Polyunsaturated fatty acids(PUFA) for attention deficit hyperactivitydisorder (ADHD) in children and adolescents
Polyunsaturated fatty acids(PUFA) for attention deficit hyperactivitydisorder (ADHD) in children and adolescents
Year: 2012
Authors: Gillies, D. Sinn, J.K.H. Lad, S.S. Leach, M.J. Ross, M.J.
Publication Name: Cochrane Database of Systematic Reviews
Publication Details: DOI: 10.1002/14651858.CD007986.pub2.
Abstract:
Attention deficit hyperactivity disorder (ADHD) is a major problem in children and adolescents, characterised by age inappropriate levels of inattention, hyperactivity and impulsivity, and is associated with long-term social, academic and mental health problems. The stimulant medications methylphenidate and amphetamine are the most frequently used treatments for ADHD, but these are not always effective and can be associated with side effects. Clinical and biochemical evidence suggests that deficiencies of polyunsaturated fatty acids (PUFA) could be related to ADHD. Children and adolescents with ADHD have been shown to have significantly lower plasma and blood concentrations of PUFA and, in particular, lower levels of omega 3 PUFA. These findings suggest that PUFA supplementation may reduce the attention and behaviour problems associated with ADHD. (Authors abstract)
The objective of this review paper was to compare the efficacy of PUFA to other forms of treatment or placebo in treating the symptoms of ADHD in children and adolescents. Thirteen trials with 1011 participants were included in the review. After screening 18 papers describing the13 trials were included. Eight of the included trials had a parallel design, five compared an omega-3 PUFA supplement to placebo; two compared a combined omega3 and omega6 supplement to placebo, and one compared an omega3 PUFA to a dietary supplement. Five of the included trials had a cross over design: two compared combined omega3 and 6 PUFA to placebo; two compared omega6 PUFA with placebo; one compared omega3 to omega6 PUFA, and one compared omega6 PUFA to dexamphetamine. Supplements were given for a period of between four and 16 weeks. There was a significantly higher likelihood of improvement in the group receiving omega3 and 6 PUFA compared to placebo. However, there were no statistically significant differences in parent-rated ADHD symptoms. There were no statistically significant differences in teacher ratings of overall ADHD symptoms. There were also no differences between groups in behaviour, side effects or loss to follow up. Overall, there were no other differences between groups for any other comparison. Overall, there is little evidence that PUFA supplementation provides any benefit for the symptoms of ADHD in children and adolescents. The majority of data showed no benefit of PUFA supplementation, although there were some limited data that did show an improvement with combined omega 3 and omega 6 supplementation. It is important that future research addresses current weaknesses in this area, which include small sample sizes, variability of selection criteria, variability of the type and dosage of supplementation, short follow up times and other methodological weaknesses. (Editors comments)
The objective of this review paper was to compare the efficacy of PUFA to other forms of treatment or placebo in treating the symptoms of ADHD in children and adolescents. Thirteen trials with 1011 participants were included in the review. After screening 18 papers describing the13 trials were included. Eight of the included trials had a parallel design, five compared an omega-3 PUFA supplement to placebo; two compared a combined omega3 and omega6 supplement to placebo, and one compared an omega3 PUFA to a dietary supplement. Five of the included trials had a cross over design: two compared combined omega3 and 6 PUFA to placebo; two compared omega6 PUFA with placebo; one compared omega3 to omega6 PUFA, and one compared omega6 PUFA to dexamphetamine. Supplements were given for a period of between four and 16 weeks. There was a significantly higher likelihood of improvement in the group receiving omega3 and 6 PUFA compared to placebo. However, there were no statistically significant differences in parent-rated ADHD symptoms. There were no statistically significant differences in teacher ratings of overall ADHD symptoms. There were also no differences between groups in behaviour, side effects or loss to follow up. Overall, there were no other differences between groups for any other comparison. Overall, there is little evidence that PUFA supplementation provides any benefit for the symptoms of ADHD in children and adolescents. The majority of data showed no benefit of PUFA supplementation, although there were some limited data that did show an improvement with combined omega 3 and omega 6 supplementation. It is important that future research addresses current weaknesses in this area, which include small sample sizes, variability of selection criteria, variability of the type and dosage of supplementation, short follow up times and other methodological weaknesses. (Editors comments)
