Omega-3 may improve concentration and hyperactivity

Omega-3 may improve concentration and hyperactivity

Omega-3 may improve symptoms of ADHD in children

Learning and behaviour problems associated with attention deficit hyperactivity disorder can cause a great deal of distress for children, their parents and teachers.


Recent research supported by CSIRO Human Nutrition and the University of South Australia shows fish oil might provide some relief.

Many people either have, or know someone with, a child who has difficulty sitting still, controlling impulses, or concentrating at school. When these problems start to adversely impact school performance and behaviour, the child may receive a diagnosis of attention deficit hyperactivity disorder (ADHD). The number of children diagnosed with ADHD has increased dramatically in America, Europe and Australia, with recent estimates by the Australian Bureau of Statistics placing 7% of girls and 19% of boys aged 6-12 in this category.

ADHD is more common in boys, and the major symptoms are hyperactivity, impulsivity and inattention. These symptoms often overlap with other problems including learning disabilities (e.g. dyslexia), depression, anxiety, and oppositional or antisocial behaviour, and can be associated with poor academic achievement, low self-esteem and problems with self-discipline. When someone in the family has ADHD, very often there will also be other mental health problems within the same family like developmental disorders (e.g. autism or Asperger’s syndrome), depression and schizophrenia.

Evidence suggests children with ADHD have slower brain wave activity in specific areas of their brain, particularly the frontal lobes (behind the forehead), which are responsible for controlling attention. Studies looking at brainwaves have found that when children normally concentrate on something like reading, their brainwave patterns increase. However, when children with ADHD try to concentrate their brainwave patterns slow down. This would make it very difficult for them to keep their attention focussed.

Therefore many treatments for ADHD aim to address symptoms at a biological level. However, there has been a great deal of concern over increasing prescriptions of stimulant medications for these children. Many people have opted for a nutritional approach, and there is some evidence that eliminating food additives and specific foods from the diet, or nutritional supplementation with zinc might help. A recent study conducted in South Australia has found that fish oil, containing omega-3 fatty acids, may also help alleviate these symptoms.

What are omega-3 fatty acids?

Omega-3 and omega-6 fatty acids are polyunsaturated fats. Unlike saturated fats, which are used for energy and can be harmful (and fattening) if we eat too much of them, polyunsaturated fats are chemically active fats that are important structural components of every cell membrane in our body. A large body of research has shown omega-3 fats are important for cardiovascular health, and can therefore help to maintain a healthy heart. However, our bodies can’t make these polyunsaturated fats, and unfortunately, diets in Western societies have become increasingly deficient in omega-3.

Vegetable sources of omega-3 include dark leafy vegetables, nuts (e.g. walnuts), and seeds (e.g. linseeds/flaxseeds). These can be converted to long-chain omega-3 fatty acids in the body, which are particularly important. However, many people have difficulty making these conversions. For these people the long-chain omega-3 fatty acids can be obtained directly from oily, deep sea fish like tuna, mackerel, pilchards and sardines or marine algae.

Omega-3 fatty acids for concentration and behaviour

How can omega-3 fatty acids help with concentration and behaviour? Most of us are aware of the importance of good nutrition for physical health, but not as many of us think about how food might affect our brain. However, it may make sense if we consider that the brain, just like the heart, liver, kidneys or lungs, is an organ. Furthermore, the brain influences our learning, moods and behaviour. Therefore, if our brain doesn’t receive the right nutrients, this is likely to impact the way we think, feel and behave.

In fact, our brain has very high requirements for energy and nutrients from food, and one of the very important nutrients is omega-3 fatty acids. Over half the brain is fat, and although the body normally has a 10:1 ratio of omega-6:omega-3 fatty acids, the long-chain omega-3 fatty acid DHA is the most concentrated polyunsaturated fat in the brain. Therefore it is thought that long-chain omega-3 fatty acids have important structural and functional roles in the brain, including the maintenance of cell membrane fluidity and transmission of neural chemical signals.

Research has established omega-3 fatty acids are crucial for healthy infant brain development, and researchers are also finding that omega-3 deficiencies might be related to a range of mental health problems including depression, bipolar disorder, schizophrenia, dementia, dyslexia, and ADHD.

The research

A small number of research trials have shown that omega-3s in fish oil might help to reduce symptoms of ADHD1,2,3, although results have been inconsistent. A large study conducted in South Australia with 145 children confirmed that the omega-3s may help with these symptoms.3 Children aged 7-12 years were given either placebo oil or fish oil for 15 weeks, and then all children were given the fish oil for a further 15 weeks. They were given cognitive psychological assessments before, during and after the 30 weeks, and parents filled in questionnaires at each of these times. The trial was double-blind, therefore the children, parents and researchers didn’t know which groups were taking the real fish oil or placebo oil capsules.

After 15 weeks of taking the capsules, children in the fish oil groups showed significant improvements compared with the placebo group on parent ratings of their hyperactivity, impulsivity and inattention. When the placebo group then switched to the fish oil supplement for 15 weeks they showed the same improvements, and the children who had been taking the active fish oil for 30 weeks showed continued improvements. The cognitive assessments also showed improvements in children’s ability to switch and control their attention, and in their vocabulary (ability to define the meaning of words). This may be an indirect benefit from increased concentration span resulting in longer reading time. Anecdotally, one parent reported that her son was reading for up to an hour at a time, whereas beforehand he was unable to concentrate on reading for longer than 5 minutes.

Should I give fish oil to my child?

The results from this research are very promising. It should be noted that it can take up to 8-12 weeks to start seeing improvements from the fish oil, and that not all children showed the same benefits. Up to half the children showed notable improvements over 30 weeks of supplementation. Further research needs to determine which children are most likely to benefit and which ratio of omega-3 fatty acids EPA and DHA is most effective. We also need to look more closely at specific effects of fish oil on cognition and learning.

No adverse side effects from taking the fish oil have been reported in studies to date, although omega-3 fatty acids do have a blood thinning effect (hence their benefit for blood circulation and cardiovascular health). Therefore, caution is advised when taking aspirin (which also has a blood thinning effect) and in people with haemophilia. Recently published guidelines recommended an upper limit of 3g fish oil per day in children and adults.

The fish oil supplement used for our study contained a 4:1 ratio of fish oil to evening primrose oil (containing omega-6 fatty acids) with active ingredients EPA (93 mg), DHA (29 mg), GLA (10 mg), and vitamin E (1.8 mg). Children took six capsules per day, providing a daily dose of 2.4g fish oil and 0.6g evening primrose oil. It is important to note that although this combination of polyunsaturated fatty acids has shown positive results with ADHD-related symptoms, it is not yet clear how important the addition of the evening primrose oil or the high EPA:DHA ratio is.

It is also important to recognise that the symptoms associated with ADHD are complex, and could be impacted by various biological, nutritional and environmental influences. Therefore, parents who have concerns about their child’s learning or behaviour are advised to consult their physician.

 

References:

  1. Richardson AJ. Clinical trials of fatty acid supplementation in ADHD. In: Glen AIM, Peet M, Horrobin DF, eds. Phospholipid Spectrum Disorders in Psychiatry and Neurology. Carnforth: Marius Press; 2003:529-541.
  2. Sinn N, Wilson C. Dietary supplementation with highly unsaturated fatty acids: Implications for interventions with persons with mental retardation from research on infant cognitive development, ADHD, and other developmental disabilities. International Review of Research in Mental Retardation. 2006;32:159-196.
  3. Richardson AJ, Montgomery P. The Oxford-Durham study: a randomised, controlled trial of dietary supplementation with fatty acids in children with developmental coordination disorder. Pediatrics. 2005;115:1360-1366.
  4. Sinn N, Bryan J. Effect of supplementation with polyunsaturated fatty acids and micronutrients on attention and behavior problems associated with child ADHD. Journal of Developmental & Behavioral Pediatrics. 2006;28(2):82-91.

Acknowledgements

Thanks go to Dr Janet Bryan and Dr Carlene Wilson for their help with the SA project, and Equazen UK / Novasel Australia for supply of fish oil supplements.

This article was originally published by Australasian Science, September 2006, in the name Natalie Sinn.

 

 

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