Eicosapentaenoic and Docosahexaenoic Acids, Cognition, and Behavior in Children with Attention-Deficit/Hyperactivity Disorder: a Randomized Controlled Trial

This study investigated the treatment of ADHD symptoms with omega-3 supplements. Thisis a very cool study because 1) they measure blood levels of omega-3s 2) it lasted for along time (4 months) 3) these were very symptomatic kids (90% on the Conner’s ADHD scale and were not medicated. Also the study used very robust amounts of omega-3s and the researchers also investigated whether DHA or EPA was superior. The doses in the groups were: EPA 1109 mg and DHA 108 mg; a DHA-rich fish oil providing EPA 264 mg and DHA 1032 mg; or a safflower oil (control) providing LA 1467 mg/d (omega-6). While the primary outcomes measure did not show significant differences, the blow levels of DHA was correlated with better reading and less oppositional behavior as rated by parents. Not a home run for omega-3s, but certainly something worth investigating if your child has a low intake of omega-3s and attentional/behavioral problems.

Authors CM Milte, N Parletta, JD Buckley, AM Coates, RM Young, PR Howe
Institution Nutritional Physiology Research Centre, University of South Australia
Publication Name Nutrition
Publication Date June 2012

To determine the effects of an eicosapentaenoic acid (EPA)-rich oil and a docosahexaenoic acid (DHA)-rich oil versus an ω-6 polyunsaturated fatty acid-rich safflower oil (control) on literacy and behavior in children with attention-deficit/hyperactivity disorder (ADHD) in a randomized controlled trial.
Supplements rich in EPA, DHA, or safflower oil were randomly allocated for 4 mo to 90 Australian children 7 to 12 y old with ADHD symptoms higher than the 90th percentile on the Conners Rating Scales. The effect of supplementation on cognition, literacy, and parent-rated behavior was assessed by linear mixed modeling. Pearson correlations determined associations between the changes in outcome measurements and the erythrocyte fatty acid content (percentage of total) from baseline to 4 mo.
There were no significant differences between the supplement groups in the primary outcomes after 4 mo. However, the erythrocyte fatty acid profiles indicated that an increased proportion of DHA was associated with improved word reading (r = 0.394) and lower parent ratings of oppositional behavior (r = 0.392). These effects were more evident in a subgroup of 17 children with learning difficulties: an increased erythrocyte DHA was associated with improved word reading (r = 0.683), improved spelling (r = 0.556), an improved ability to divide attention (r = 0.676), and lower parent ratings of oppositional behavior (r = 0.777), hyperactivity (r = 0.702), restlessness (r = 0.705), and overall ADHD symptoms (r = 0.665).
Increases in erythrocyte ω-3 polyunsaturated fatty acids, specifically DHA, may improve literacy and behavior in children with ADHD. The greatest benefit may be observed in children who have comorbid learning difficulties.

Drew Ramsey, MD

Drew Ramsey, M.D. is a psychiatrist, author, and farmer. He is a clear voice in the mental health conversation and one of psychiatry’s leading proponents of using nutritional interventions. He is an assistant clinical professor of psychiatry at Columbia University College of Physicians and Surgeons.

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