Omega-3 and
omega-6 fatty acids are precursors of bioactive
lipid mediators posited to modulate both physical
pain and psychological distress. In a randomized trial of 67 subjects with severe
headaches, we recently demonstrated that targeted dietary manipulation-increasing
omega-3 fatty acids with concurrent reduction in omega-6
linoleic acid (the H3-L6 intervention)-produced major reductions in
headache compared with an omega-6 lowering (L6) intervention. Because
chronic pain is often accompanied by psychological distress and impaired health-related quality of life (HRQOL), we used data from this trial to examine whether the H3-L6 intervention favorably impacted these domains. Additionally, we examined the effect of the interventions on the number of cases with substantial physical or mental impairments as defined by cutoff values in the Brief Symptom Inventory (BSI-18), Medical Outcomes Study Short Forms 12 (SF-12),
Headache Impact Test (HIT-6), and the number of
headache days per month. In the intention-to-treat analysis, participants in the H3-L6 group experienced statistically significant reductions in psychological distress (BSI-18 mean difference: -6.56; 95% confidence interval [CI]: -11.43 to -1.69) and improvements in SF-12 mental (mean difference: 6.01; 95% CI: 0.57 to 11.45) and physical (mean difference: 6.65; 95% CI: 2.14 to 11.16) health summary scores. At 12 weeks, the proportion of subjects experiencing substantial impairment according to cutoff values in the BSI-18, SF-12 physical, HIT-6, and
headache days per month was significantly lower in the H3-L6 group. Dietary manipulation of n-3 and
n-6 fatty acids, previously shown to produce major improvements in
headache, was found to also reduce psychological distress and improve HRQOL and function.