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Potential Nutritional Treatment for ADD/ADHD

Dr. David Rabiner’s Atten­tion Research Update drew my atten­tion to some recent research arti­cles on the poten­tial of fat­ty acid dietary sup­ple­men­ta­tion to help treat ADD/ADHD.

Stim­u­lant med­ica­tion for chil­dren with ADD/ADHD has been the pre­dom­i­nant treat­ment for years. Thus far, it has been quite suc­cess­ful, but we have yet to see the long term effects of chron­ic med­ica­tion. Giv­en that, it is worth at least inves­ti­gat­ing alter­na­tive ther­a­pies that can be used either in place of or in con­junc­tion with tra­di­tion­al phar­ma­ceu­ti­cal and behav­ioral treat­ment.

As one of the four pil­lars of brain health, nutri­tion has a sig­nif­i­cant impact on both phys­i­cal struc­tures in the body and behav­ior. Stud­ies sug­gest chil­dren with ADHD have low­er lev­els of both omega-3 and omega-6 essen­tial fat­ty acids.

Omega-3 fat­ty acids are found main­ly in flaxseed oil, canola oil, soy­beans, wal­nuts, hemp seeds, dark green leafy veg­eta­bles, and cold-water fish (salmon, trout, sar­dines, mack­er­el, her­ring, hal­ibut, and cod). These fat­ty acids tend to be low­er in Amer­i­can diets.

Omega-6 fat­ty acids tend to be more com­mon in Amer­i­can diets than the omega-3s. These are found in cook­ing oils includ­ing saf­flower, sun­flower, soy­bean, corn, and cot­ton­seed; meat; egg yolks; and oth­er ani­mal prod­ucts.

While both types are essen­tial to a human diet, a close bal­ance between the types is impor­tant. The ratio should be in the range of 1:1 to 4:1 (in favor of omega-6s), while the typ­i­cal North Amer­i­can diet nor­mal­ly pro­vides exces­sive omega-6 fat­ty acids in the range of 11:1 to 30:1.

Dr. Rabin­er sum­ma­rizes the results of these stud­ies look­ing at fat­ty acid sup­ple­men­ta­tion say­ing:

* There was lit­tle change in children’s motor skills and no indi­ca­tion that treat­ed chil­dren showed greater improve­ment than chil­dren receiv­ing place­bo.

* Before treat­ment, aver­age read­ing and spelling achieve­ment scores were about 1 year below age lev­el for chil­dren in both groups. After 3 months, chil­dren receiv­ing fat­ty acid sup­ple­men­ta­tion gained an aver­age of 9.5 months in read­ing and 6.6 months in spelling. Chil­dren receiv­ing place­bo, in con­trast, gained only 3.3 months in read­ing and 1.2 months in spelling. Thus, com­pared to the place­bo group, gains made by treat­ed chil­dren were high­ly sig­nif­i­cant.

* At base­line, the aver­age score on the ADHD scale of the Con­ners was ele­vat­ed in both groups. Scores for treat­ed chil­dren showed a sig­nif­i­cant decline while scores for place­bo chil­dren were essen­tial­ly unchanged. With­in the treat­ed group, 16 chil­dren ini­tial­ly had scores on the ADHD scale in the clin­i­cal­ly ele­vat­ed range; after 3 months, 7 no longer fell in this range. Among chil­dren in the place­bo group, only 1 of 16 chil­dren showed this same improve­ment.

* ADHD symp­toms declined sig­nif­i­cant­ly in chil­dren who began receiv­ing sup­ple­men­ta­tion. Scores con­tin­ued to decline among chil­dren con­tin­u­ing on active treat­ment.

* On the one hand, par­ents who were blind to their child’s treat­ment sta­tus observed sig­nif­i­cant improve­ment in their child’s core ADHD symp­toms, as well as reduc­tions in cog­ni­tive prob­lems and oppo­si­tion­al behav­ior. By the end of 30 weeks, the mag­ni­tude of this improve­ment was sub­stan­tial, and not dis­sim­i­lar from what is often seen in med­ica­tion treat­ment stud­ies. As not­ed above, these ben­e­fits were linked to fat­ty acid sup­ple­men­ta­tion alone, as the addi­tion of a mul­ti-vit­a­min pro­vid­ed no addi­tion­al ben­e­fit.

* On the oth­er hand, how­ev­er, no com­pa­ra­ble improve­ments were evi­dent in the teacher rat­ings of children’s behav­ior. Thus, despite clear improve­ments observed by par­ents, children’s behav­ior at school did not change, at least as report­ed by their teach­ers.

* The authors note that because treat­ment with fat­ty acid sup­ple­men­ta­tion can take 8–12 weeks before any improve­ment is observed, it would not be advis­able as a stand alone treat­ment when a child’s symp­toms are espe­cial­ly severe, and where more imme­di­ate symp­to­matic relief is required.

The net con­clu­sion seems to be: inter­est­ing and promis­ing research, but not con­clu­sive­ly estab­lished at this point in time.

Ref­er­ences

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4 Responses

  1. Hueina Su says:

    Car­o­line,

    Thank you for shar­ing these fas­ci­nat­ing research find­ings with the Car­ni­val of Heal­ing. I hope future research will find a potent cure for ADD/ADHD. The car­ni­val will be up at my blog short­ly.

    Warm­ly,
    Hueina

  2. Caroline says:

    Hueina, thanks for includ­ing us in the Car­ni­val of Heal­ing.

  3. Arlene Karidis says:

    You men­tion sev­er­al study results begin­ning with “Before treat­ment, aver­age read­ing and spelling achieve­ment scores were about 1 year below age lev­el for chil­dren in both groups. After 3 months, chil­dren receiv­ing fat­ty acid sup­ple­men­ta­tion gained an aver­age of 9.5 months in read­ing and 6.6 months in spelling …”

    Who per­formed the study and where? You ref­er­ence sev­er­al pub­li­ca­tions in your bib­li­og­ra­phy, but I can not tell where these par­tic­u­lar results you ref­er­ence come from. I’d like to be able to attribute the study in an arti­cle I am writ­ing on the use of omega 3’s to improve func­tion in kids with ADHD. Thank you.

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