods.od.nih.gov/factsheets/Omega3FattyAcids-Consumer/. But, I was now intrigued. Were these guys just snake fish oil salesman? Is there any real science that Omega 3s can protect or help with minor to severe traumatic brain injuries?

    Quite frankly, I didn't know and I hate not knowing. So I spent a few hours researching by looking at actual medical articles and papers (not relying conclusory websites). I'm sharing with all of you my research. I've drawn my conclusions, maybe this will benefit some kid in a positive manner.

    Turns out there is a "growing" body of research that seems to indicate positive results (Concussions, Traumatic Brain Injury, and the Innovative Use of Omega-3s (2016), The potential for DHA to mitigate mild traumatic brain injury (2014), Neuroprotection by docosahexaenoic acid in brain injury (2014), Dietary supplementation with the omega-3 fatty acid docosahexaenoic acid in traumatic brain injury (2011 - 40mg of DHA is best, but lower doses also work); and Protection Before Impact: the Potential Neuroprotective Role of Nutritional Supplementation in Sports-Related Head Trauma (2018) [note, this 2018 TCU paper reviews the previous research in the context of sports related concussions and provides and excellent summary of the research to date]

    The basic conclusion of the research to date (summarized well in the 2018 "Neuroprotective Role" out of Texas Christian University) is that the research, mostly on mice and rats concludes that Omega-3s (DHA (docosahexaenoic acid) more so than EPA (eicosapentaenoic acid) seems help, but the results are better when taken before the injury, which makes logical sense when you consider the elevated DHA levels are already in the brain when the injury occurs, thus the potential benefit begins earlier.

    Which brings me back to this Action Armor product. A dose (2 chews) contains 250mg of EPA and DHA (the constituent breakdown is not disclosed, so we don't know how much DHA (key ingredient) is actually in there). A 90 day supply retails for $93.99 and is on sale for $83.99 (84), which makes a daily dose of 250 mg of who knows how much DHA $1.04 to $.94 (per day). Is this a good deal?

    Setting aside the fact doesn't disclose how much DHA v. EPA is in the product, I was curious what else is out there:
    In Action Armor's defense, they position the product as a "multi-vitamin" and not just a concussion prophylactic and includes another nutritional brain related supplement Resveratrol (30mg) (found in red wine, plants and nuts). While some claim a benefit, and there may be an animal study or two that supports this, Harvard released a study on humans and found no impact. (See, article here).

    Curiously, the Action Armor product does not contain Curcumin (Found in turmeric), like omega-3 fatty acids, there have been animal studies showing positive results both before and after a concussion occurs. These studies are cited in the 2018 Texas Christina University article above. However, no human studies have been done.

    Conclusion

    A growing body of scientific evidence (in the form of peer reviewed studies) suggest that the Omega 3 fatty acid, DHA may have a genuine benefit for concussions. We know that a 40mg dose of DHA in rats had a good impact when taken before an injury, and we know that if we convert that dosage for humans, we need something on the order of 300mg to 500mg of DHA depending on the athlete's weight (see, here for conversion formula), which should be taken daily, weeks before the injury to insure its in the system and available to use.

    Curcumin may also have a positive impact, the jury is out, 30mg may be fine, but most research on humans in other areas of health (joints) use 400mg or more.

    The Action Armor product may have some benefit, but (if you buy into the current state of the science), the product is likely deficient in ideal levels of DHA and costs about double to triple what other products that deliver much higher doses of DHA cost. The product contains potentially misleading statements in that it attempts to distinguish the broad category of Omega 3 as different than DHA (which is an Omega 3, note the 3 in Omega are the following fatty acids DHA, EPA and ALA).

    If you are sold on the Action Armor product because of its multi-vitamin aspect, you should probably supplement it with additional Omega 3 tablets to increase the DHA load. Alternatively, just go with a higher Omega 3 pill that has or more than 300 to 500mg of DHA depending on the athlete's weight.
     
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  2. younothat

    younothat Silver

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    Good info, I will vouch for Dr. Tobias Omega 3 Fish Oil Triple Strength as a Omega 3 Nutritional Supplement. Been using the product for a number of years , helps reduces arthritic pain and balance cholesterol levels for me. My doctor recommend it to better balance cholesterol levels, my low was too low and the pain reduction was just a side benefit.
     
  3. Not_that_Serious

    Not_that_Serious Bronze

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    I use this site often: labdoor.com

    Fish Oil Ratings which are ranked fairly well. Also can find a guy on amazon reviews who broke down most of the fish oil supps.

    I use to use Nutrigold (was cheapest pharm grade oil) until they really jacked up the price. Ive tried just about everything. I use Viva and InnovixLabs. Just have to make sure what the company lists is factual. I use at least 2200mg daily and when im heavy lifting ill go to 3000mg (helps with joint inflamation) . As mentioned, really helps with cholesterol levels - along with nails, hair, skin health.

    As far as kids needing Omega 3 Supplementation, depends on what you read and who you ask. Some doctors say needed, some say no. Most med studies are designed around children with ADHD and/or Autism. Im a fan of getting blood work done before supplementing to make sure A) supplementation is needed B) once on the supplement, can track changes and C) eliminate supplements that dont do anything. Fish Oil seems like a simple thing to take but can get complicated when factoring things like AA/EPA ratios.
     
  4. Not_that_Serious

    Not_that_Serious Bronze

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    you are also right to cringe about product pushing. Big Pharma does the same thing. Doctors themselves only tend to know info provided by the sales reps. The reps have studies, but studies they had "third party" researchers conduct - companies they own themselves. Websites like goalnation will write up stories if a company pays them enough money.
     
  5. younothat

    younothat Silver

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  6. Surfref

    Surfref Silver Elite

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    As long as there are limited substitutions, professional teams will still try to send players with a concussion back onto the field. IFAB and FIFA would need to change the substitution policy to allow for players suspected of having a concussion to be substituted out and another player take their place while an in-depth, 20-30 minute, evaluation can be accomplished. I am sure there would have to be some stipulations put into place or teams would abuse it to get an extra substitution. It will be interesting to see if FIFA follows their concussion protocols and keeps Matuidi out of the final.

    One thing that I have not seen much of over the past year is coaches in youth games arguing with the referee when the referee indicates a possible head injury/concussion. The last coach that argued with me about a possible head injury/concussion at Man City Cup turned out to be wrong and the trainer would not clear the player. This one stood out to me because the girls father actually came over and thanked me for insisting his daughter get evaluated. Her symptoms developed over the 20 minutes that the trainer spent evaluating her and included a severe headache, sensitivity to light and sound and dizziness.

    As referees in youth games we are not supposed to use the word concussion, we can only refer to it as a possible head injury. Since we are referees and medically trained professionals, it makes sense for referees to not say a player has a concussion.
     
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