ω-3 Fatty Acid Supplementation Does Not Affect Autism Spectrum Disorder in Children: A Systematic Review and Meta-Analysis

Horvath, Andrea; Łukasik, Jan; Szajewska, Hania

doi:10.3945/jn.116.242354

Cited by 50 publications

(38 citation statements)

References 11 publications

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“…To the best of our knowledge, there have been two meta-analyses so far to assess the effects of supplementation of omega 3 fatty acids in ASD patient. 23 , 24 The first meta-analysis, which included only two clinical trials with a very small total sample size (n=40), failed to show any benefits of supplementation of omega 3 fatty acids compared to placebo. 23 A more recent meta-analysis by Horvath et al, 24 which included more clinical trials, demonstrated no significant positive impact of supplementation of omega 3 fatty acids on most subscales of the Aberrant Behavior Checklist (ABC), despite an improved lethargy subscale.…”

Section: Introductionmentioning

confidence: 99%

Supplementation of omega 3 fatty acids may improve hyperactivity, lethargy, and stereotypy in children with autism spectrum disorders: a meta-analysis of randomized controlled trials

Cheng¹,

Tseng²,

Chen³

et al. 2017

NDT

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AimDeficiency of omega 3 fatty acids may be linked to autism spectrum disorder (ASD). Evidence about the potential therapeutic effects of supplementation of omega 3 fatty acids is lacking in ASD patients.MethodsWe searched major electronic databases from inception to June 21, 2017, for randomized clinical trials, which compared treatment outcomes between supplementation of omega 3 fatty acids and placebo in patients with ASD. An exploratory random-effects meta-analysis of the included studies was undertaken.Results and conclusionSix trials were included (n=194). Meta-analysis showed that supplementation of omega 3 fatty acids improved hyperactivity (difference in means =−2.692, 95% confidence interval [CI] =−5.364 to −0.020, P=0.048, studies =4, n=109), lethargy (difference in means =−1.969, 95% CI =−3.566 to −0.372, P=0.016, studies =4, n=109), and stereotypy (difference in means =−1.071, 95% CI =−2.114 to −0.029, P=0.044, studies =4, n=109). No significant differences emerged between supplementation of omega 3 fatty acids and placebo in global assessment of functioning (n=169) or social responsiveness (n=97). Our preliminary meta-analysis suggests that supplementation of omega 3 fatty acids may improve hyperactivity, lethargy, and stereotypy in ASD patients. However, the number of studies was limited and the overall effects were small, precluding definitive conclusions. Future large-scale randomized clinical trials are needed to confirm or refute our findings.

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Section: Introductionmentioning

confidence: 99%

Supplementation of omega 3 fatty acids may improve hyperactivity, lethargy, and stereotypy in children with autism spectrum disorders: a meta-analysis of randomized controlled trials

Cheng¹,

Tseng²,

Chen³

et al. 2017

NDT

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“…EPA and DHA are of fundamental importance for brain structure and function because they are orthomolecules and their functional sites are exclusively cell membranes ( 92 ). Therefore, DHA and EPA have been studied for the treatment of multiple neurodevelopmental disorders, including ASD ( 93 , 94 ), ADHD ( 95 , 96 ), schizophrenia ( 97 ), and mood disorders ( 98 , 99 ). Also, reduced concentrations of omega-3 fatty acids have been observed in children with ASD ( 10 , 100 ), suggesting omega-3 fatty acids supplementation may be of help for the treatment of symptoms associated with ASD.…”

Section: Resultsmentioning

confidence: 99%

“…Among the six included RCTs, five showed that omega-3 fatty acid supplementation does not affect core symptoms of ASD in overall measures, and the only study that reported the most significant results was clearly limited in sample size ( 105 ). Besides, a recent meta-analysis of five RCTs have assessed the association, and results from their quantitative analyses indicated that there were no statistically significant differences in ASD symptoms between groups measured by validated scales ( 93 ).…”

Section: Resultsmentioning

confidence: 99%

Dietary Supplement for Core Symptoms of Autism Spectrum Disorder: Where Are We Now and Where Should We Go?

2017

Front. Psychiatry

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Autism spectrum disorders (ASDs) are a class of severe and chronic conditions and core symptoms are deficits in social interaction, language communication impairments, and repetitive/stereotyped behavior. Given the limitations of available treatments and substantially increased prevalence of the disease, additional interventions are needed. Since the use of dietary supplements for ASD is of high prevalence, up-to-date information about those supplements are required for both parents and clinicians. Relevant articles were identified through a systematic search of PubMed, EMBASE, Cochrane library, and PsychINFO databases (through May 2017). Current best evidences of 22 randomized controlled trials on 8 different dietary supplements for core symptoms of ASD were reviewed. For each supplement, this report focuses on the definition and potential therapeutic mechanisms, the latest advances, and discussion of study limitations and future directions. Most studies were small and short term, and there is little evidence to support effectiveness of dietary supplements for children with ASD.

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“…Previous systematic reviews on PUFAs for children and adolescents with ASD included respectively two RCTs [64], four RCTs [65], and five RCTs [66] concluding that there was no evidence of effect [64,66] or that PUFAs could potentially improve some ASD symptoms [65]. The differences between our findings and the one of the meta-analysis of RCTs by Mazahery et al [65], especially when considering the efficacy of PUFAs on communication outcome they found (4 RCTs; MD -1.96, 95% CI − 3.57 to − 0.34), could be partially due to the different methods used: the authors performed their analyses extracting the mean change and SD of change from baseline to endpoint.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, we used the Standardized Mean Difference to pool data from assessed through different scales, while Mazahery et al extracted only data regarding ABC subscales. Horvath et al [66] performed different meta-analyses for each instrument used to assessed the outcomes of interest; they found PUFAs to be efficacious in improving lethargy-social withdrawal (2 RCTs; MD 1.98, 95% CI 0.32 to 3.63) when assessed with the ABC, and daily-living (1 RCT; MD 6.2, 95% CI 0.37 to 12.03) as assessed by VABS. Also, the authors found the PUFAs to worsen externalizing behavior (2 RCTs; MD -6.22, 95% CI − 10.9 to − 1.59) and social skills (1 RCT; MD -7.0, 95% CI − 13.62 to − 0.38) as assessed through BASC.…”

Section: Discussionmentioning

confidence: 99%

Impact of polyunsaturated fatty acids on patient-important outcomes in children and adolescents with autism spectrum disorder: a systematic review

Crescenzo

D’Alò

Morgano

et al. 2020

Health Qual Life Outcomes

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Background: Recent randomized controlled trials (RCTs) claimed PUFAs to be effective for autism spectrum disorder (ASD) but international guidelines have not considered yet this body of evidence. Our aim was to assess the effectiveness of PUFAs in children and adolescents with ASD, for the Italian national guidelines on the management of ASD in children and adolescents. Methods: We performed a systematic review and meta-analysis of RCTs comparing PUFAs versus placebo or a healthy diet for the treatment of ASD in children and adolescents. The outcomes considered were deemed by the guideline panel to be highly relevant to children and adolescents with ASD and to their caregivers. The outcomes included hyperactivity, quality of sleep, self-harm, aggression, irritability, anxiety, attention, adaptive functioning, social interaction, restricted and repetitive interests and behavior, communication, hyperactivity and disruptive behaviors coexistent with core symptoms. The risk of bias of the included studies was assessed with the Cochrane tool, and the rating of the confidence in the effect estimates according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results: We included 9 studies with 405 participants. The strength of evidence ranged from low to very low. Six studies included preschoolers and school-age children, three studies included both children and adolescents. The majority of participants were males (83.8%), with a mean age of 6.7 years. PUFAs were superior compared to placebo in reducing anxiety in individuals with ASD (SMD-1.01, 95% CI − 1.86 to − 0.17; very low certainty of evidence). Moreover, PUFAs worsened quality of sleep compared to a healthy diet (SMD 1.11, 95% CI 0.21 to 2.00; very low certainty of evidence). PUFAs were not better than placebo in reducing aggression, hyperactivity, adaptive functioning, irritability, restricted and repetitive interests and behaviors and communication. Effects on some critical outcomes such as sleep, self-harm and disruptive behavior are currently unknown. The main limitations were the small number of participants included in the RCTs and the dosage which varied greatly (from 200 mg/day to 1540 mg/day), making it difficult to address causal inference.

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ω-3 Fatty Acid Supplementation Does Not Affect Autism Spectrum Disorder in Children: A Systematic Review and Meta-Analysis

Cited by 50 publications

References 11 publications

Supplementation of omega 3 fatty acids may improve hyperactivity, lethargy, and stereotypy in children with autism spectrum disorders: a meta-analysis of randomized controlled trials

Supplementation of omega 3 fatty acids may improve hyperactivity, lethargy, and stereotypy in children with autism spectrum disorders: a meta-analysis of randomized controlled trials

Dietary Supplement for Core Symptoms of Autism Spectrum Disorder: Where Are We Now and Where Should We Go?

Impact of polyunsaturated fatty acids on patient-important outcomes in children and adolescents with autism spectrum disorder: a systematic review

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