How Essential Fatty Acids Affect Brain Health and ADHD
Omega-3 and omega-6, the two classes of essential fatty acids also commonly referred to as fish oil (see What Are Omega-3s), participate in brain development and are necessary components of brain cell plasma and membranes.
As such, scientists believe that essential fatty acids may contribute to the absorption or release of neurotransmitters – i.e. chemical signals – between brain cells, which has many implications for people struggling with attention-deficit/ hyperactivity disorder (ADHD) or similar symptoms. Omega-3 supplements are proven to be an effective way of raising levels of fatty acids in our blood profiles.3
The role of omega fatty acids in neural development in utero and during the rapid brain growth of early childhood has led to their inclusion in most dietary recommendations and supplements for pregnant women and young children. Consuming a sufficient amount of fish oil is suggested to encourage healthy cognitive structure and functioning.
Omega-3 and omega-6 essential fatty acids are also building blocks for eicosanoid hormones, other types of chemical messengers that regulate inflammation all over the body, including within the brain. Above certain levels, brain inflammation can negatively impact cognitive functioning. Thus maintaining a chemical environment in the central nervous system that does not promote unnecessary inflammation by maintaining adequate levels of the omegas could likely benefit ADHD symptoms.6
Omega-3 Fish Oil and ADHD
As knowledge grows of how omega-3 fish oil participates in the structure and function of the brain, especially the critical EPA and DHA, scientists have been researching whether bioavailability of EPA and DHA omega-3 fatty acids could be related to ADHD. Samples from studies have shown that children with ADHD have lower levels of both EPA and DHA omega-3 fatty acids in their blood profiles compared to children without attention difficulties.3 This could be due to genetic factors that inhibit the omega-3 metabolic pathway, or deficient dietary consumption, or a combination of both. Regardless of the cause for this lower baseline of omega-3 fatty acids in their systems, a significant number of rigorous scientific studies have shown marked improvements in ADHD symptoms, particularly in the area of attention,2 with dietary supplementation of fish oil.
OmegaBrite contains both EPA and DHA Omega-3 fatty acid fish oil.
Especially remarkable are the 2015 findings that attention improved even in the control group (i.e. normally developing boys included for comparison who did not have age-inappropriate attention deficiencies) in a 16-week double-blind placebo group study of 79 boys. The researchers from European hospitals and medical centers concluded, “Dietary supplementation with omega-3 fatty acids reduces symptoms of ADHD, both for individuals with ADHD and typically developing children.”2
Conclusions across studies that found modest increases in attention abilities that are significant enough to be recommended by some doctors for ADHD treatment in addition to pharmaceuticals for severe cases or as a possible alternative for mild cases or in patients who cannot or do not wish to tolerate drugs.1,2,3,4,5
Omega-3 dietary supplements have been shown to augment the benefits of ADHD prescription medications, allowing many patients to downgrade to a lower dose of psychostimulants.1,4 This is an attractive consideration given the disruptive side effects of common ADHD drugs, such as insomnia and loss of appetite. Some children even showed improvements in the lack of appetite often associated with stimulant medications.4
The absence of harmful downsides to taking fish oil supplements for ADHD led researchers to determine that omega-3 fatty acids have a “relatively benign side-effect profile”1 and a “low incidence of side effects.”3
Ideal Dosage for ADHD Supplements
Recommendations for daily intake of fish oil in typically healthy individuals varies widely between sources, organizations, and countries, and the same holds true between doses used in studies. On average, about 200-550mg of omega-3s per day was administered across scores of clinical trials researching the effects on ADHD symptoms.
Each OmegaBrite capsule contains an ideal 500mg dose of Omega-3 fish oil.
Ratio of EPA: DHA Omega-3 Fatty Acids
Ratios of EPA and DHA omega-3 fatty acids in supplements also varied widely across studies.
In 2014, a study comprised of two meta-analyses of about 580 and 1400 cases in each at Oregon Health & Science University School of Medicine concluded, “Larger doses of EPA showed a greater reduction in ADHD symptoms… larger doses of DHA did not further improve ADHD symptoms.”
These were on par with 2011 findings by two doctors at Yale Child Study Center who extrapolated from data on 699 children: “Omega-3 fatty acid supplementation, particularly those with higher doses of EPA, was modestly effective in the treatment of ADHD.”
OmegaBrite contains 7 EPA:1 DHA of Omega-3 fatty acid fish oil.
References / More Information
Studies on ADHD and Omega-3:
1. Bloch MH, Qawasmi A. Omega-3 fatty acid supplementation for the treatment of children with attention-deficit/ hyperactivity disorder symptomatology: systematic review and meta-analysis. J Am Acad Child Adolesc Psychiatry. 2011; 50:991-1000.
Summary: Meta-analysis of 10 placebo-controlled trials involving 699 children with both clinically diagnosed ADHD and reported but undiagnosed ADHD symptoms. Conclusion: “Omega-3 fatty acid supplementation, particularly those with higher doses of EPA, was modestly effective in the treatment of ADHD… modest compared to currently available pharmacotherapies [i.e. drugs]… relatively benign side-effect profile.”
2. Bos DJ, Oranje B, Veerhoek ES, et al. Reduced symptoms of inattention after dietary omega-3 fatty acid supplementation in boys with and without attention deficit/ hyperactivity disorder. Neuropsychopharmacology. 2015; 40(10):2298-2306.
Summary: 16-week double-blind placebo group study of 40 boys with clinically diagnosed (DSM-IV) ADHD and 39 boys with no reported attention deficiencies of the same age, body mass index, and dominant hand. The conclusion was that “dietary supplementation with omega-3 fatty acids reduces symptoms of ADHD, both for individuals with ADHD and typically developing children… supplementation may be an effective augmentation for pharmacological treatments of ADHD.”
3. Hawkey E, Nigg JT. Omega-3 fatty acid and ADHD: Blood level analysis and meta-analytic extension of supplementation trials. Clin Psychol Rev. 2014; 34(6): 496-505.
Summary: 2 meta-analyses. The first analyzed results of 9 prior studies and concluded, “Omega-3 levels are reduced in children with ADHD.” The second analyzed results of 16 prior studies and found “the effect of Omega-3 fatty acid supplementation is ¼ as large [as ADHD drugs]” with “low incidence of side effects” and thus, “there is enough evidence to justify the use of Omega-3 fatty acids for ADHD as a supplement to other empirically supported therapies.”
4. Konigs A, Kiliaan AJ. Critical appraisal of omega-3 fatty acids in attention-deficit/ hyperactivity disorder treatment. Neuropsychiatric Disease and Treatment. 2016; 12:1869-1882.
Summary: Meta-analysis of 25 studies. 20 double-blind trials with a placebo group and 5 open-label trials without a placebo group. Overall conclusions were, “Two particular groups could benefit from a possible treatment with Omega-3 PUFAs… patients with mild forms of ADHD [and] patients who suffer both from severe ADHD and from side effects of the stimulant treatment.”
5. Sonuga-Barke EJS, Brandeis D, Cortese S, Daley D, Ferrin M, Holtmann M et al. Nonpharmacological interventions for ADHD: systemic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. Am J Psychiatry. 2013; 170:275-289.
Summary: 6 meta-analyses based on 2,904 individual records from prior studies. The analysis of studies using fatty acid supplementation found “beneficial effects on ADHD symptoms, although the effect of the former are small.” Researchers concluded these are “small but significant reductions in ADHD symptoms.”
Articles on Brain and Omega-3:
6. Bazinet RP, Laye S. Polyunsaturated fatty acids and their metabolites in brain function and disease. Nat Rev Neurosci. 2014; 15:771-785.
Summary: Explains how PUFAs participate in brain structure and function to affect mood and cognitive processing. Some disease regulated by these neurological pathways are discussed (ADHD, Dementia, Depression, Alzheimer’s, Parkinson’s, Ischaemia and more). Concludes, “Diet and drugs targeting PUFAs may lead to novel therapeutic approaches for prevention and treatment of disorders.”
double-blind trials – Subjects and evaluators do not know who is being treated or with what amount. Results should be more objective than an open-label trial.
meta-analysis – An analysis of data from prior trials (rather than new clinical trial).
open-label trial – Subjects and researchers know who is being treated. Less objective than a double-blind trial.
placebo group – Control group of untreated subjects for comparison, ideally as physiologically similar to the experimental group in relevant factors as possible (age, gender, diagnosis, genetics, weight, activity level, etc).
Essential Fatty Acids (EFAs):
Polyunsaturated fats (PUFAs) that are critical to consume as we do not synthesize enough of them in the human body for optimal health. They are present in a variety of natural food sources.
Omega-3 Metabolic Pathway:
1. Alpha Linolenic Acid (ALA) – medium-chain, from plant sources that may be slowly converted to the following long-chain fatty acids. The efficiency of this varies between individuals, decreases with age, and may be inhibited by a deficiency in certain vitamins and minerals.
2. Stearidonic Acid
3. Eicosatetraenoic Acid
4. Eicosapentaenoic Acid (EPA) – long-chain, in oily fish, algae, and krill
5. Docosapentaenoic Acid (DPA)
6. Tetracosapentaenoic Acid (24:5n-3 fatty acid)
7. Tetracosahexaenoic Acid (24:6n-3 fatty acid)
8. Docosahexaenoic Acid (DHA) – long-chain, in oily fish, algae, and krill
Omega-6 Metabolic Pathway:
1. Linoleic Acid (LA)
2. Gamma Linolenic Acid (GLA)
3. Dihomo Gamma Linolenic Acid (DGLA or DHGLA)
4. Arachidonic Acid (AA)
5. Adrenic Acid
6. Tetracosatetraenoic Acid (24:4n-6 fatty acid)
7. Tetracosapentaienoic (24:5n-6 fatty acid)
8. Docosapentaenoic Acid
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