Effect of docosahexaenoic acid-containing food administration on symptoms of attention-deficit/hyperactivity disorder — a placebo-controlled double-blind study

Abstract

Objectives: To investigate whether docosahexaenoic acid (DHA) supplementation was able to ameliorate attention-deficit/ hyperactivity disorder(AD/HD) symptoms in AD/HD children. Design and subjects: A placebo-controlled double-blind study with 40 AD/HD (including eight AD/HD-suspected) children of 6-12 y of age who were mostly without medication. Subjects of a DHA group (n ¼ 20) took active foods containing fish oil (fermented soybean milk, bread rolls and steamed bread; 3.6 g DHA/week from these foods) for 2 months, whereas those of a control group (n ¼ 20) took indistinguishable control foods without fish oil. The following items were measured at the start and end of the study: (1) attention deficit, hyperactivity and impulsivity (AD/HD-related symptoms according to DSM-IV criteria); (2) aggression assessed by both parents and teachers; (3) visual perception (finding symbols out of a table); (4) visual and auditory short-term memory; (5) development of visual-motor integration; (6) continuous performance; (7) impatience. Results: Changes in tests 1, 2, 3, 5 and 7 over time did not significantly differ between the two groups. However, visual shortterm memory and errors of commission (continuous performance) significantly improved in the control group compared with the changes over time in the DHA group (P ¼ 0.02 and 0.001, respectively). Recalculation without AD/HD-suspected subjects (n ¼ 4 each group) showed similar P-values with regard to both measures. Conclusion: DHA supplementation did not improve AD/HD-related symptoms. Treatment of ADHD with fatty acids deserves further investigation, but careful attention should be paid as to which fatty acid(s) is used.

Effect of randomized supplementation with high dose olive, flax or fish oil on serum phospholipid fatty acid levels in adults with attention deficit hyperactivity disorder

“…Similarly, adults with ADHD also show low levels of the long-chain polyunsaturated omega-3 fatty acid DHA [24]. There are conflicting reports in the literature about the cognitive benefits of omega-3 supplementation in patients with ADHD [25][26][27]. Normalizing levels of these fatty acids and reducing the AA/EPA ratio to levels observed in populations such as the Greenland Eskimos and the Japanese should be beneficial due to the association of these fatty acids with various measures of health, including CHD, which is the main cause of death in Western industrialized countries, and depression, with which ADHD is frequently comorbid [28].…”

Is there a role forn-3 long-chain polyunsaturated fatty acids in the regulation of mood and behaviour? A review of the evidence to date from epidemiological studies, clinical studies and intervention trials

“…Two further studies also found improvements in aggression following supplementation compared with placebo, where aggression increased in the placebo group but remained stable in the group treated with EPA þ DHA (153,156) . Four of the studies report no differences in aggression/irritability between treatment and placebo groups following supplementation (126,155,157,158) , one study reports no differences in hostility between treatment and placebo groups (154) and one study reports no differences in anger between treatment and placebo groups (119) . One study also reports increases in aggression following supplementation with EPA þ DHA compared with placebo (156) , and one study reports decreases in aggression following placebo compared with treatment following supplementation with EPA þ DHA (154) .…”

“…The majority of these studies, however, measured inattention, hyperactivity, impulsivity and conduct as described by parents and teachers, but found effects only in selected measures. Three studies also found no benefits of n-3PUFA compared with placebo for inattention, hyperactivity or impulsivity (157,175) or impulsivity alone (126) , and one study found no benefits of n-3PUFA compared with current medication (Ritalin) (176) .…”

“…The majority of studies have been conducted on children diagnosed with ADHD (157,170,175,176) , but studies are also available involving children with no clinical mood diagnoses (156,177) , children diagnosed with developmental co-ordination disorder (178) , children and adolescents diagnosed with autism (158) and adults with diagnosed self-harm (126) . Three studies found improvements in inattention following supplementation with EPA þ DHA þn-6PUFA (170,177,178) compared with placebo, two studies found improvements in hyperactivity following supplementation with EPA þ DHA (158) and EPA þ DHA þ n-6PUFA (178) compared with placebo, one study found improvements in impulsivity following supplementation with EPA þ DHA (156) , two studies found improvements in general ADHD symptoms following supplementation with EPA þ DHA þn-6PUFA (177,178) compared with placebo, and one study found improvements in disruptive behaviour following supplementation with EPA þ DHA þ n-6PUFA (170) .…”

The Oxford‐Durham study: a randomized, controlled trial of dietary supplementation with fatty acids in children with developmental co‐ordination disorder

“…4 Some benefits from -3/-6 supplementation were reported for children with dyslexia or ADHD, 5,6 whereas 2 studies found no benefits for ADHD with the -3 fatty acid docosahexaenoic acid alone. 7,8 No randomized, controlled trials of fatty acid treatment for either autism or DCD/dyspraxia have yet been reported, although one small open study suggested possible benefits for dyspraxic children. 9 DCD, as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), involves specific impairments of motor function independent of general ability.…”