An Omega-3 Combination for Cognitive Impairment

French pine bark is rich in antioxidants that improve vascular health and modulate neurotransmitters. Although medical studies began in the 1970’s, it has been used for centuries as a folk remedy.

Adding an antioxidant to fish oil may protect short-term memory, but the study is tiny

STUDY: Hsiao TC et al, Antioxidants 2026

STUDY TYPE: Randomized, double-blind, parallel-group pilot trial

FUNDING: Formosa Produce Corporation; QWB (Saint-Viance, France)

Background

Fish oil’s omega-3 fatty acids have anti-inflammatory and neuroprotective properties, but they’re highly susceptible to lipid peroxidation. One theory holds that pairing fish oil with an antioxidant could protect those benefits. Pine bark extract, rich in proanthocyanidins, is a potent antioxidant that improved memory in small trials of older adults.

This trial tested whether combining the two worked better than fish oil alone in adults with mild cognitive impairment.

The Study

• 28 adults aged 55–75 with mild cognitive impairment, randomized to fish oil alone or fish oil plus 100 mg pine bark extract daily for 24 weeks.
• Both groups received one fish oil capsule (350 mg EPA, 250 mg DHA) daily; the combination group added pine bark extract (100 mg of a commercial Pinus pinaster Aiton, French maritime pine bark extract supplied by Formosa Produce Company, New Taipei).
  City, Taiwan), comprising 65–75% oligomeric proanthocyanidins and
• Cognitive function was assessed with the Cognitive Abilities Screening Instrument (CASI), a 100-point battery covering memory, attention, language, and visuospatial skills.

Results

Fish oil alone improved scores on global cognition scales and visuospatial drawing. The combination group showed a specific improvement in short-term memory on the CASI. Neither group improved significantly on the CASI total score. On the antioxidant side, fish oil alone raised lipid peroxidation markers and lowered catalase activity, suggesting it increased oxidative stress. Adding pine bark extract attenuated that oxidative rise and kept catalase activity higher than fish oil alone.

Side Effects

Both supplements were well tolerated in this study. Pine bark can cause dizziness and gastrointestinal distress (improves by taking with food). Omega-3 can cause fishy burps, diarrhea, and indigestion. Although it improves vascular health and lipids, it may have risks in cardiac diseases like atrial fibrillation, particularly in high doses above 2,000 mg.

Limitations

Only 14 participants completed each arm. There was no placebo-only control group, so the trial can’t isolate what fish oil alone actually does versus doing nothing. Industry funding from the pine bark extract supplier is worth noting. The 24-hour dietary recall is a weak way to assess diet.

Practice Implications

1. This is a hypothesis-generating pilot study. Pine bark has better evidence for sexual dysfunction. The studies in memory and cognition are just emerging. Omega-3, however, has more evidence for cognition, including two large and 6 small trials in older adults.
2. Although most pine bark trials use the branded extract pycnogenol (150 mg daily), this trial used a different formulation.