Combined ω3 and ω6 Supplementation in Children With Attention-Deficit Hyperactivity Disorder (ADHD) Refractory to Methylphenidate Treatment

Perera, Hemamali; Jeewandara, Kamal Chandima; Seneviratne, Sumudu Nimali; Guruge, Chandima

doi:10.1177/0883073811435243

Cited by 63 publications

(57 citation statements)

References 29 publications

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“…showing some improvements (195)(196)(197)(198)(199)(200)(201)(202)(203)(204)(205) and others finding no effect (206)(207)(208)(209)(210)(211)(212)(213)(214) . These trials have been reviewed many times, with differing conclusions.…”

Section: Neurocognitive Healthmentioning

confidence: 99%

Very long-chainn-3 fatty acids and human health: fact, fiction and the future

2017

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Eicosapentaenoic acid (EPA) and docosahexaenoioc acid (DHA) appear to be the most important omega-3 (n-3) fatty acids, but roles for n-3 docosapentaenoic acid (DPA) are now also emerging. Intakes of EPA and DHA are usually low, typically below those recommended.Increased intakes result in higher concentrations of EPA and DHA in blood lipids, cells and tissues. Increased content of EPA and DHA modifies the structure of cell membranes and the function of membrane proteins. EPA and DHA modulate the production of lipid mediators and through effects on cell signaling can alter the patterns of gene expression. Through these mechanisms, EPA and DHA alter cell and tissue responsiveness in a way that often results in more optimal conditions for growth, development and maintenance of health. DHA has vital roles in brain and eye development and function. EPA and DHA have a wide range of physiological roles which are linked to certain health or clinical benefits, particularly related to cardiovascular disease, cancer, inflammation, and neurocognitive function. The benefits of EPA and DHA are evident throughout the life course. Future research will include better identification of the determinants of variation of responses to increased intake of EPA and DHA; more in-depth dose response studies of the effects of EPA and DHA; clearer identification of the specific roles of EPA, DPA and DHA; testing strategies to enhance delivery of n-3 fatty acids to the bloodstream; and exploration of sustainable alternatives to fish-derived very long chain n-3 fatty acids. Omega-3 (n-3) fatty acids -structure, metabolic interrelationships, dietary sources and intakes Omega-3 (n-3) fatty acids are a family of polyunsaturated fatty acids (PUFAs) (1) . They are defined by the position of the double bond closest to the methyl terminus of the hydrocarbon (acyl) chain. This is on carbon number three when counting the methyl carbon as number one.Eicosapentaenoic acid (EPA; 20:5n-3) and docosahexaenoic acid (DHA; 22:6n-3) appear to be the most important n-3 fatty acids (2,3) , although roles for docosapentaenoic acid (DPA; 22:5n-3) are now also emerging (4,5) . Because of their long hydrocarbon chain, EPA, DPA and DHA are sometimes termed very long chain n-3 fatty acids, in order to differentiate them from the 18-carbon plant-derived n-3 fatty acids like -linolenic acid (ALA; 18:3n-3) and stearidonic acid (SDA; 18:4n-3). In this article, the term "very long chain n-3 fatty acids" will be used to individually and collectively describe EPA, DPA and DHA.EPA, DPA and DHA are metabolically related to one another, and there is a pathway by which EPA can be synthesized from the simpler plant-derived n-3 fatty acids (Figure 1).The conversion of ALA to EPA involves three steps catalyzed, in turn, by delta-6 desaturase, elongase 5 and delta-5 desaturase (Figure 1). Further conversion of EPA to DHA, via DPA, occurs by a complex pathway (Figure 1) involving chain elongation catalyzed by elongase 5, a second chain elongation catalyzed by elongase 2 or 5...

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Section: Neurocognitive Healthmentioning

confidence: 99%

Very long-chainn-3 fatty acids and human health: fact, fiction and the future

2017

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“…We added 5 studies that none of the other meta-analyses used. Three of these are relatively new reports that met our criteria for inclusion (Milte et al, 2012; Perara, Jeewandara, Seneviratne, & Guruge, 2012; Richardson, Burton, Sewell, Spreckelsen, & Montgomery, 2012). As far as we can tell, should they have been published at the time, they would have met the inclusion criteria for one or more of the prior meta-analyses.…”

Section: Introductionmentioning

confidence: 99%

Omega−3 fatty acid and ADHD: Blood level analysis and meta-analytic extension of supplementation trials

Hawkey

Nigg

2014

Clinical Psychology Review

136

115

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Interest in the value of Omega—3 (n—3) fatty acid supplementation for treatment of ADHD remains high. No prior meta-analysis has examined whether ADHD is associated with alterations in blood lipid levels and meta-analyses of supplementation have reached conflicting conclusions. Methods We report two new meta-analyses. Study 1 examined blood levels of Omega—3 fatty acids in relation to ADHD. Study 2 examined a larger sample of randomized intervention trials than previously reported. Results Study 1 included 9 studies (n = 586) and found lower overall blood levels of n—3 in individuals with ADHD versus controls (g = 0.42, 95% CI = 0.26–0.59; p < .001). Study 2 included 16 studies (n = 1408) and found that n—3 supplementation improved ADHD composite symptoms; using the best available rating and reporter (g = 0.26, 95% CI = 0.15–0.37; p < .001). Supplementation showed reliable effects on hyperactivity by parent and teacher report, but reliable effects for inattention only by parent report. Conclusions Omega—3 levels are reduced in children with ADHD. Dietary supplementation appears to create modest improvements in symptoms. There is sufficient evidence to consider Omega—3 fatty acids as a possible supplement to established therapies. However it remains unclear whether such intervention should be confined to children with below normal blood levels.

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“…Research has suggested that an n-3 PUFA deficiency may lead to a variety of neuronal and psychological abnormalities, such as attention-deficit hyperactivity disorder, depression, schizophrenia, autism and anxiety [1,11,12,[15][16][17][18][19]. N-3 PUFA deficiency in rodents can result in hyperactivity, a feature underlying these neuropsychiatric disorders [14,20,21].…”

Section: Introductionmentioning

confidence: 99%