Page 82 - JSOM Spring 2021

Applications of Fish Oil Supplementation
for Special Operators

1
Jeffery L. Heileson *; LesLee K. Funderburk ; Thomas D. Cardaci 3
2

ABSTRACT
7
Fish oil supplementation (FOS) is beneficial for human health were published. The expert panel agreed that recommending
and various disease states. FOS has recently received attention increased omega-3 PUFA intake would likely improve mission
related to its anabolic and anti-catabolic effects on skeletal readiness and TBI outcomes. 8
muscle and cognitive performance. Since Special Operations
Forces (SOF) personnel endure rigorous combat and training In the context of athletic performance, much of the attention
environments that are mentally and physically demanding, garnered by FOS is related to its anti-inflammatory prop-
9
FOS may have important applications for the SOF Warf- erties. However, EPA and DHA also have the ability to be
ighter. The purpose of this narrative review is to explore the incorporated into skeletal muscle, alter cell membrane fluid-
evidence for FOS and its application to multiple physiologi- ity, influence the interactions between membrane lipids and
cal and psychological contexts experienced by SOF personnel. proteins, and effect skeletal muscle anabolism and catabolism.
For physical performance, FOS may promote lean body mass This could, collectively, enhance training adaptations. 9 –15 As
(LBM) accretion; however, there seems to be minimal impact such, FOS has received considerable research interest due to
on strength, power, or endurance. During physiological stress, its anabolic and anticatabolic effects on skeletal muscle that
FOS may preserve strength, power, LBM (during muscle dis- could improve physical performance and recovery. 14,15
use, not weight loss) and enhance recovery. For cognition, FOS
likely improves reaction time, mental fatigue, and may reduce Accordingly, a recent review highlighted the sport performance
the incidence and severity of mild traumatic brain injury; applications of omega-3 PUFA supplementation, primarily
however, FOS has minimal impact on attentional control and in the form of fish oil, in various athletic contexts (strength/
16
mood states. No safety concerns were evident. In conclusion, power based, endurance based, and team based). Although
there are multiple applications of FOS for SOF personnel. similar to athletes, SOF personnel embody a broader range of
Due to the minimal safety concerns and potential anabolic, training and combat contexts beyond those experienced by the
anti-catabolic and cognitive benefits, FOS is a viable method typical athlete. SOF personnel are oftentimes exposed to multi-
to promote and sustain SOF Warfighter physical and cognitive stressor environments during Sustained training and combat
performance. Although promising, the FOS trials to date have operations (SUSOPS). Training is designed to be mentally
not been conducted in the context of the multi-stressor envi- and physically challenging to test and fortify SOF resiliency
ronments experienced by SOF personnel, thus, future studies and performance. Common SUSOPS stressors include sleep
should be conducted in a SOF population. deprivation, elevated psychological strain, high energy expen-
ditures, insufficient calorie intake, heavy combat loads, and
Keywords: omega-3 fatty acids; eicosapentaenoic acid; doco- extreme evironments. 17,18 The unique combination of physio-
sahexaenoic acid; skeletal muscle; cognition; performance logical and psychological stressors during SUSOPS inevitably
leads to detrimental effects on performance through the loss of
muscle mass, reduced strength, lack of endurance, suboptimal
recovery, poor cognitive performance, and increased suscepti-
Introduction
bility to injuries, including concussions or mild TBI. 18
Omega-3 PUFA supplementation has steadily grown in popu-
larity over the past two decades. A recent survey found that While the human body cannot synthesize omega-3 PUFAs, it
1
69% of military personnel take a dietary supplement and 26% does have the ability to further metabolize these fatty acids
2
of those surveyed reported taking fish oil. Omega-3 PUFAs, through stages of elongation and desaturation. Alpha-linolenic
especially eicosapentaenoic acid (EPA) and docosahexaenoic acid (ALA), the plant precursor of omega-3 PUFAs, can be me-
acid (DHA), are well known to play a role in cardiovascu- tabolized to EPA and DHA. However, the conversion of ALA
lar and cognitive health. Nearly a decade ago, fish oil sup- to EPA or DHA is very inefficient with 9 –21% conversion in
3 –5
plementation (FOS) was offered as a potential prophylactic females and 4–8% in males. 19–21 It has been suggested that a
treatment for traumatic brain injury (TBI) in Special Oper- conservative fish oil dose to provide musculoskeletal benefits
ators. Shortly after, results from the “Nutritional Armor: would be ≥ 2g/d, thus FOS may be the most appropriate method
6
Omega-3 for the Warfighter” conference and expert panel to ensure an adequate intake based on the relatively high EPA
*Correspondence to Robbins College of Health and Human Sciences, Baylor University, One Bear Place #97311, Waco, TX 76798; or
Jeffery_heileson@baylor.edu
2
1 MAJ Heileson and COL (Ret) Funderburk are affiliated with the Department of Health, Human Performance, and Recreation at the Robbins
College of Health and Human Sciences of Baylor University, in Waco, TX. Mr Cardaci is affiliated with the Department of Exercise Science,
3
Arnold School of Public Health, University of South Carolina, in Columbia, SC.
78