Whether ADHD may be related to inadequate bioavailability of omega 3 fatty acids, or that it may be improved by dietary supplementation, has drawn increasing interest, due to the growing awareness of the role of nutrition in neural development, and, potentially in ADHD.
Polyunsaturated fatty acids (PUFAs) exist in two classes: Omega 3 (n-3) and Omega 6 (n-6), and humans cannot synthesise either. Optimal health and development require a balanced ratio of n-3 to n-6 but the typical Western diet provides a much larger share of n-6 as compared to n-3, often resulting in an imbalance and insufficient intake of n-3.
Multiple studies, reviews and three meta analyses have examined the efficacy of fatty acid supplementation on ADHD symptoms. Prior to 2014, it was unclear as to whether children with ADHD had inadequate baseline omega-3 levels. This was considered a relevant finding, directing future work that could determine whether all or only some children with ADHD may benefit from Omega-3 supplementation. Moreover, it remains uncertain as to whether ADHD symptom domains such as inattention/disorganization or hyperactivity/impulsivity respond differently to Omega-3 supplementation and dosing protocols.
A recent meta-analyses published in the journal, Clinical Psychology Review (2014), noted that children with ADHD exhibit lower blood levels of Omega-3 Fatty Acids. It was also indicated that children diagnosed with ADHD have reduced blood levels of the essential fatty acids, EPA and DHA, a result of either inadequate dietary intake or disruption in the conversion of the Omega-3 fatty acid, Alpha Linolenic Acid (ALA), to the polyunsaturated fatty acids EPA/DHA. Of the research undertaken thus far, there is no reliable data to suggest differences in dietary intake of fatty acids among children diagnosed with ADHD compared to the 'typical developing child'. It is therefore noted by the authors that further research be undertaken to ascertain whether children with ADHD have an inability to convert ALA to EPA/DHA.
Recent findings suggest an overall reduction in ADHD symptoms when children are administered EPA/DHA supplementation. Theoretically, direct administration of EPA/DHA is capable of bypassing conversion of ALA to EPA/DHA, potentially elevating blood levels of essential fatty acids. However, it must be made clear that the foregoing notion is still under investigation, despite growing evidence that high doses of EPA/DHA are capable of reducing ADHD symptoms. Nonetheless, further investigation is required before EPA/DHA supplementation is recommended as a reliable source of supplementation for children with ADHD.
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