Krill Oil for Pain in Elders

Mobility is a critical factor in the maintenance of independence and quality of life ofolder adults. Chronic musculoskeletal pain contributes to mobility disabilitydisproportionately among older adults. Current treatments for pain and functional declineare often ineffective and add to heightened risks of polypharmacy in older adults. Assuch, nutritional interventions can play a significant role in promoting health andlongevity, managing pain, and enhancing physical function in older adults. Omega (ω)‐3polyunsaturated fatty acids (PUFAs) are essential nutrients that are well recognized fortheir anti‐inflammatory and cardioprotective benefits, as well as their analgesic andanti‐nociceptive properties. Most American adults do not meet the recommendations for ω‐3intakes, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), foundprimarily in seafood. Due to competing pathways, an elevated ω‐6 to ω‐3 ratio contributesto an overproduction of pro‐inflammatory eicosanoids and the development of chronicdiseases. A high ω‐6:ω‐3 ratio is associated with higher chronic pain prevalence andincreased pain severity. Additionally, ω‐3 PUFAs may play a role in the preservation ofmuscle and physical function in older adults. Low levels of ω‐3s in blood are associatedwith reduced muscle strength, slower gait speed, and mobility disability among olderadults. Considered largely safe and cost‐effective, ω‐3 supplementation may be crucial toincreasing the intake of these essential nutrients and achieving optimal levels amongolder adults. Although the use of EPA and DHA has been incorporated into severalguidelines, a scarcity of data has prevented the development of strong recommendations onthe use of ω‐3 supplementation for the maintenance of physical function in older adults,particularly those with chronic musculoskeletal pain. Krill oil has been recentlyproposed as an advantageous alternative to traditional fish oil supplements, due to agreater bioavailability of EPA and DHA and additional bioactive compounds. The goal ofthe proposed pilot study is to assess the feasibility of a 3‐month randomized controlledtrial to determine the effectiveness of krill oil supplementation on pain and physicalfunction in older adults with chronic musculoskeletal pain. The investigators will enroll40 older adults (≥60 years) who will be randomly assigned to 4 g krill oil (1,288 mg/dEPA+DHA, 0.45 mg astaxanthin, 320 mg choline) daily or matched placebo (mixed lipidswithout EPA and DHA). The investigators will determine the impact of krill oilsupplementation on the omega‐3 index (%EPA+DHA in erythrocytes), the ω‐6/ω‐3 ratio, andinflammatory biomarkers in blood, and obtain preliminary evidence of its impact on painand physical function in older adults. The findings of this pilot will inform a futurefully‐powered randomized controlled trial by assessing the feasibility and acceptabilityof krill oil supplementation among older U.S. adults with chronic musculoskeletal pain.