Page 83 - JSOM Spring 2021

TABLE 1 EPA and DHA Content of Various Fish body mass [LBM]), strength, power, recovery), other unique
Daily amount (oz) scenarios (energy deficits, muscle disuse), and cognition. Sec-
Per 3 oz portion (g) needed to reach: ond, this review will address the safety concerns of FOS and
EPA Content DHA Content 1g EPA 1g DHA make recommendations for future research.
Herring 0.738 0.897 4.07 3.34
Mackerel 0.552 1.008 5.43 2.98 Physical Performance
Sardines 0.402 0.432 7.46 6.94
Salmon 0.159 0.288 18.87 10.42 Lean Body Mass
Cod 0.030 0.084 100.00 35.71 During periods of stress, such as that experienced during
Tuna 0.024 0.168 125.00 17.86 SUSOPS, lean body mass (LBM) maintenance becomes a criti-
cal factor in health and military task performance.
SUSOPS
33–35
Catfish 0.012 0.045 250.00 66.67 studies have reported 2.0–6.3% losses of LBM, resulting in
Tilapia 0.003 0.072 1000.00 41.67 detrimental effects on physical performance such as reduced
Data from USDA Food Data Central (https://fdc.nal.usda.gov/) power and maximal and explosive strength. 36–42 Recently, data
EPA = eicosapentaenoic acid; DHA = docosahexaenoic acid.
has emerged demonstrating FOS’s positive impact on muscle
protein turnover, the ratio of muscle protein synthesis (MPS) to
and DHA profile. While a foods first approach is the optimal breakdown, and influence on key regulatory proteins involved
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and recommended method, it can be challenging to consume in skeletal muscle accretion. 43,44 Therefore, FOS could impact
adequate amounts of EPA and DHA through diet alone, espe- the promotion of LBM and subsequently attenuate decrements
cially if deployed to an austere location without commercial in military task performance. Noreen et al. observed a signifi-
food service support. Additionally, athletes and military ser- cant increase in LBM (0.5kg) following 6 weeks of FOS (4g/d)
vicemembers have notoriously poor intakes of dietary omega-3 compared to placebo (4g/d safflower oil). Similarly, Couet et
45
PUFAs and exhibit low serum EPA and DHA. 22–26 al. found that FOS for 3 weeks resulted in a 0.2kg increase of
LBM compared to a 0.24kg loss in the placebo group. A re-
46
Another important distinction to be made regarding EPA and cent case-controlled study in athletes found that FOS (3.2g/d)
DHA is that skeletal muscle benefits associated with FOS seem increased LBM by 1.36kg in combination with sport-specific
to be uniquely mediated by the EPA component, while DHA training and an increase in calories and protein within 4 weeks
seems to be more important for cognitive protection and per- (Table 2). 47
formance. 27 –31 As Table 1 illustrates, the EPA profile of fish
drastically differs from the DHA profile. For example, an indi- However, the unique stressors experienced by SOF personnel
vidual would have to consume 5–1000 ounces or 3 – 67 ounces during SUSOPS are often not conducive to LBM accretion.
of fish to obtain 1g/d EPA or 1g/d DHA, respectively. As Therefore, data highlighting FOS’s influence on the preserva-
32
such, an appropriate dose needed to benefit from EPA’s poten- tion of LBM should be reviewed. Since the research investi-
tial anabolic and anticatabolic effects on skeletal muscle and gating this phenomenon is in the context of weight loss or
DHA’s effects on cognition would most likely require FOS. immobilization, this will be covered in subsequent sections.

Given the potential health benefits and the limited amount of Strength
EPA and DHA available from food sources, FOS may pro- Military tasks and demand analyses have indicated that
vide a broad spectrum of performance-enhancing and superior strength is one of the important fitness parameters and deter-
recovery capabilities particularly important to Special Opera- minants of battlefield performance. Due to the relatively high
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tors. First, the purpose of this narrative review is to highlight amounts of strength that is required for military tasks includ-
the applications of FOS for situations relevant to SOF person- ing loaded marching, repetitive lifting, digging, and carrying,
nel. This is namely, FOS impact on physical performance (lean development and/or preservation of strength may have robust

TABLE 2 Applications of FOS for Special Operators: Physical Performance
Application
Context Anabolic Anti-catabolic
• Based on one case study and two trials, FOS may increase • FOS seems to only preserve LBM in certain situations
Lean body mass LBM; however, this finding needs to be confirmed in (e.g., muscle disuse)
future trials
Strength • FOS unlikely to promote strength • FOS likely preserves strength during rigorous training
• FOS unlikely to promote power • FOS likely preserves lower body power after intense
Power
training or muscle damaging exercise
• Aerobic: FOS unlikely to impact endurance performance • No data available
Endurance • Anaerobic: It is unclear if FOS increases anaerobic
endurance
Recovery • No data available • FOS enhances recovery from physiological stress
• No data available • It is unclear if FOS preserves LBM
Energy deficit
• Although not conclusive, FOS likely preserves strength
• No data available • FOS likely preserves:
Muscle disuse • LBM (at least 2g EPA+DHA for 2 weeks)
• Strength (longer duration needed, ~6 weeks)
FOS = fish oil supplementation; LBM = lean body mass; EPA = eicosapentaenoic acid; DHA = docosahexaenoic acid.

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