ADHD and ADD
Attention issues like attention deficit/hyperactivity disorder (ADHD) seem to be diagnosed with increasing prevalence in both children and adults alike. Millions of children and adults are living with attention problems, for example, and many people wonder what the most effective treatment for the disorder might be. The interest in “natural” remedies – a remedy that can be achieved by altering diet or other lifestyle choices – is particularly high. This is perhaps especially true when it comes to children as many parents are understandably concerned about giving their children excessive medication at such a young age.
What treatment options for attention issues aside from a prescription are out there? One interesting area is the role of omega 3 fatty acids in attention and viability of using polyunsaturated fatty acids (PUFAs) as a treatment for attention problems.
Research on Omega 3 for ADD and ADHD
Before I get too far into the post, I want to take just a moment to talk about the current research regarding fatty acids and attention issues. While reading this post, you might find yourself a bit confused at some of the information presented – it might seem as though the evidence is unclear or incomplete, in other words. And that is because, to be frank, the data is a bit preliminary at the moment. We have a lot of research on the use of omega 3s that is quite messy, as different studies use different types of fatty acids – vegetarian vs fish oil, at different concentration and in different ratios of EPA/DHA and with a variety of active placebos. Don’t worry if the information seems a bit confusing at first – I’ll do my best to make it as clear as possible!
The Studies on Omega 3 for ADHD – Overall Trends
Now that we have the above out of the way, let’s talk about the data! Out of the studies I have analyzed, a few trends emerged regarding the effectiveness of using fatty acids to help treat attention issues. In general, parents reported that their children displayed fewer symptoms associated with attention issues when taking increased levels of PUFAs (polyunsaturated fatty acids), particularly combined ω-3/6 (omega 3 and omega 6) PUFA supplements, than they did when taking the placebo. With that said, without the combined ω-3/6 supplements, the impact of PUFAs on attention issues was negligible. This was explicitly investigated by the first study, published in 2012 and linked above.
A second study, published in 2014, was conducted as a meta analysis. The results of this study ultimately reinforce those of the first, with parent-rated symptoms of attention issues decreasing significantly when PUFA supplements were administered versus the placebo. It should be noted, however, that much like the first study, parent-rated symptoms was the only rating that decreased significantly as a result of PUFA supplementation.
So what exactly does this mean for attention issues and fatty acids? Well, it might initially sound as though there is little hope in this particular area, however it is important to understand that the studies also acknowledged that as the studies wore on, the interaction between eicosapentaenoic acid (EPA) and γ-linolenic acid (GLA) were associated with a significant decrease in inattention. That means that fatty acids might still be useful in the fight against attention issues – the exact duration, dosage, and interaction simply need to be discovered. Some studies hint that higher doses may matter, but this has not been established.
Omega 3s and Oppositional Behavior in ADHD
Finally, let’s take a look at how PUFA supplementation affects symptoms common with attention issues such as oppositional behavior, emotional dysregulation, and conduct problems. Published in 2016, this meta-analysis and systematic review found at most small benefits of omega-3 supplementation for emotional lability and oppositional behavior in some children with ADHD, and ruled out moderate-to-large effects. Note that this study specifically studied the effect of omega 3 (ω-3) on symptoms. Omega-3s are not a substitute for evidence-based ADHD treatment.
To briefly sum up all of the above information, PUFAs present an interesting supplemental treatment option for individuals with attention issues. This is especially true of a combined omega 3 and omega 6 supplements, which saw parent-rated symptoms decrease in multiple studies. Omega 3 supplementation showed, at most, small benefits for behavioral issues like emotional lability and oppositional behavior in some children with ADHD. While the studies presented in this post found that PUFA supplementation was only somewhat effective as a treatment option, it should be noted once again that the relative dearth of quality and in-depth studies in this area greatly impact those conclusions.
In conclusion, the interaction of PUFAs and attention issues is an area that is ripe for careful, thorough future research. Studies to date have found that PUFA supplementation, especially a combination of omega 3 and omega 6 fatty acids, has been linked to small improvements in some parent-rated ADHD symptoms and behavior issues. Omega-3s are not a substitute for evidence-based ADHD treatment. High-dose fish oil can increase bleeding risk with blood thinners, so check with your clinician before starting, especially if you or your child take psychiatric medication, or if you are pregnant or breastfeeding.
