DHA/EPA Supplementation Found to Reduce Symptoms of ADHD in Dutch Children

April 24, 2015


Reduced Symptoms of Inattention after Dietary Omega-3 Fatty Acid Supplementation in Boys with and without Attention Deficit/Hyperactivity Disorder
Bos, D. J. et al., Neuropsychopharmacology , in press , 2015
Dept. of Psychiatry , University Medical Ctr. Utrecht, The Netherlands


ADHD (Attention deficit hyperactivity disorder) is a developmental neuropsychiatric disorder found in approximately 7 % of children often resulting in inattention symptoms which can adversely affect performance in school. ADHD management can involve combinations of counselling, lifestyle modifications, and medications. While the existing literature has reported lower levels of DHA/EPA omega-3 fatty acids in children and adolescents with ADHD, the intervention trials to date have given mixed results. Thus, the present clinical trial was designed to evaluate the effects of dietary supplementation with DHA/EPA on ADHD symptoms in young boys with and without ADHD. In this randomized and placebo-controlled trial, 40 boys between the ages of 8-14 years with a DSM-IV diagnosis of ADHD were recruited through the Dept. of Psychiatry (Univ. Medical Ctr. in Utrecht) while 39 typically-developing matched boys (‘reference group’) were recruited from local schools.

Children (all boys) with ADHD and the reference children consumed either a normal margarine daily with no supplementary DHA/EPA (‘control’ group) or else one which provided 650 mg of DHA plus 650 mg EPA for a 16-week period. At entry and after follow-up, parent-rated behavioral measures to assess the severity of ADHD symptoms along with measurements of omega-3 levels (using cheek cells as collected using cotton swabs). As expected, the latter assessments showed significantly higher levels of DHA in the cheek cell phospholipids (a biomarker for compliance to the omega-3 margarine) in the DHA/EPA-supplemented children at follow-up. At the time of entry, subjects with ADHD scored significantly higher that the reference group for attention problems, rule-breaking behavior, and aggressive behavior. Statistical analyses indicated that, after supplementation , the average measures of attention problems were significantly lower (by 27 %) for the ADHD children who were receiving the supplementary DHA/EPA as compared to the corresponding controls who were not. DHA/EPA supplementation also improved parent-rated attention in the boys without ADHD. Higher levels of omega-3 in the cheek cells were also correlated with lessened attention problems in the ADHD subjects. The authors concluded that ‘this study offers support that omega-3 supplementation may be an effective augmentation for pharmacological treatments of ADHD.’

Dr. Holub's Comments:

The authors noted that previous research using omega-3 supplementation in ADHD subjects which did not show a significant benefit may be related to the use of a supplement which contained much more EPA than DHA whereas the present trial gave equal amounts of each fatty acid. It is noteworthy that most of the children received the DHA/EPA supplementation while still being treated with their regular medication. It can be estimated that the DHA plus EPA intake per day via supplementation (1300 mgs) would be at least 10-fold that of their background dietary intake of these long-chain omega-3 fatty acids.

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