Running Head: ADHD and omega-3/6 fatty acids Biochemical and psychological effects of omega-3/6 supplements in male adolescents with ADHD: A randomized, placebo-controlled, clinical trial (original) (raw)
Related papers
Journal of Child and Adolescent Psychopharmacology, 2015
Background: An abnormality in long chain-polyunsaturated fatty acid (LC-PUFA) levels has been implicated in attention-deficit/ hyperactivity disorder (ADHD). Studies evaluating LC-PUFA supplementation for therapeutic efficacy in ADHD have shown mixed and, therefore, inconclusive results. Methods: Seventy-six male adolescents (age 12-16 years, mean = 13.7) with ADHD were assessed for the effects of 12 weeks omega-3 and omega-6 supplements on biochemical and psychological outcomes in a randomized, placebo-controlled, clinical trial. The primary outcome measure was change in the Conners' Teacher Rating Scales (CTRS) following 12 weeks of supplementation of LC-PUFA or placebo. At baseline, the placebo and treatment groups had comparable levels of LC-PUFA as measured by red blood cell phosphatidylcholine. In the treatment group, supplementation enhanced eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and total omega-3 fatty acid levels. Results: No superiority of LC-PUFAs to placebo was observed on the primary outcome. Further, there were no reliable treatment effects on aggression, impulsivity, depression, and anxiety. Conclusions: Future studies should use larger sample sizes and longer supplementation period to detect small-modest effects for clinical recommendations in ADHD.
Attention deficit hyperactivity disorder (ADHD) may persist into adolescence and adulthood. It is suggested that insufficient nutritional supply of LC-PUFAs (long-chain polyunsaturated fatty acids) and minerals (including serum levels of zinc, iron, magnesium, calcium and copper) may develop ADHD symptoms. However, clear and convincing evidence is lacking. Subjects in the present report were boys with moderate ADHD symptoms who were categorized into control group (C; mean age: 8.34 years), ADHD group (mean age: 8.72 years), and ADHD-O group (or ADHD-supplemented with omega-3 fatty acids (mean age: 8.69 years). Significant reduction in serum zinc, iron, magnesium and calcium in ADHD group without omega-3 supplementation compared to healthy control subjects, and significant increase in these nutrient bioelements after omega-3 supplementation in ADHD reaching to the levels found in healthy non-ADHD control subjects were the findings in our present study. Although the definite cause/ causes of ADHD are not yet known, omega-3 and other long-chain polyunsaturated fatty acids (LCPUFA) seem promising in understanding the pathophysiology and exploring additional management of ADHD.
Journal of Attention Disorders, 2009
Objective: The aim of the study was to assess omega 3/6 fatty acids (eye q) in attention deficit hyperactivity disorder (ADHD). Method: The study included a randomized, 3-month, omega 3/6 placebo-controlled, one-way crossover trial with 75 children and adolescents (8-18 years), followed by 3 months with omega 3/6 for all. Investigator-rated ADHD Rating Scale-IV and Clinical Global Impression (CGI) scale were outcome measures. Results: A majority did not respond to omega 3/6 treatment. However, a subgroup of 26% responded with more than 25% reduction of ADHD symptoms and a drop of CGI scores to the near-normal range. After 6 months, 47% of all showed such improvement. Responders tended to have ADHD inattentive subtype and comorbid neurodevelopmental disorders. Conclusion: A subgroup of children and adolescents with ADHD, characterized by inattention and associated neurodevelopmental disorders, treated with omega 3/6 fatty acids for 6 months responded with meaningful reduction of ADHD symptoms. (J. of Att. Dis. 2008; XX(X) xx-xx)
Paediatrics & child health, 2009
Although several clinical trials have evaluated the impact of n-3 polyunsaturated fatty acid (PUFA) on patients with attention-deficit hyperactivity disorder (ADHD), changes in plasma PUFA composition were not always assessed following n-3 supplementation. Furthermore, no reports are available on the efficacy of n-3 PUFA in Canadian youth with ADHD. To determine fatty acid (FA) composition, and the efficacy and safety of n-3 PUFA supplementation on ADHD clinical symptoms in French Canadian primary school children. The Strengths and Weaknesses in ADHD and Normal Behaviors (SWAN) and Conners' questionnaires were used to assess changes in ADHD symptoms in 37 children (only 26 children completed the study from zero to 16 weeks). They were divided into two groups (A and B), and participated in a 16-week, double-blind, one-way, crossover randomized study. In the first phase, group A received the n-3 PUFA supplement and group B received n-6 PUFA (sunflower oil) as a placebo. During the...
Attention Deficit Hyperactivity Disorder and Omega-3 Fatty Acid Supplementation: A Systematic Review
Yeni symposium psikiyatri ve nörolojik bilimler dergisi, 2018
Objective: Attention deficit hyperactivity disorder (ADHD) is a chronic multifactorial disorder mainly affecting school-aged children and resulting in inattention, hyperactivity and impulsivity symptoms. While exact underlying cause remains unknown, observations regarding the low plasma levels of omega-3 fatty acids in ADHD patients leads to a new treatment approach, omega-3 fatty acid supplementation. Method: Literature search is performed about the relation between omega-3 fatty acid supplementation and ADHD treatment by using 3 databases. Nineteen studies met the inclusion criteria and further analyzed. Results: Studies performed with higher number of participants and for longer trial period demonstrate beneficial effects of omega-3 fatty acids in ADHD treatment while no significant additional adverse effects are recorded compared to regular treatment options. Discussion: Omega-3 fatty acid supplementation approach in ADHD treatment is one of the highly investigated issues while there is a lack of comprehensive literature review regarding that issue. In this literature review, we conclude beneficial effects of omega-3 fatty acids in ADHD treatment while it is important to emphasize the need for additional and more comprehensive clinical trials about this issue.
Omega-3 Fatty Acid Supplementation Improves Attention Deficit Hyperactivity Disorder Symptoms in Children, 2022
Background: Attention Deficit-Hyperactivity Disorder (ADHD) is one of the most common neuropsychiatric disorders in children. Increasing evidence suggests an association between omega-3 fatty acid and ADHD. We aimed to investigate the effects of 6-month omega-3 fatty acid supplementation on the fatty-acid profile of erythrocytes and on the clinical severity of ADHD symptoms in children. Methods: Recruitment included 32 children aged 6-14 years diagnosed with ADHD at the Child and Adolescent Psychiatry Department at Ziv Medical Center, Israel. Intervention included refrigerated omega-3 fatty acid supplementation normalized to body weight. Blood samples were taken at baseline, 3 and 6 months after intervention for quantification of fatty acids from erythrocyte membranes. ADHD symptoms were assessed by parents and teachers according to the ADHD Rating-Scale and the Strengths and Difficulties Questionnaire. ADHD severity was additionally assessed by a psychiatrist according to the Clinical Global Impressions Scale. Results: Supplementation of omega-3 fatty acid in children with ADHD raised their omega-3 index statistically significantly from an average of 4.4% omega-3 index at baseline to 11.6% after 6 months and had beneficial effects on ADHD symptoms, as measured by validated questionnaires and in accordance with a pediatric psychiatrist examination. Conclusion: Our pilot study showed that dietary supplementation of omega-3 fatty acid increased the blood omega-3 index levels and improved ADHD symptoms even at the midpoint of 3 months.
Critical appraisal of omega-3 fatty acids in attention-deficit/hyperactivity disorder treatment
Neuropsychiatric Disease and Treatment
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder. The classical treatment of ADHD where stimulant medication is used has revealed severe side effects and intolerance. Consequently, the demand to search for alternative treatment has increased rapidly. When comparing levels of omega-3 polyunsaturated fatty acids (ω-3 PUFAs) in ADHD patients with those in age-matching controls, lower levels are found in ADHD patients' blood. ω-3 PUFAs are essential nutrients and necessary for a proper brain function and development. Additionally, there are strong indications that ω-3 PUFA supplements could have beneficial effects on ADHD. However, the results of ω-3 PUFA supplementation studies show a high variability. Therefore, we reviewed recent studies published between 2000 and 2015 to identify effective treatment combinations, the quality of design, and safety and tolerability of ω-3-containing food supplements. We searched the databases MEDLINE, PubMed, and Web of Science with keywords such as "ADHD" and "ω-3/6 PUFA" and identified 25 studies that met the inclusion and exclusion criteria. The results of these ω-3 PUFA studies are contradictory but, overall, show evidence for a successful treatment of ADHD symptoms. Tolerability of the given supplements was high, and only mild side effects were reported. In conclusion, there is evidence that a ω-3 PUFA treatment has a positive effect on ADHD. It should be added that treatment could be more effective in patients with mild forms of ADHD. Moreover, the dosage of stimulant medication could be reduced when used in combination with ω-3 PUFA supplements. Further studies are necessary to investigate underlying mechanisms that can lead to a reduction of ADHD symptoms due to ω-3 PUFA treatments and also to determine the optimal concentrations of ω-3 PUFAs, whether used as single treatment or in combination with other medication.
Attention deficit/hyperactivity disorder (ADHD) is one of the most common child psychiatric disorders, and is often treated with stimulant medication. Nonpharmacological treatments include dietary supplementation with omega-3 fatty acids, although their effectiveness remains to be shown conclusively. In this study, we investigated the effects of dietary omega-3 fatty acid supplementation on ADHD symptoms and cognitive control in young boys with and without ADHD. A total of 40 boys with ADHD, aged 8–14 years, and 39 matched, typically developing controls participated in a 16-week double-blind randomized placebo-controlled trial. Participants consumed 10 g of margarine daily, enriched with either 650 mg of eicosapentaenoic acid (EPA)/docosahexaenoic acid (DHA) each or placebo. Baseline and follow-up assessments addressed ADHD symptoms, fMRI of cognitive control, urine homovanillic acid, and cheek cell phospholipid sampling. EPA/DHA supplementation improved parent-rated attention in both children with ADHD and typically developing children. Phospholipid DHA level at follow-up was higher for children receiving EPA/DHA supplements than placebo. There was no effect of EPA/DHA supplementation on cognitive control or on fMRI measures of brain activity. This study shows that dietary supplementation with omega-3 fatty acids reduces symptoms of ADHD, both for individuals with ADHD and typically developing children. This effect does not appear to be mediated by cognitive control systems in the brain, as no effect of supplementation was found here. Nonetheless, this study offers support that omega-3 supplementation may be an effective augmentation for pharmacological treatments of ADHD (NCT01554462: The Effects of EPA/DHA Supplementation on Cognitive Control in Children with ADHD; http://clinicaltrials.gov/show/ NCT01554462).
Neuropsychopharmacology, 2017
The role of omega-3 polyunsaturated fatty acids (omega-3 or n-3 PUFAs) in the pathogenesis and treatment of children and adolescents with attention deficit hyperactivity disorder (ADHD) is unclear. A systematic review followed by meta-analysis was conducted on: (1) randomized controlled trials (RCTs) assessing the effects of n-3 PUFAs on clinical symptoms and cognition in children and adolescent with ADHD; and (2) case-control studies assessing the levels of n-3 PUFAs in blood and buccal tissues of children and adolescents with ADHD. In seven RCTs, totalling n = 534 randomized youth with ADHD, n-3 PUFAs supplementation improves ADHD clinical symptom scores (g = 0.38, po0.0001); and in three RCTs, totalling n = 214 randomized youth with ADHD, n-3 PUFAs supplementation improves cognitive measures associated with attention (g = 1.09, p = 0.001). Moreover, children and adolescents with ADHD have lower levels of DHA (seven studies, n = 412, g = − 0.76, p = 0.0002), EPA (seven studies, n = 468, g = − 0.38, p = 0.0008), and total n-3 PUFAs (six studies, n = 396, g = − 0.58, p = 0.0001). In summary, there is evidence that n-3 PUFAs supplementation monotherapy improves clinical symptoms and cognitive performances in children and adolescents with ADHD, and that these youth have a deficiency in n-3 PUFAs levels. Our findings provide further support to the rationale for using n-3 PUFAs as a treatment option for ADHD.
Brain Sciences
Omega-3 long-chain polyunsaturated fatty acids (LC-PUFA) play a central role in neuronal growth and in the development of the human brain, and a deficiency of these substances has been reported in children with attention deficit hyperactive disorder (ADHD). In this regard, supplementation with omega-3 polyunsaturated fatty acids is used as adjuvant therapy in ADHD. Seafood, particularly fish, and some types of nuts are the main dietary sources of such fatty acids in the Spanish diet. In order to assess the effect of the intake of common foods containing high amounts of omega-3 polyunsaturated fatty acids, a food frequency questionnaire was administered to parents of children with ADHD (N = 48) and to parents of normally developing children (control group) (N = 87), and the intake of dietary omega-3 LC-PUFA, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), was estimated. Children with ADHD consumed fatty fish, lean fish, mollusks, crustaceans, and chicken eggs sign...