Researchers at UT Health San Antonio's Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases discover that even small increases in consumption of omega-3s work to protect brain health for people in middle age. Credit: AGA/

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Want to improve brain health at midlife? Eat more omega-3s.

Eating cold-water fish and other sources of omega-3 fatty acids may preserve brain health and enhance cognition in middle age, new evidence from The University of Texas Health Science Center at San Antonio (UT Health San Antonio) indicates.

Having at least some omega-3s in red blood cells was associated with better brain structure and cognitive function among healthy study volunteers in their 40s and 50s, according to research published online Oct. 5 in Neurology, the medical journal of the American Academy of Neurology. UT Health San Antonio faculty and other investigators of the Framingham Heart Study conducted the analysis.

“Studies have looked at this association in older populations. The new contribution here is that, even at younger ages, if you have a diet that includes some omega-3 fatty acids, you are already protecting your brain for most of the indicators of brain aging that we see at middle age,” said Claudia Satizabal, PhD, assistant professor of population health sciences with the Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases at UT Health San Antonio. Satizabal is the lead author of the study.

The volunteers’ average age was 46. The team looked at the relation of red blood cell omega-3 fatty acid concentrations with MRI and cognitive markers of brain aging. Researchers also studied the effect of omega-3 red blood cell concentrations in volunteers who carried APOE4, a genetic variation linked to higher risk of Alzheimer’s disease.

The study of 2,183 dementia- and stroke-free participants found that:

  • Higher omega-3 index was associated with larger hippocampal volumes. The hippocampus, a structure in the brain, plays a major role in learning and memory.
  • Consuming more omega-3s was associated with better abstract reasoning, or the ability to understand complex concepts using logical thinking.
  • APOE4 carriers with a higher omega-3 index had less small-vessel disease. The APOE4 gene is associated with cardiovascular disease and vascular dementia.
  • Researchers used a technique called gas chromatography to measure docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) concentrations from red blood cells. The omega-3 index was calculated as DHA plus EPA.

“Omega-3 fatty acids such as EPA and DHA are key micronutrients that enhance and protect the brain,” said study coauthor Debora Melo van Lent, PhD, postdoctoral research fellow at the Biggs Institute. “Our study is one of the first to observe this effect in a younger population. More studies in this age group are needed.”

The team divided participants into those who had very little omega-3 red blood cell concentration and those who had at least a little and more. “We saw the worst outcomes in the people who had the lowest consumption of omega-3s,” Satizabal said. “Although the more omega-3 the more benefits for the brain, you just need to eat some to see benefits.”

Researchers don’t know how DHA and EPA protect the brain. One theory is that, because those fatty acids are needed in the membrane of neurons, when they are replaced with other types of fatty acids, these neurons — or nerve cells — become unstable. Another explanation may be the anti-inflammatory properties of DHA and EPA. “It’s complex. We don’t understand everything yet, but we show that, somehow, if you increase your consumption of omega-3s — even by a little bit — you are protecting your brain,” Satizabal said.

It’s encouraging that DHA and EPA also protected APOE4 carriers’ brain health. “It’s genetics, so you can’t change it,” Melo van Lent said, referring to the vulnerability of this risk group. “So, if there is a modifiable risk factor that can outweigh genetic predisposition, that’s a big gain.”

Funding for this project comes in part from the National Heart, Lung, and Blood Institute; the National Institute on Aging; the National Institute of Neurological Disorders and Stroke; and the Alzheimer’s Association.

Dr. Sudha Seshadri, founding director of the Biggs Institute and professor of neurology in the Joe R. and Teresa Lozano Long School of Medicine at UT Health San Antonio, is senior author of the study. The Framingham Heart Study, launched in 1948, has enrolled thousands of participants over multiple generations.

Read more about the research of UT Health San Antonio’s Biggs Institute that increases the world’s knowledge of Alzheimer’s disease and sparks drug potential at and

Learn how UT Health San Antonio is promoting brain health through multifaceted, state-of-the-art patient care and research at

A primary driver for San Antonio’s $42.4 billion health care and biosciences sector, UT Health San Antonio has an annual research portfolio of $350 million and a Department of Education designation as a Hispanic-Serving Institution.

Ranking in the top 3% worldwide of all organizations that receive National Institutes of Health funding, the university’s six professional schools, annual operating budget of more than $1 billion and clinical practices that afford 2 million patient visits a year unite in a mission to make lives better through education, research, patient care and community engagement.

The Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases at UT Health San Antonio is a National Institute on Aging-designated Alzheimer’s Disease Research Center dedicated to providing comprehensive dementia care while advancing treatment through clinical trials and research.

UT Health San Antonio

UT Health San Antonio, with a $350 million annual research portfolio, is South Texas’ largest research university, a primary driver for San Antonio’s health care and biosciences industry and dedicated...