Academic Stress and Proinflammatory Cytokines: Omega-3 Intervention

• Serum ln(IL-6) [ Time Frame: every 3 weeks for 3 months after initiating supplementation (outcome reported is the average outcome across all 4 time points) ] [ Designated as safety issue: Yes ]

  log-transformed serum Interleukin-6 (IL-6)

  Serum cytokine levels provide an assessment of systemic inflammation, the cytokine level circulating throughout the body. Higher levels are typically interrupted as worse unless an individual is acutely ill.

  Stimulated cytokine production reflects the inflammatory cytokine production capacity of monocytes.

  
  
• Serum ln(TNF-a) [ Time Frame: every 3 weeks for 3 months after initiating supplementation (outcome reported is the average outcome across all 4 time points) ] [ Designated as safety issue: Yes ]

  log-transformed serum Tumor Necrosis Factor-alpha (TNF-alpha)

  All cytokine measurements (e.g., IL-6 and TNF-a, serum and stimulated) were analyzed across time; however, no stress effects were found. Therefore, all assessments post-supplementation were averaged (time points 3-6) and analyzed to determine whether fish oil supplementation had an effect. Pooling these 4 assessments provides a better estimate of an individual's cytokine levels because single time point measurements can be affected by changes in exercise, alcohol consumption, or sleep in the preceding 24-48 hours.

  
  
• Stimulated ln(IL-6) [ Time Frame: every 3 weeks for 3 months after initiating supplementation (outcome reported is the average outcome across all 4 time points) ] [ Designated as safety issue: Yes ]

  log-transformed stimulated IL-6

  Serum cytokine levels provide an assessment of systemic inflammation, the cytokine level circulating throughout the body. Higher levels are typically interrupted as worse unless an individual is acutely ill.

  Stimulated cytokine production reflects the inflammatory cytokine production capacity of monocytes.

  
  
• Stimulated ln(TNF-alpha) [ Time Frame: every 3 weeks for 3 months after initiating supplementation (outcome reported is the average outcome across all 4 time points) ] [ Designated as safety issue: Yes ]
  log-transformed stimulated TNF-alpha
  
  

• ln(Beck Anxiety Score) [ Time Frame: every 3 weeks for 3 months after initiating supplementation (outcome reported is the average outcome across all 4 time points) ] [ Designated as safety issue: No ]
  log-transformed Beck anxiety score, min-max values - 0-4.1: higher means greater anxiety
  
  
• ln(CES-D) [ Time Frame: every 3 weeks for 3 months after initiating supplementation (outcome reported is the average outcome across all 4 time points) ] [ Designated as safety issue: No ]

  log-transformed Center for Epidemiologic Studies Depression Scale (CES-D) score

  The CES-D is a self-report scale designed to measure current symptoms of depression rated on a four-point likert scale.

  Scores range from 0-60, with higher scores indicating a higher frequency of depressive symptoms.

  
  

This study will examine how supplementation with omega-3 polyunsaturated fatty acids (key fish oil components) affects immune and mood responses to examination stress. This study will examine these outcomes in medical students during academic examination periods as well as less stressful non-exam periods. Participants will take fish oil supplements or placebo pills for approximately 3 months during which time relevant mood, endocrine, and immune measures will be assessed.

For detailed information about the study, please visit our website at http://www.stressandhealth.org