Breast Cancer Research and Treatment

, Volume 161, Issue 3, pp 391–398 | Cite as

Clearing the fog: a review of the effects of dietary omega-3 fatty acids and added sugars on chemotherapy-induced cognitive deficits

  • Tonya S. OrchardEmail author
  • Monica M. Gaudier-Diaz
  • Kellie R. Weinhold
  • A. Courtney DeVries


Cancer treatments such as chemotherapy have been an important part of extending survival in women diagnosed with breast cancer. However, chemotherapy can cause potentially toxic side effects in the brain that impair memory, verbal fluency, and processing speed in up to 30% of women treated. Women report that post-chemotherapy cognitive deficits negatively impact quality of life and may last up to ten years after treatment. Mechanisms underlying these cognitive impairments are not fully understood, but emerging evidence suggests that chemotherapy induces structural changes in the brain, produces neuroinflammation, and reduces adult hippocampal neurogenesis. Dietary approaches that modify inflammation and neurogenesis are promising strategies for reducing chemotherapy-induced cognitive deficits in breast cancer survivors. In this review, we describe the cognitive and neuronal side effects associated with commonly used chemotherapy treatments for breast cancer, and we focus on the often opposing actions of omega-3 fatty acids and added sugars on cognitive function, neuroinflammation, and adult hippocampal neurogenesis. Omega-3 fatty acids administered concurrently with doxorubicin chemotherapy have been shown to prevent depressive-like behaviors and reduce neuroinflammation, oxidative stress, and neural apoptosis in rodent models. In contrast, diets high in added sugars may interact with n-3 FAs to diminish their anti-inflammatory activity or act independently to increase neuroinflammation, reduce adult hippocampal neurogenesis, and promote cognitive deficits. We propose that a diet rich in long-chain, marine-derived omega-3 fatty acids and low in added sugars may be an ideal pattern for preventing or alleviating neuroinflammation and oxidative stress, thereby protecting neurons from the toxic effects of chemotherapy. Research testing this hypothesis could lead to the identification of modifiable dietary choices to reduce the long-term impact of chemotherapy on the cognitive functions that are important to quality of life in breast cancer survivors.


Chemotherapy Omega-3 fatty acids Added sugars Cognition Inflammation Neurogenesis Chemobrain 



Magnetic resonance imaging


Functional magnetic resonance imaging




Tumor necrosis factor alpha


Adult hippocampal neurogenesis


Eicosapentaenoic acid


Docosahexaenoic acid

n-3 FA

Omega-3 fatty acid




Randomized controlled trial


Interleukin one beta


Center for Epidemiologic Studies Depression


Nuclear factor kappa beta


C-reactive protein


Peroxisome proliferator-activated receptor alpha



Maryam Lustberg, MD, MPH for her expertise in clinical implications of chemotherapy and her contributions to preliminary data. TO and ACD received funding on this topic from NCI (R01CA18997); the funding source provides salary support for TO, ACD, and MMGD but was not directly involved in any aspect of the preparation of this review paper.

Author contributions

TSO & ACD were involved in conceptualization of the manuscript; TSO, ACD, MMGD, and KRW were involved in writing the manuscript; all authors were involved in revision of the manuscript. All authors read and approved the final manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interests.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Tonya S. Orchard
    • 1
    Email author
  • Monica M. Gaudier-Diaz
    • 2
  • Kellie R. Weinhold
    • 1
  • A. Courtney DeVries
    • 2
  1. 1.Department of Human SciencesThe Ohio State UniversityColumbusUSA
  2. 2.Department of NeuroscienceThe Ohio State University Wexner Medical CenterColumbusUSA

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