Docosahexaenoic acid supplementation for children with attention deficit hyperactivity disorder: A comprehensive review of the evidence

Ramalho, Renata; Pereira, Ana Colaço; Vicente, Filipa; Pereira, Paula

doi:10.1016/j.clnesp.2018.03.126

Cited by 9 publications

(10 citation statements)

References 75 publications

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“…Nowadays, several studies showing that food is not only useful for providing energy for bodily functions [35], but it can also prevent or moderate several diseases and a proper diet can improve both physical and mental health [4,5,25,36,37,38]. Omega-3 LC-PUFA supplementation has been shown to produce beneficial effects in children with ADHD, as summarized by two recent meta-analyses, although some conflicting results have been also reported [12,13,14,15]. To our knowledge, no studies have explored whether the intake of the omega-3 LC-PUFA EPA and DHA (expressed as mg/day) through the diet is adequate in children with ADHD.…”

Section: Discussionmentioning

confidence: 99%

“…The consumption of supplements containing omega-3 LC-PUFA has been shown to be an effective measure in addition to the administration of psychotropic drugs for treating several psychiatric diseases [9,10,11,12]. In this regard, it has been demonstrated that omega-3 LC-PUFA such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) may be helpful in the treatment of attention deficit hyperactive disorder (ADHD) in children [13,14,15,16,17]. Whether the pathophysiology of ADHD may be linked to inadequate bioavailability of omega-3 LC-PUFA, and whether it may be counteracted by dietary supplementation or increased intake of foods containing large amounts of omega-3 LC-PUFA, has gained growing interest in part due to the increasing knowledge of the role of nutrition in psychiatric disorders and in ADHD [18,19,20].…”

Section: Introductionmentioning

confidence: 99%

“…Although many studies on omega-3 LC-PUFA supplementation in ADHD have been published in recent years [13,14], most refer to either interventions performed in patients who were given omega-3 LC-PUFA supplements apart from their normal diets. Remarkably, there are few studies on the intake of omega-3 LC-PUFA through diet in patients with ADHD.…”

Section: Introductionmentioning

confidence: 99%

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Omega-3 Long-Chain Polyunsaturated Fatty Acids Intake in Children with Attention Deficit and Hyperactivity Disorder

2019

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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 significantly less often (p < 0.05) than children in the control group. The estimated daily omega-3 LC-PUFA intake (EPA + DHA) was significantly below that recommended by the public health agencies in both groups, and was significantly lower in children with ADHD (p < 0.05, Cohen’s d = 0.45) compared to normally developing children. Dietary intervention to increase the consumption of fish and seafood is strongly advised and it is especially warranted in children with ADHD, since it could contribute to improve the symptoms of ADHD.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Omega-3 Long-Chain Polyunsaturated Fatty Acids Intake in Children with Attention Deficit and Hyperactivity Disorder

2019

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“…Studies showed evidence for the successful treatment of a mild form of ADHD symptoms with DHA supplementation (Kiliaan and Königs, 2016). Several reviews on DHA supplementation in ADHD were published in recent years(Ramalho et al, 2018; Sun et al, 2018). Despite the heterogeneity of the studies, DHA may contribute to improvements in the capacity of reading, learning, nonverbal cognitive development, perceptive visual capacity and executive function of ADHD children.…”

Section: Roles Of Dha and Its Metabolites In Brain Functionmentioning

confidence: 99%

Docosahexaenoic acid, 22:6n‐3: Its roles in the structure and function of the brain

Mallick

Basak

Duttaroy

2019

Intl J of Devlp Neuroscience

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Docosahexaenoic acid,22:6n-3 (DHA) and its metabolites are vital for the structure and functional brain development of the fetus and infants, and also for maintenance of healthy brain function of adults. DHA is thought to be an essential nutrient required throughout the life cycle for the maintenance of overall brain health. The mode of actions of DHA and its derivatives at both cellular and molecular levels in the brain are emerging. DHA is the major prevalent fatty acid in the brain membrane. The brain maintains its fatty acid levels mainly via the uptake of plasma free fatty acids. Therefore, circulating plasma DHA is significantly related to cognitive abilities during ageing and is inversely associated with cognitive decline. The signaling pathways of DHA and its metabolites are involved in neurogenesis, antinociceptive effects, anti-apoptotic effect, synaptic plasticity, Ca 2+ homeostasis in brain diseases, and the functioning of nigrostriatal activities. Mechanisms of action of DHA metabolites on various processes in the brain are not yet well known. Epidemiological studies support a link between low habitual intake of DHA and a higher risk of brain disorders. A diet characterized by higher intakes of foods containing high in n-3 fatty acids, and/or lower intake of n-6 fatty acids was strongly associated with a lower Alzheimer's Disease and other brain disorders. Supplementation of DHA improves some behaviors associated with attention deficit hyperactivity disorder, bipolar disorder, schizophrenia, and impulsive behavior, as well as cognition. Nevertheless, the outcomes of trials with DHA supplementation have been controversial. Many intervention studies with DHA have shown an apparent benefit in brain function. However, clinical trials are needed for definitive conclusions. Dietary deficiency of n-3 fatty acids during fetal development in utero and the postnatal state has detrimental effects on cognitive abilities. Further research in humans is required to assess a variety of clinical outcomes, including quality of life and mental status, by supplementation of DHA.

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“…In relation to ADHD, lower levels of PUFAs in blood and red blood cells and higher ω-6/ω-3 ratios have been associated with the severity of ADHD,16–19 and increased DHA and EPA concentrations in erythrocyte membranes resulting from ω-3 PUFAs supplementation appeared to ameliorate symptoms of ADHD 20. Systematic reviews and meta-analyses of randomized controlled trials (RCTs) assessing outcomes of supplementation with PUFAs have shown inconsistent results,16,18,21–27 possibly due to heterogeneity of clinical samples, inclusion of patients with diagnosis other than ADHD, non-parallel designs, or mixed supplementation interventions. However, a recent meta-analysis of seven RCTs with 534 youths with ADHD reported by Chang et al7 showed that ω-3 PUFA supplementation significantly improved parental reports of total symptom score, inattention, and hyperactivity.…”

Section: Introductionmentioning

confidence: 99%

<p>Supplementation with high-content docosahexaenoic acid triglyceride in attention-deficit hyperactivity disorder: a randomized double-blind placebo-controlled trial</p>

Pérez¹,

García²,

Areces³

et al. 2019

NDT

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Background: Attention-deficit hyperactivity disorder (ADHD) is a complex disorder in terms of etiology, clinical presentation, and treatment outcome. Pharmacological and psychological interventions are recommended as primary treatments in ADHD; however, other nonpharmacological intervention such as a dietary supplementation with omega-3 polyunsaturated fatty acids (ω-3 PUFAs) has emerged as an attractive option. Purpose: The objective of the present study was to assess whether dietary supplementation with highly concentrated ω-3 docosahexaenoic acid (DHA) triglyceride may improve symptoms in ADHD. Method: A 6-month prospective double-blind placebo-controlled randomized clinical trial was designed in 66 patients with ADHD, aged between 6 and 18 years. Participants in the experimental group received a combination of ω-3 fatty acids (DHA 1,000 mg, eicosapentaenoic acid 90 mg, and docosapentaenoic acid 150 mg). Instruments included d2-test, AULA Nesplora, EDAH scales, and abbreviated Conner’s Rating Scale. Results: In the cognitive test, between-group differences were not found, but within-group differences were of a greater magnitude in the DHA group. Between-group differences in favor of the DHA arm were observed in behavioral measures, which were already detected after 3 months of treatment. Results were not changed when adjusted by ADHD medication. Conclusions: This study provides further evidence of the beneficial effect of supplementation with ω-3 DHA in the management of ADHD.

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Docosahexaenoic acid supplementation for children with attention deficit hyperactivity disorder: A comprehensive review of the evidence

Cited by 9 publications

References 75 publications

Omega-3 Long-Chain Polyunsaturated Fatty Acids Intake in Children with Attention Deficit and Hyperactivity Disorder

Omega-3 Long-Chain Polyunsaturated Fatty Acids Intake in Children with Attention Deficit and Hyperactivity Disorder

Docosahexaenoic acid, 22:6n‐3: Its roles in the structure and function of the brain

<p>Supplementation with high-content docosahexaenoic acid triglyceride in attention-deficit hyperactivity disorder: a randomized double-blind placebo-controlled trial</p>

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