(P03-020-23) Associations Between Omega-3 Fatty Acid Intakes, Blood Levels, and Quality of Life in a Migraine Population: A Path Analysis of Randomized Trial Data

Objectives: Migraine is a disabling condition impacting 10% of the population.  Comorbid symptoms contribute greatly to the overall burden of suffering in migraine. Evidence suggests that boosting dietary omega-3 fatty acids (n-3 FA) can improve pain outcomes among headache sufferers. The interrelationship of dietary n-3 FA, blood n-3 FA, and comorbid symptoms are less clear. The present study is a secondary analysis of a completed 3-arm randomized, controlled 16-week dietary intervention trial to reduce pain in migraine. We aimed to examine pathways linking diet assignment, dietary intakes, and n-3 biomarkers to pain interference and comorbid symptoms.

Methods: Study participants with migraine (n=182) were randomized to a high n-3/average omega-6 (n-6), a high n-3/low n-6, or a control diet with average n-3/n-6 intakes. For this analysis, we compared the high n-3 diets to the control. We used structural equation models with latent variables to test the fit of the models. We used exploratory factor analysis to identify latent structures.

Results: A four-factor structure explained 60% of the total variance. Factors included 1) anxiety and depression; 2) Headache Impact Test and pain interference; 3) sleep disturbance and fatigue; and 4) physical function. Models show satisfactory fit with Robust chi-square=204.73, p-value = 0.002, CFI = 0.957, RMSEA = 0.043, and SRMR = 0.058 for the EPA model, and Robust chi-square= 205.63, p = 0.002, CFI = 0.949, RMSEA = 0.045, and SRMR = 0.059 for the DHA model.

Controlling for baseline, higher blood levels of both eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) at week 16 were associated with lower pain interference (B = -3.58, p = .08 for EPA, B = -3.742, p = 0.005 for DHA) and lower fatigue levels (B =-2.00, p < 0.001 for EPA, B = -2.931, p = 0.03 for DHA). Increased EPA and DHA were positively associated with physical functioning (B =4.42, p = 0.01 for EPA, B = 5.39, p = 0.01 for DHA). Increasing DHA appeared to be associated with decreased anxiety/depression (B =-5.21, p = 0.08). Both blood EPA and blood DHA significantly mediated the relationship between randomization to the high n-3 diet and pain interference.

Conclusions: This analysis demonstrated the positive effects of increasing dietary EPA and DHA on clinically important outcomes in migraine.

Funding Sources: NIH: NCCIH & NCATS