Hello, there my lovelies. Welcome to part 3 of my series The ADHD Diet – where I examine the role food plays in controlling ADHD behavior and symptoms.
I am so delighted to be bringing this series to you. This journey has involved a tonne of review of research and literature. There has been so much learning. The process culminates by bringing the very best to you via these blog posts.
Three weeks ago we flagged off this journey by looking at how Sugar impacts behavior amongst kids.
Last week was all about the much-debated synthetic food colors and their impact on hyperactivity.
This week we move forward with another essential food item that has been much researched: the Poly Unsaturated Fatty Acids (PUFAs) or Omega 3s and 6s.
What Are Omega-3 Fatty Acids?
Fats as a nutrient in our food are termed as
- Good – unsaturated fat
- Bad – saturated fat
- Ugly – trans fat
Most oils derived from animal sources are high in saturated fats and not good for us. Those derived from plant sources are generally good for us because of their high content of unsaturated fats.
However, not all unsaturated fats are healthy. Many plant seed oils such as sunflower, peanut, corn oil contain polyunsaturated fatty acids (PUFAs) of the inflammatory kind.
On the other hand, some plant seed oils such as canola oil, flaxseed oil, and olive oil contain a healthy balance of anti-inflammatory and the inflammatory PUFAs (and are considered better for us.)
The anti-inflammatory PUFAs are the Omega-3 (also written as ω-3 or n-3) fatty acids.
The inflammatory PUFAs are the Omega-6 fatty acids.
The most common Omega-3 fatty acids are ALA, EPA, and DHA.
ALA is mainly found in plants. Olive oil, Canola oil, and flaxseed oil are good sources of ALA. The human body cannot synthesize ALA and must get it from dietary sources. Therefore, it is referred to as an essential fatty acid.
EPA and DHA are mainly found in animal foods (fish) and algae.
Do Omega-3 Fatty Acid Supplements Improve ADHD Symptoms?
In a 2012 Australian study1, 53 children were given randomized supplements of EPA, DHA or a control for 4 months each. The study found that increasing DHA and EPA levels via dietary supplements may improve behavior, attention, and literacy in children with ADHD.
The next year, another study2 showed that supplements of Omega-3 fatty acids produced small but significant reductions in ADHD symptoms.
Around the same time, for another study3, 200 8-16-year-old children were given omega-3 supplements over a 12-month long period. Their behavior was recorded at the start of the study and then at 6-month intervals till 6 months after the supplements were stopped. This was the largest study to date to provide evidence that supplements can reduce behavior problems.
In 2014 a team of researchers sought to find out if Omega-3/6 fatty acids were as effective as methylphenidate and to see if there was potential for them to be used as an alternative to methylphenidate4. Their results showed that Omega-3/6 had benefits similar to MPH. In fact, supplementing MPH with Omega-3/6 showed even greater benefits. Thus, it may be possible to reduce MPH dosages, and therefore, side effects.
In the same year, a meta-analysis5 confirmed
- Omega-3 levels are reduced in children with ADHD.
- Dietary supplements of Omega-3 result in modest improvement of ADHD behavior.
This study once again confirmed the potential of using Omega-3 as a supplement to established therapies.
A review of 52 dietary intervention studies of children with ADHD was done by the University of Copenhagen, Denmark6. The review concluded that fish oil supplements are a promising intervention for a reduction in ADHD symptoms in children. However, they wanted a more thorough investigation in order to recommend these as a part of ADHD treatment.
Another review of literature carried out in 20157 of the studies done during the previous 12 months concluded that ” given the current economic burden of ADHD, estimated in the region of $77 billion in the USA alone, in addition to the fact that a proportion of patients with ADHD are either treatment resistant, nonresponders or withdraw from medication because of adverse side-effects, the investigation of nonpharmacological interventions including omega-3 HUFAs in clinical practice warrants extrapolating.”
In 2017, a research led by Jane Pei-Chen Chang at the King’s College London8 suggested that omega-3s may be used as a treatment option for ADHD.
In summary, here is what we know
Omega-3 PUFA levels are lower in individuals with ADHD.
Several studies, including meta-analyses of studies, have found a small to medium improvement in symptoms of ADHD.
Omega-3 fatty acids may be useful as a supplement to medications or in cases where parents choose not to medicate, the medicine is not effective – as an alternative treatment.
Foods Rich in Omega 3s
Fish oil supplements are the most common way to get your daily supplement of omega-3s. Make sure that yours are mercury free. A list of toxin-free omega-3 products can be found at The International Fish Oil Standards Program website.
Apart from fish oil supplements here are some foods you can add to your daily diet to give a boost to your ADHD brain
- Fish like mackerel, tuna, salmon
- Egg yolks
- Brussels Sprouts
- Sea Weeds
- Soy Beans
So go on, make these a part of your daily diet.
Research about the benefits of Omega-3 Poly Unsaturated Fatty Acids for controlling is very promising.
Do you include Omega-3 rich foods or an omega-3 supplement in your child’s diet? Let me know in the comments below.
Eicosapentaenoic and docosahexaenoic acids, cognition, and behavior in children with attention-deficit/hyperactivity disorder: a randomized controlled trial. Milte CM, Parletta N, Buckley JD, Coates AM, Young RM, Howe PR. Nutrition. 2012 Jun;28(6):670-7. doi: 10.1016/j.nut.2011.12.009. Epub 2012 Apr 25. PMID: 22541055 [pubmed]
Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. Sonuga-Barke EJ, Brandeis D, Cortese S, Daley D, Ferrin M, Holtmann M, Stevenson J, Danckaerts M, van der Oord S, Döpfner M, Dittmann RW, Simonoff E, Zuddas A, Banaschewski T, Buitelaar J, Coghill D, Hollis C, Konofal E, Lecendreux M, Wong IC, Sergeant J; European ADHD Guidelines Group. Am J Psychiatry. 2013 Mar;170(3):275-89. doi: 10.1176/appi.ajp.2012.12070991. [pubmed]
Reduction in behavior problems with omega-3 supplementation in children aged 8-16 years: a randomized, double-blind, placebo-controlled, stratified, parallel-group trial. Raine A, Portnoy J, Liu J, Mahoomed T, Hibbeln JR. J Child Psychol Psychiatry. 2015 May;56(5):509-20. doi: 10.1111/jcpp.12314. Epub 2014 Aug 22. PMID: 25146492 [pmcfreearticle]
Efficacy and Safety of Omega-3/6 Fatty Acids, Methylphenidate, and a Combined Treatment in Children With ADHD. Barragán E, Breuer D, Döpfner M. J Atten Disord. 2017 Mar;21(5):433-441. doi: 10.1177/1087054713518239 [pubmed]
Omega-3 fatty acid and ADHD: blood level analysis and meta-analytic extension of supplementation trials. Hawkey E, Nigg JT. Clin Psychol Rev. 2014 Aug;34(6):496-505. doi: 10.1016/j.cpr.2014.05.005. Epub 2014 Jun 2. PMID: 25181335 [Free PMC Article]
- Diet in the treatment of ADHD in children – a systematic review of the literature. Heilskov Rytter MJ, Andersen LB, Houmann T, Bilenberg N, Hvolby A, Mølgaard C, Michaelsen KF, Lauritzen L. Nord J Psychiatry. 2015 Jan;69(1):1-18. doi: 10.3109/08039488.2014.921933. Epub 2014 Jun 16. [Taylor & Francis]
- Current evidence and future directions for research with omega-3 fatty acids and attention deficit hyperactivity disorder. Rachel V. Gowa, Joseph R. Hibbelna, and Natalie Parlettab. [semantics scholar]
Omega-3 Polyunsaturated Fatty Acids in Youths with Attention Deficit Hyperactivity Disorder: a Systematic Review and Meta-Analysis of Clinical Trials and Biological Studies. Jane Pei-Chen Chang, Kuan-Pin Su, Valeria Mondelli, Carmine M Pariante