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Reduced Symptoms of Inattention after Dietary Omega-3 Fatty Acid Supplementation in Boys with and without Attention Deficit/Hyperactivity Disorder.

Bos DJ, Oranje B, Veerhoek ES, Van Diepen RM, Weusten JM, Demmelmair H, Koletzko B, de Sain-van der Velden MG, Eilander A, Hoeksma M, Durston S - Neuropsychopharmacology (2015)

Bottom Line: Nonpharmacological treatments include dietary supplementation with omega-3 fatty acids, although their effectiveness remains to be shown conclusively.Phospholipid DHA level at follow-up was higher for children receiving EPA/DHA supplements than placebo.This effect does not appear to be mediated by cognitive control systems in the brain, as no effect of supplementation was found here.

View Article: PubMed Central - PubMed

Affiliation: NICHE Lab, Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.

ABSTRACT
Attention deficit/hyperactivity disorder (ADHD) is one of the most common child psychiatric disorders, and is often treated with stimulant medication. Nonpharmacological treatments include dietary supplementation with omega-3 fatty acids, although their effectiveness remains to be shown conclusively. In this study, we investigated the effects of dietary omega-3 fatty acid supplementation on ADHD symptoms and cognitive control in young boys with and without ADHD. A total of 40 boys with ADHD, aged 8-14 years, and 39 matched, typically developing controls participated in a 16-week double-blind randomized placebo-controlled trial. Participants consumed 10 g of margarine daily, enriched with either 650 mg of eicosapentaenoic acid (EPA)/docosahexaenoic acid (DHA) each or placebo. Baseline and follow-up assessments addressed ADHD symptoms, fMRI of cognitive control, urine homovanillic acid, and cheek cell phospholipid sampling. EPA/DHA supplementation improved parent-rated attention in both children with ADHD and typically developing children. Phospholipid DHA level at follow-up was higher for children receiving EPA/DHA supplements than placebo. There was no effect of EPA/DHA supplementation on cognitive control or on fMRI measures of brain activity. This study shows that dietary supplementation with omega-3 fatty acids reduces symptoms of ADHD, both for individuals with ADHD and typically developing children. This effect does not appear to be mediated by cognitive control systems in the brain, as no effect of supplementation was found here. Nonetheless, this study offers support that omega-3 supplementation may be an effective augmentation for pharmacological treatments of ADHD (NCT01554462: The Effects of EPA/DHA Supplementation on Cognitive Control in Children with ADHD; http://clinicaltrials.gov/show/NCT01554462).

No MeSH data available.


Related in: MedlinePlus

Main effect of omega-3 PUFA supplementation. (a) The mean difference between baseline and follow-up CBCL attention problems in both diagnostic groups, with main effects of diagnosis and the intervention. (b) The mean difference between baseline and follow-up square-root transformed %DHA levels as collected from cheek cell samples, with similar main effects. The asterisks denote significance at p<0.01. ADHD, attention deficit/hyperactivity disorder; CBCL, Child Behavior Checklist; DHA, docosahexaenoic acid; RG, reference group of typically developing children.
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fig2: Main effect of omega-3 PUFA supplementation. (a) The mean difference between baseline and follow-up CBCL attention problems in both diagnostic groups, with main effects of diagnosis and the intervention. (b) The mean difference between baseline and follow-up square-root transformed %DHA levels as collected from cheek cell samples, with similar main effects. The asterisks denote significance at p<0.01. ADHD, attention deficit/hyperactivity disorder; CBCL, Child Behavior Checklist; DHA, docosahexaenoic acid; RG, reference group of typically developing children.

Mentions: At baseline, subjects with ADHD scored higher than the reference group on the CBCL subscales Attention Problems (p<0.001, see Table 2), Rule Breaking Behavior (p<0.001), and Aggressive Behavior (p<0.001). CBCL scores did not correlate with age in either diagnostic group. Completer analyses by means of ANCOVA showed a main effect of diagnostic status (F(1, 67)=6.92, p=0.011) at follow-up, where children with ADHD scored higher on CBCL attention problems. ANCOVA further showed a main effect of treatment condition, where after supplementation with omega-3 PUFAs, scores on CBCL attention problems were reduced in comparison with supplementation with placebo (Figure 2a: F(1, 67)=14.99, p<0.001). Although there was no interaction between diagnostic status and treatment condition, it should be noted that the typically developing group receiving active treatment did not show a significant reduction in attention problems. The ITT analysis using the LME model yielded similar results for CBCL attention problems showing a significant effect of diagnostic status (MAD=6.37, 95% CI 8.31–4.42), t(90)=6.51, p<0.001) and an interaction effect between treatment condition and time (MAD=−1.83, 95% CI (−2.91 to −0.76), t(67)=3.42, p=0.001). There were no significant effects of treatment on the CBCL Rule Breaking and Aggressive Behavior subscales, or on the SWAN questionnaire.


Reduced Symptoms of Inattention after Dietary Omega-3 Fatty Acid Supplementation in Boys with and without Attention Deficit/Hyperactivity Disorder.

Bos DJ, Oranje B, Veerhoek ES, Van Diepen RM, Weusten JM, Demmelmair H, Koletzko B, de Sain-van der Velden MG, Eilander A, Hoeksma M, Durston S - Neuropsychopharmacology (2015)

Main effect of omega-3 PUFA supplementation. (a) The mean difference between baseline and follow-up CBCL attention problems in both diagnostic groups, with main effects of diagnosis and the intervention. (b) The mean difference between baseline and follow-up square-root transformed %DHA levels as collected from cheek cell samples, with similar main effects. The asterisks denote significance at p<0.01. ADHD, attention deficit/hyperactivity disorder; CBCL, Child Behavior Checklist; DHA, docosahexaenoic acid; RG, reference group of typically developing children.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4538345&req=5

fig2: Main effect of omega-3 PUFA supplementation. (a) The mean difference between baseline and follow-up CBCL attention problems in both diagnostic groups, with main effects of diagnosis and the intervention. (b) The mean difference between baseline and follow-up square-root transformed %DHA levels as collected from cheek cell samples, with similar main effects. The asterisks denote significance at p<0.01. ADHD, attention deficit/hyperactivity disorder; CBCL, Child Behavior Checklist; DHA, docosahexaenoic acid; RG, reference group of typically developing children.
Mentions: At baseline, subjects with ADHD scored higher than the reference group on the CBCL subscales Attention Problems (p<0.001, see Table 2), Rule Breaking Behavior (p<0.001), and Aggressive Behavior (p<0.001). CBCL scores did not correlate with age in either diagnostic group. Completer analyses by means of ANCOVA showed a main effect of diagnostic status (F(1, 67)=6.92, p=0.011) at follow-up, where children with ADHD scored higher on CBCL attention problems. ANCOVA further showed a main effect of treatment condition, where after supplementation with omega-3 PUFAs, scores on CBCL attention problems were reduced in comparison with supplementation with placebo (Figure 2a: F(1, 67)=14.99, p<0.001). Although there was no interaction between diagnostic status and treatment condition, it should be noted that the typically developing group receiving active treatment did not show a significant reduction in attention problems. The ITT analysis using the LME model yielded similar results for CBCL attention problems showing a significant effect of diagnostic status (MAD=6.37, 95% CI 8.31–4.42), t(90)=6.51, p<0.001) and an interaction effect between treatment condition and time (MAD=−1.83, 95% CI (−2.91 to −0.76), t(67)=3.42, p=0.001). There were no significant effects of treatment on the CBCL Rule Breaking and Aggressive Behavior subscales, or on the SWAN questionnaire.

Bottom Line: Nonpharmacological treatments include dietary supplementation with omega-3 fatty acids, although their effectiveness remains to be shown conclusively.Phospholipid DHA level at follow-up was higher for children receiving EPA/DHA supplements than placebo.This effect does not appear to be mediated by cognitive control systems in the brain, as no effect of supplementation was found here.

View Article: PubMed Central - PubMed

Affiliation: NICHE Lab, Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.

ABSTRACT
Attention deficit/hyperactivity disorder (ADHD) is one of the most common child psychiatric disorders, and is often treated with stimulant medication. Nonpharmacological treatments include dietary supplementation with omega-3 fatty acids, although their effectiveness remains to be shown conclusively. In this study, we investigated the effects of dietary omega-3 fatty acid supplementation on ADHD symptoms and cognitive control in young boys with and without ADHD. A total of 40 boys with ADHD, aged 8-14 years, and 39 matched, typically developing controls participated in a 16-week double-blind randomized placebo-controlled trial. Participants consumed 10 g of margarine daily, enriched with either 650 mg of eicosapentaenoic acid (EPA)/docosahexaenoic acid (DHA) each or placebo. Baseline and follow-up assessments addressed ADHD symptoms, fMRI of cognitive control, urine homovanillic acid, and cheek cell phospholipid sampling. EPA/DHA supplementation improved parent-rated attention in both children with ADHD and typically developing children. Phospholipid DHA level at follow-up was higher for children receiving EPA/DHA supplements than placebo. There was no effect of EPA/DHA supplementation on cognitive control or on fMRI measures of brain activity. This study shows that dietary supplementation with omega-3 fatty acids reduces symptoms of ADHD, both for individuals with ADHD and typically developing children. This effect does not appear to be mediated by cognitive control systems in the brain, as no effect of supplementation was found here. Nonetheless, this study offers support that omega-3 supplementation may be an effective augmentation for pharmacological treatments of ADHD (NCT01554462: The Effects of EPA/DHA Supplementation on Cognitive Control in Children with ADHD; http://clinicaltrials.gov/show/NCT01554462).

No MeSH data available.


Related in: MedlinePlus