Sinn N, Bryan J (2007) Journal of Developmental & Behavioural Pediatrics 28 82-91
Methods: Various developmental problems including attention-deficit/hyperactivity disorder (ADHD) have been linked to biological deficiencies in polyunsaturated fatty acids (PUFAs). Additionally, there is evidence that symptoms may be reduced with PUFA supplementation. This study investigated effects of supplementation with PUFAs on symptoms typically associated with ADHD. Because nutrients work synergistically, additional effects of micronutrient supplementation were also investigated. A total of 132 Australian children aged 7 to 12 years with scores >=2 SD above the population average on the Conners ADHD Index participated in a randomized, placebo-controlled, double-blind intervention over 15 weeks, taking PUFAs alone, PUFAs + micronutrients, or placebo. Due to unreturned questionnaires, data were only available for 104 children.
Results: Significant medium to strong positive treatment effects were found on parent ratings of core ADHD symptoms, inattention, hyperactivity/impulsivity, on the Conners Parent Rating Scale (CPRS) in both PUFA treatment groups compared with the placebo group; no additional effects were found with the micronutrients. After a one-way crossover to active supplements in all groups for a further 15 weeks, these results were replicated in the placebo group, and the treatment groups continued to show significant improvements on CPRS core symptoms. No significant effects were found on Conners Teacher Rating Scales.
Conclusion: These results add to preliminary findings that ADHD-related problems with inattention, hyperactivity, and impulsivity might respond to treatment with PUFAs and that improvements may continue with supplementation extending to 30 weeks.
The lead researcher, Natalie Sinn, wrote:
"The present study is the largest PUFA trial to date with children falling in the clinical ADHD range on Conners Index. The result support those of other studies that have found improvements in developmental problems symptomatic of ADHD with PUFA supplementation. These results have significant implications for children with ADHD-related symptoms, parents, and clinicians."
Dr. Sinn also emphasised that many questions remain unanswered. "This work needs to be replicated in other scientifically controlled trials in populations of children with different constellations of symptoms and other developmental disorders that overlap with ADHD," she was reported as saying by the industry newsletter, Nutraingredients.com
"We need more understanding about biological mechanisms, degree of relative PUFA deficiency and which children are most likely to respond, and also the relative importance of the omega-3 fatty acids EPA and DHA, and the inclusion of omega-6 fatty acid GLA"
We couldn't agree more. And the views attributed to Sarah Newman, a spokesperson for the UK FSA, also seemed sensible:
"The agency is aware that there is some evidence of benefits of fish oil supplements for some children with learning difficulties - such as Attention Deficit Hyperactivity Disorder (ADHD). Although the evidence is not clear enough to justify recommending supplements to be taken by children, it does underline the importance of a healthy balanced diet including fish for children and the need for their carers and meal providers to be advised and trained to deliver this," she said.
"The agency will continue to monitor any emerging evidence in this area."
It would be better still, however, if the FSA would fund some research to address the many questions that still need answering.