This past weekend, I went to Hershey Park and spent the
entire day going on roller coasters, or, as they were called by the medical
advisory signs posted throughout the park, Aggressive Thrill Rides. Over the
course of the day, I was tossed, shaken, rattled, and accelerated within an
inch of my life, confirming my suspicion that I’m not a huge fan of roller
coasters. By the end of they day, I felt pretty sick and had a headache.
While it wasn’t exactly like having a concussion, I spent a
lot of the next day wondering whether modern roller coasters are designed to
prevent brain injuries in the same way they’re now designed to prevent whiplash
injuries. I don’t have any clear answers, but allow me to explain my concerns.
As most of us know, whiplash injuries happen due to rapid deceleration,
frequently because of some kind of impact, which causes the head to move
rapidly forward and then backward. Fortunately, roller coasters decelerate a
bit more gradually, so that whiplash injuries don’t happen. Additionally, the
simple use of headrests means that whiplash injuries are less common.
However, the brain is also injured by rapid deceleration. Of
course, many brain injuries happen because the head itself comes into collision
with a solid object, such as a windshield, the ground, a tree limb, etc. but
many other injuries happen because of the motion of the brain inside the bony
skull. This type of brain injury happens when, for example, a car stops
suddenly – the skeletal body stops quickly, but the brain, resting in a liquid
environment inside the skull, doesn’t stop at the same time as the skeleton.
Instead, the brain keeps moving forward after the skull has stopped moving, and
collides with the skull. This is referred to as a coup injury. What happens
next is that the brain ‘bounces’ off of the interior surface of the skull, and
then hits the opposite side of the skull. This second impact is called a contrecoup injury. In both cases, the brain is bruised
where it came into contact with the skull. So, as you can imagine, with all of
this rapid deceleration and changing of direction on the roller coasters, at
speeds in excess of 50-70 mph, I was concerned about how my poor old brain was
doing.
One of the most concerning things about brain injury is that
there are no established therapies for recovery after an injury, be they from
car accidents, collisions on the football field, or IEDs in Afghanistan. To be
sure, a lot can be done to medically manage acute trauma, and there are
physical and occupational therapy treatments to help patients recover function,
but there is little that can be done to help conserve or repair brain tissue.
If you break a leg really badly, you treat the acute injury, you put a cast on
it, and then you go to physical therapy to regain function – when it comes to
the brain, there is no cast to use, so this crucial repair phase is lost.
However, there may be some hope for preserving brain tissue
when it comes to traumatic brain injury. A number of interesting animal studies
have suggested that the omega-3 fatty acid DHA, which comes from fish oil,
reduces inflammation in the brain following brain injury (1, 2, 3), and at least one of
them also indicates that DHA also helps preserve brain function. In addition,
there is a published case study in the American Journal of Emergency Medicine
of a case in which a teenager was able to progress from an injury-induced
vegetative state to near-normal functioning after use of extremely high doses
of DHA and EPA. This is all extremely exciting information, and prompted two
authors to suggest in the journal Military Medicine that the Department ofDefense seriously investigate the prevention and treatment of traumatic braininjury using omega-3 fatty acids. This isn’t quite time to start jumping up and
down giving one another high fives, but, should human trials pan out, this could
be a great treatment for a very serious problem.
So what does all of this mean to a consumer? First of all, do
what you can to prevent injuries in the first place. This means wearing proper
protective equipment when playing contact sports like football and hockey,
wearing a seatbelt when driving or riding in a car, and, possibly, limiting
your use of roller coasters. An ounce or prevention is worth a pound of cure,
and when the cure is experimental, that ounce is worth much more than a pound
of it. Second, this is yet another reason to take fish oil for preventive
health. While the effects of omega-3 fats as treatment for brain injuries are
questionable, these studies have demonstrated that fish oil seems to exert a
protective effect when taken in advance, and hopefully you’re already taking
fish oil for cardiovascular health.
Before I sign off for the day, here are a few notes about
omega-3s, separate from their use in brain or heart health. The first is that
quality does matter when it comes to fish oil, and it’s worth investing in ‘the
good stuff’. While mercury, dioxins and other contaminants are of some concern
with fish oil (and high quality oils will have removed these substances), the greater
concern is freshness – fish oil spoils easily in processing, and taking spoiled
fish oil is as good as not taking any. You may pay less in buying a low price
fish oil, but if the fish oil has spoiled, you’re losing money.
Secondly, it’s now becoming clearer that relatively high
doses of fish oil are necessary to achieve true benefit both in the
cardiovascular and neurological realms, so consume your fish oil or cod liver
oil with some liberty. A number of companies are now selling concentrated
EPA/DHA products that allow you to get relatively high doses of these active
compounds without taking massive amounts of capsules.
Finally, we are now, at long last, seeing the emergence of
vegetarian EPA/DHA formulas. Previously, these were completely nonexistent, and
vegetarian consumers were left with the choice of either taking non-vegetarian
fish oil, or taking flax oil, whose benefits on cardiovascular health were
largely hypothetical. Now, finally, we are seeing oils containing EPA and DHA
that are derived from algae. These oils offer patients the ability to gain
important nutrients, while maintaining their dietary preferences.
