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    Treatments for mild traumatic brain injury : fish oil supplementation and information provision in New Zealand health care services : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, Wellington, New Zealand
    (Massey University, 2020) Cresswell, Brylee
    Mild Traumatic Brain Injury (mTBI) has the highest incidence of all brain injuries and can lead to symptoms in the physical, cognitive and mood domains. Most symptoms abate within weeks to months, however some individuals experience ongoing symptoms leading to longer-term disruption of social and occupational functioning. Current mTBI management recommendations include providing early injury related education, and addressing symptoms in a multidisciplinary fashion as they arise. As with any injury, it is important to ensure treatments are effective in order to reduce the costs to both the health system and the individual. The studies presented in this thesis aimed to assess the effectiveness of fish oil – a novel treatment for mTBI symptoms, and the current practice for providing information to mTBI patients. Study One was a randomised placebo controlled trial of fish oil as an adjunct treatment for mTBI symptoms. This study was cancelled due to recruitment difficulties, nevertheless the literature review delineates the pre-clinical evidence of its potential to treat both cognitive and mood symptoms via various pathways. In addition, the outlined procedures and the researcher’s reflections highlight the unforeseen difficulties that will need to be addressed should a similar trial be conducted in future. Study Two surveyed New Zealand health practitioners on their current practice of information provision for mTBI patients. It aimed to assess whether practices have changed in the 16 years since similar research was published, and since the introduction of information sheets by the Accident Compensation Corporation (ACC). It also assessed the quality and accessibility of the information provided. The frequency of information provision after mTBI has improved since 2004, though the issues with variability and formatting of presented information remain similar. The majority of respondents provided information verbally and in writing, and had information available only in English and standard print formats, potentially disadvantaging those with visual impairment or whose first language is not English. Time constraints, patient concentration and distress, and a lack of appropriate resources were cited as barriers to providing information.
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    Ageing, cognition and omega-3 fatty acids : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Psychology at Massey University, Wellington, New Zealand
    (Massey University, 2018) Mengelberg, Alexia
    The evidence for omega-3 polyunsaturated fatty acids (n-3 PUFA) in fish oil supplements being a safe therapeutic agent is steadily growing. However, there is still a lack of evidence around the cognitive effects of n-3 PUFAs in older adults with Mild Cognitive Impairment (MCI), the moderating effect of the Apolipoprotein E (APOE) ɛ4 allele on cognition and well-being, and the popularity of fish oil supplements in New Zealand (NZ). The primary aim of this thesis was to conduct a clinical trial to investigate the cognitive effects of a high dose docosahexaenoic acid (DHA) fish oil supplement in older adults with MCI, and to examine how the presence of the APOE ɛ4 allele affects the efficacy of fish oil. The trial involved a 12-month randomised, double-blind, placebo-controlled design with testing sessions at baseline, 6-months, 9-months and at the end of the trial. Seventy-two adults with MCI between the ages of 60 and 90 were recruited from Wellington, NZ. Participants were either given a DHA fish oil supplement containing 1491 mg of DHA and 351 mg of eicosapentaenoic acid (EPA) per day or a placebo supplement containing sunflower oil. Outcome measures included the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the National Adult Reading Test (NART), the Coin Rotation Task (CRT), the California Older Adult Stroop Test (COAST), the Trail Making Test A and B (TMT), Digit Span Backwards Test (DSBT), the Geriatric Depression Scale (GDS), the Geriatric Anxiety Inventory (GAI), the 36-Item Short Form Health Survey Questionnaire (SF-36), height, weight and blood pressure as well as red blood cell (RBC) fatty acid profiles. ANCOVAs, t-tests and chi-square tests were used to test for differences between the DHA and placebo groups. The secondary aim of this thesis was to conduct an online cross-sectional survey to investigate how popular fish oil supplements are within a sample population of New Zealanders, to determine why fish oil supplements are used, what dose fish oil users take, and where fish oil users store their supplements. The aim of the survey was to test the hypothesis that fish oil users are more likely to display healthier dietary and lifestyle habits. The final analysis (n = 60) of the trial found no evidence of a treatment effect using the cognitive measures, although it did find a treatment effect on systolic blood pressure (p = .03, ƞ2 = .08), and a treatment interaction for APOE ɛ4 carriers on depression (p = .04, ƞ2= .07) and anxiety (p = .02, ƞ2 = .09) scores in favour of the DHA group. The survey found that in a sample of 334 New Zealanders, 66.8% reported using supplements and 21.9% reported using fish oil supplements. The survey found that respondents who regularly eat oily fish are most likely to take fish oil supplements (p < .01), and that only 26% of fish oil users reported taking a dose that would meet dietary recommendations. Over half of fish oil users reported taking fish oils to ‘improve brain functioning’ and only 6.8% of fish oil users reported storing fish oil supplements in the refrigerator. The evidence from epidemiological studies suggests that fish consumption is protective against cognitive decline and dementia, and yet the evidence from clinical trials investigating the cognitive effects of n-3 PUFAs in older adults has been inconsistent and at times conflicting. It appears that the protective effect of fish may be more than the n-3 PUFA content, and that fish consumption may be part of an overall healthier diet and lifestyle, along with regular physical activity, strong social connections and an emphasis on educational attainment and engagement in cognitive activities.
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    A new horizon for fish oil in food industry : a proposed application in dairy products : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosophy in Product Development, Massey University, New Zealand
    (Massey University, 1993) Taha, Maysoon M
    Researchers have shown considerable interest in the beneficial health effects of long­ chain polyunsaturated fatty adds present in fish oil, and dietary advantages have been recognised. As a result food companies are keen to develop "health" foods containing refined and deodorised fish oils. This research is an attempt on this line. Two product ideas are presented here, where it is proposed to incorporate fish oil in processed and spread cheese. The response of potential consumers is gauged through a purpose-designed questionnaire. The responses are discussed and analyzed using the statistical package SPSS. The statistical analysis aimed at determining the factors that may affect product acceptability and buying trends. The results showed that sex, income and age of respondents added to their awareness of fish oil benefits and are factors that affect both product acceptability and buying trend and frequency with varying significance. The product that incorporates fish oil in processed cheese appears to be more acceptable and has a better potential market. The target groups of potential customers include the very young(< 20 years) and the old (> 40 years). Marketing needs to include strategies to increase the people's awareness of fish oil benefits. It is recommended that the survey be re-conducted on a larger sample to confirm the results and that further work be carried out to develop a product acceptable to more than one market segment or cultural group.