Design and methods for the Ranger Resilience and Improved Performance on Phospholipid bound Omega-3's (RRIPP-3 study)

Abstract

Intake of nutrients fundamental for optimal neuronal function is of increasing interest. The potential importance of omega-3 highly unsaturated fatty acids (HUFAs) for optimizing emotional states, cognitive function, and mental health has been demonstrated in observational studies and randomized controlled trials. Omega-3 (HUFAs), specifically EPA (eicosapentaenoic acid) and docosahexaenoic acid (DHA), are concentrated in neural tissues and are essential for neural function, normative neurodevelopment, neurotransmitter, and neural immune functions. Omega-3 HUFAs must be obtained from the diet, predominantly from marine sources such as fish and other seafood. HUFAs also can be found in a variety of dietary supplements (omega-3 fatty acid esters, fish oil and krill oil). As dietary supplements, omega-3 HUFAs (fatty acid esters, fish and krill oils) differ substantially in their physicochemical properties and nutrient content. Here we present the design and methods for the Ranger Resilience and Improved Performance on Phospholipid bound Omega-3's (RRIPP-3) study. RRIPP-3 was a double blind, randomized, controlled trial among individuals in the United States (US) Army Infantry Basic Officer Leaders Course (IBOLC) and following US Ranger School training (RC) at Fort Benning, GA of omega-3 HUFA on krill oil versus placebo supplementation. The RRIPP-3 study sought to determine if krill oil supplementation with omega-3 HUFAs supports aspects of cognitive functioning critical to battlefield success when measured immediately after an intense combat simulation. Sub-analyses addressed basic improvements in IBOLC performance. We also describe additional outcome measures critical for interpretation of the study results, such as diet and other dietary supplement use.

Vascular and blood-brain barrier-related changes underlie stress responses and resilience in female mice and depression in human tissue

“…Similarities between the PFC female resilient and male susceptible endothelial transcriptome profiles for this pathway and the fact that both subgroups maintain BBB integrity in this brain region despite chronic stress exposure suggest that it could play a protective role in stress-induced BBB permeability loss. With previous reports linking omega-3 fatty acid consumption with resilience to stress in rodents 52 and humans 53 , further studies are warranted to confirm their potential beneficial effect on the neurovasculature and gain mechanistic insights.…”

A Food-Based Intervention in a Military Dining Facility Improves Blood Fatty Acid Profile

“…The chicken and egg products were evaluated for taste and cooking acceptability by the Human Systems Integration and Sciences Division, U.S. Army Combat Capabilities Development Command-Soldier Center, Natick, MA, and received positive ratings. These same intervention foods were also used in a previous randomized controlled study [25] and were independently analyzed for nutritional content by Lipid Technologies, LLC, Austin, MN.…”

“…However, increasing n-3 HUFA intake by consuming oily fish and regular dietary supplementation does not remediate the excess n-6 PUFA in the diet. A fatty acid supplementation study using krill oil in military personnel failed to show treatment effect on outcomes due to poor compliance to n-3 pills [25,26].…”

Poor effort on cognitive testing in voluntary research predicts failure in US Army Ranger School: Implications for clinical trial design

“…More recently, we conducted the Ranger Resilience and Improved Performance on Phospholipid bound Omega-3’s study (RRIPP-3), a randomized controlled trial (RCT) of omega-3 supplementation from krill oil on cognition and resilience among young military officers. Methodology 7 and results 8 from this trial have been previously reported. A digital adaptation of the Stroop Color-Word Inhibition test 9 was employed as a co-primary outcome, and 7% performed below chance at baseline.…”