The Oxford-Durham Study: A Randomized, Controlled Trial of Dietary Supplementation With Fatty Acids in Children With Developmental Coordination Disorder

Abstract

In addition to the core deficits in motor function, this condition is associated commonly with difficulties in learning, behavior, and psychosocial adjustment that persist into adulthood. Mounting evidence suggests that a relative lack of certain polyunsaturated fatty acids may contribute to related neurodevelopmental and psychiatric disorders such as dyslexia and attention-deficit/hyperactivity disorder. Given the current lack of effective, evidence-based treatment options for DCD, the use of fatty acid supplements merits investigation. Methods. A randomized, controlled trial of dietary supplementation with -3 and -6 fatty acids, compared with placebo, was conducted with 117 children with DCD (5-12 years of age). Treatment for 3 months in parallel groups was followed by a 1-way crossover from placebo to active treatment for an additional 3 months.Results. No effect of treatment on motor skills was apparent, but significant improvements for active treatment versus placebo were found in reading, spelling, and behavior over 3 months of treatment in parallel groups. After the crossover, similar changes were seen in the placebo-active group, whereas children continuing with active treatment maintained or improved their progress.Conclusions. Fatty acid supplementation may offer a safe efficacious treatment option for educational and behavioral problems among children with DCD. Additional work is needed to investigate whether our inability to detect any improvement in motor skills reflects the measures used and to assess the durability of treatment effects on behavior and academic progress. Pediatrics 2005;115:1360-1366; developmental coordination disorder, fish oil, supplementation, RCT, reading, spelling, behavior, omega-3 fatty acids, dyspraxia.ABBREVIATIONS. ADHD, attention-deficit/hyperactivity disorder; DCD, developmental coordination disorder; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; CTRS-L, Conners' Teacher Rating Scales, Long Version. O mega-3 fatty acids are essential for normal brain development and function and must be provided by the diet. However, their low levels in modern diets in developed countries are a known risk factor for physical disorders such as cardiovascular and inflammatory diseases. 1 Converging evidence indicates that fatty acid deficiencies or imbalances may also contribute to a range of adult psychiatric and neurologic disorders 2 and to several common and overlapping childhood neurodevelopmental disorders, including attention-deficit/hyperactivity disorder (ADHD), dyslexia (specific reading difficulties), dyspraxia (developmental coordination disorder [DCD]), and autistic spectrum disorders. 3 Although this suggests that dietary supplementation with -3 fatty acids may be of benefit in these conditions, results from the few small, randomized, controlled trials published to date have been mixed. 4 Some benefits from -3/-6 supplementation were reported for children with dyslexia or ADHD, 5,6 whereas 2 studies found no benefits for ADHD with the -3 fat...

Relationship between long-chain polyunsaturated fatty acids at birth and motor function at 7 years of age

“…Movement quality may predict developmental problems like attention-deficit hyperactivity disorder and learning problems (Touwen, 1979;SooraniLunsing et al, 1993;Weisglas-Kuperus et al, 1994;Kroes et al, 2002). Therefore, our finding is in line with the idea that LCPUFA status might also be associated to this kind of disorders (Stevens et al, 1995;Burgess et al, 2000;Richardson and Montgomery, 2005;Sinn and Bryan, 2007), although the evidence for this idea is inconsistent (Busch, 2007).…”

Ethyl-Eicosapentaenoic Acid in First-Episode Psychosis. A 1H-MRS Study

“…Furthermore, controlled clinical trials in treatment-resistant depression (Nemets et al, 2002;Peet and Horrobin, 2002a, b), bipolar depression (Keck et al, 2006), bipolar affective disorder (Stoll et al, 1999), borderline personality disorder (Zanarini and Frankenburg, 2003), incarcerated young males (Gesch et al, 2002), and children with developmental coordination disorders (Richardson and Montgomery, 2005) also suggest that omega-3 fatty acids may modulate mood, impulsivity, and aggression, while potential neuroprotective effects were found in Huntington's disease (Puri et al, 2002(Puri et al, , 2005. A recently presented, yet unpublished, study (Amminger et al, 2007) suggests that omega-3 fatty acids may delay the onset of frank psychosis in adolescents at ultra-high risk of psychotic disorders.…”

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“…The lipid composition of fish is unique, having LC-PUFAs, with many beneficial effects for child development and adult health (Thilsted et al 1997;Larsen et al 2011;Richardson and Montgomery 2005). Among fish species that are cheaper in developing countries, small pelagic fish such as anchovy and sardine are some of the richest in LC-PUFAs (USDA 2011), especially compared to large freshwater fish such as carp and tilapia.…”