A double-blind placebo-controlled randomised trial of omega-3 supplementation in children with moderate ADHD symptoms

Cornu, Catherine; Mercier, Catherine; Ginhoux, Tiphanie; Masson, Sandrine; Mouchet, Julie; Nony, Patrice; Kassai, Behrouz; Laudy, Valérie; Berquin, Patrick; Franc, Nathalie; Heuzey, Marie-France Le; Desombre, H.; Revol, Olivier

doi:10.1007/s00787-017-1058-z

Cited by 42 publications

(44 citation statements)

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“…For additional analyses. Systematic reviews and other studies of this question provide inconsistent results, as they include heterogeneous groups of participants, interventions, comparators and outcomes [ 10 , 11 , 16 – 20 ]. Furthermore, there are implementation differences in dose, delivery, uptake and context both generally [ 35 ], specifically to this field [ 36 ], and with regard to this trial as discussed (see above).…”

Section: Discussionmentioning

confidence: 99%

“…Notably, this review also pointed to the lack of comparable studies reporting reading as an outcome. Since then a few smaller trials found no effects for ADHD [ 11 ] however positive effects on spelling [ 12 ] and comprehensive assessments of reading ability in mainstream Scandinavian children [ 13 , 14 ] have been found, while other trials obtained insufficient evidence in these domains [ 15 ]. However, these studies test combinations of PUFAs with e.g.…”

Section: Introductionmentioning

confidence: 99%

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Docosahexaenoic acid for reading, working memory and behavior in UK children aged 7-9: A randomized controlled trial for replication (the DOLAB II study)

et al. 2018

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BackgroundOmega-3 fatty acids are central to brain-development of children. Evidence from clinical trials and systematic reviews demonstrates the potential of long-chain Omega-3 supplementation for learning and behavior. However, findings are inconclusive and in need of robust replication studies since such work is lacking.ObjectivesReplication of the 2012 DOLAB 1 study findings that a dietary supplementation with the long-chain omega-3 docosahexaenoic acid (DHA) had beneficial effects on the reading, working memory, and behavior of healthy schoolchildren.DesignParallel group, fixed-dose, randomized (minimization, 30% random element), double-blind, placebo-controlled trial (RCT).SettingMainstream primary schools (n = 84) from five counties in the UK in 2012–2015.ParticipantsHealthy children aged 7–9 underperforming in reading (<20th centile). 1230 invited, 376 met study criteria.Intervention600 mg/day DHA (from algal oil), placebo: taste/color matched corn/soybean oil; for 16 weeks.Main outcome measuresAge-standardized measures of reading, working memory, and behavior, parent-rated and as secondary outcome teacher-rated.Results376 children were randomized. Reading, working memory, and behavior change scores showed no consistent differences between intervention and placebo group. Some behavioral subscales showed minor group differences.ConclusionsThis RCT did not replicate results of the earlier DOLAB 1 study on the effectiveness of nutritional supplementation with DHA for learning and behavior. Possible reasons are discussed, particularly regarding the replication of complex interventions.Trial registration and protocolwww.controlled-trials.com (ISRCTN48803273) and protocols.io (https://dx.doi.org/10.17504/protocols.io.k8kczuw)

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Docosahexaenoic acid for reading, working memory and behavior in UK children aged 7-9: A randomized controlled trial for replication (the DOLAB II study)

et al. 2018

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“…A recent randomized placebo-controlled trial evaluating the efficacy of omega-3 PUFAs in children and adolescents with ADHD over three months found that the total reduction in an ADHD rating score was significantly greater in the placebo group than in the PUFA group (Cornu et al, 2018). Moreover, the pooling of these data with previously published results demonstrated no overall effect of omega-3 PUFAs on ADHD symptoms (Cornu et al, 2018).…”

Section: Findings On Food Bioactives In Adhdmentioning

confidence: 97%

“…A systematic review of metaanalyses of double-blind placebo-controlled trials showed that the effect sizes for PUFA supplementation were small in regard to the ratings of ADHD symptoms by parents and teachers (Pelsser et al, 2017). A recent randomized placebo-controlled trial evaluating the efficacy of omega-3 PUFAs in children and adolescents with ADHD over three months found that the total reduction in an ADHD rating score was significantly greater in the placebo group than in the PUFA group (Cornu et al, 2018). Moreover, the pooling of these data with previously published results demonstrated no overall effect of omega-3 PUFAs on ADHD symptoms (Cornu et al, 2018).…”

Section: Findings On Food Bioactives In Adhdmentioning

confidence: 99%

Do food bioactives play a role in attention-deficit/ hyperactivity disorder?

Lange¹

2018

JFB

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Attention-deficit/hyperactivity disorder (ADHD) is a common diagnosis in children, which may persist into adulthood. Short-term benefits of pharmacological treatment have been shown, but concerns regarding long-term efficacy and safety have led to a search for alternative treatments. Nutrition may be an important factor in psychiatric disorders. At group level, food bioactives do not appear to play a significant pathogenetic or therapeutic role in ADHD. Benefits of treatment with omega-3 fatty acids, vitamins and minerals may be confined to individuals deficient in these micronutrients. Dietary patterns may be of greater importance than individual nutrients. However, both diet and consumption of certain nutrients may be precursors or consequences of ADHD. The controversy surrounding the clinical and pathogenetic heterogeneity of ADHD complicates the assessment of food bioactives. The identification of a potential role of food bioactives in ADHD is hindered by the ill-defined nature of the disorder and the lack of biological markers underpinning its validity. The therapeutic efficacy of food bioactives cannot be tested by evaluating their effect on the pathophysiology of ADHD but only by observing their effects on symptom severity.

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“…ADHD symptoms (20). Accordingly, there is currently little support for the efficacy of omega-3 PUFA supplementation on the core symptoms of ADHD.…”

mentioning

confidence: 99%

Micronutrients and Diets in the Treatment of Attention-Deficit/Hyperactivity Disorder: Chances and Pitfalls

Lange

2020

Front. Psychiatry

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Attention-deficit/hyperactivity disorder (ADHD) is one of the most common psychiatric diagnoses in childhood and adolescence. It is characterized by age-inappropriate levels of inattention, impulsivity, and hyperactivity and is associated with long-term academic, social, and mental health problems (1, 2). Both pharmacotherapy and behavior therapy yield short-term symptom reduction in individuals with ADHD. Psychostimulants, in particular, have been shown to improve attention and to decrease activity levels in children in the short term. However, their impact on academic performance and quality of life is low (3, 4), and initial symptomatic effects are not usually sustained on long-term follow-up (5, 6). The unproven long-term efficacy of commonly used ADHD drugs, together with concerns in regard to adverse effects of medication, which can be as serious as growth retardation and severe cardiovascular events (7,8), has led to a search for alternative treatment options.A range of nutrients have been linked to brain development and functioning, and diet may be a relevant factor in the high incidence and prevalence of mental disorders (9). As early as the 1920s, a possible association between food and hyperkinetic behavior was suggested (10). Children with ADHD and healthy controls appear to have different dietary patterns (11)(12)(13). Growing evidence suggests that nutrients, diet, and other lifestyle factors may play a role in the pathophysiology and management of mental disorders (14), including ADHD (15, 16).Major dietary compounds proposed to be helpful in the treatment of ADHD include micronutrients, such as minerals and vitamins, and polyunsaturated fatty acids (PUFAs). Several studies have demonstrated reduced blood plasma levels of various minerals, such as magnesium, iron, and zinc in children with ADHD at group level, and their supplementation may reduce ADHD symptoms in individuals with respective deficiencies. However, evidence in support of this is lacking (17). The questions of whether vitamin deficiencies are involved in the pathophysiology of ADHD and whether vitamin supplements exert therapeutic effects also remain open (15).The role of omega-3 PUFAs in the pathophysiology and therapy of ADHD is controversial (15,18). Since blood levels of docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA) and arachidonic acid (AA) have been found to be significantly decreased in children with ADHD compared to controls, numerous clinical studies have examined the effects of omega-3 PUFA supplementation on ADHD symptoms. A systematic review of meta-analyses of double-blind placebo-controlled trials, in which ADHD symptoms were rated by parents and teachers, concluded that the effect sizes for PUFA supplementation were small (19). The pooling of the negative results of a more recent study with previous findings showed no overall effect of omega-3 PUFAs on

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A double-blind placebo-controlled randomised trial of omega-3 supplementation in children with moderate ADHD symptoms

Abstract: This study did not show any beneficial effect of omega-3 supplement in children with mild ADHD symptoms.

Cited by 42 publications

References 28 publications

Docosahexaenoic acid for reading, working memory and behavior in UK children aged 7-9: A randomized controlled trial for replication (the DOLAB II study)

Docosahexaenoic acid for reading, working memory and behavior in UK children aged 7-9: A randomized controlled trial for replication (the DOLAB II study)

Do food bioactives play a role in attention-deficit/ hyperactivity disorder?

Micronutrients and Diets in the Treatment of Attention-Deficit/Hyperactivity Disorder: Chances and Pitfalls

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