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EPA supplementation improves teacher-rated behaviour and oppositional symptoms in children with ADHD
Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
Department of Pediatrics, Mariestad, Sweden .
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2010 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 99, no 10, 1540-1549 p.Article in journal (Refereed) Published
Abstract [en]

Aim: Measure efficacy of eicosapentaenoic acid (EPA) in children with attention deficit hyperactivity disorder (ADHD). Methods: Randomized controlled trial (RCT) of 0.5 g EPA or placebo (15 weeks) in 92 children (7-12 years) with ADHD. Efficacy measure was Conners Parent/Teacher Rating Scales (CPRS/CTRS). Fatty acids were analysed in serum phospholipids and red blood cell membranes (RBC) at baseline and endpoint with gas chromatography. Results: EPA improved CTRS inattention/cognitive subscale (p = 0.04), but not Conners total score. In oppositional children (n = 48), CTRS total score improved andgt;= 25% in 48% of the children receiving EPA vs. 9% for placebo [effect size (ES) 0.63, p = 0.01]. In less hyperactive/impulsive children (n = 44), andgt;= 25% improvement was seen in 36% vs. 18% (ES 0.41, n.s.), and with both these types of symptoms 8/13 with EPA vs. 1/9 for placebo improved andgt;= 25% (p = 0.03). Children responding to treatment had lower EPA concentrations (p = 0.02), higher AA/EPA (p = 0.005) and higher AA/DHA ratios (p = 0.03) in serum at baseline. Similarly, AA/EPA (p = 0.01), AA/DHA (p = 0.038) and total omega-6/omega-3 ratios (p = 0.028) were higher in RBC, probably because of higher AA (p = 0.011). Conclusion: Two ADHD subgroups (oppositional and less hyperactive/impulsive children) improved after 15-week EPA treatment. Increasing EPA and decreasing omega-6 fatty acid concentrations in phospholipids were related to clinical improvement.

Place, publisher, year, edition, pages
Blackwell Publishing Ltd , 2010. Vol. 99, no 10, 1540-1549 p.
Keyword [en]
ADHD, Arachidonic acid, DHA, EPA, LCPUFA, RBC, serum phospholipids
National Category
Social Sciences
URN: urn:nbn:se:liu:diva-59732DOI: 10.1111/j.1651-2227.2010.01871.xISI: 000281556700025OAI: diva2:353129
Available from: 2010-09-24 Created: 2010-09-24 Last updated: 2011-05-10Bibliographically approved
In thesis
1. Fats in Mind: Effects of Omega-3 Fatty Acids on Cognition and Behaviour in Childhood
Open this publication in new window or tab >>Fats in Mind: Effects of Omega-3 Fatty Acids on Cognition and Behaviour in Childhood
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Fats in Mind : Effekter av omega-3 fettsyror på kognition och beteende under barndomen
Abstract [en]

The aim of this thesis was to examine possible effects of omega-3 fatty acids on children’s cognition and behavior. Longitudinal as well as cross-sectional comparisons were made among children with typical development and children with ADHD /at risk developing ADHD.

The specific purposes were to examine (1) breast-feeding in relation to cognition; (2) relation between long chain poly unsaturated fatty acids (LCPUFAs) in mothers breast-milk and children´s cognition; (3) effects of EPA supplementation on cognition and behavior in children with ADHD; (4) if LCPUFAs have differential effects on working memory, inhibition, problem-solving and theory of mind (ToM).

The main conclusions were as follows; (1) duration of breast-feeding was positively correlated to children levels of intelligence (IQ); (2) LCPUFAs in breast-milk was related to children’s ToM and IQ, the quotient DHA/AA, together with length of breastfeeding and gestation week explained 76% of the variance of total IQ; (3) subtypes of children with ADHD responded to EPA supplementation with significant reductions in symptoms, but there were no effects in the whole group with ADHD; (4) ToM ability was related to LCPUFAs, but not to any other cognitive measures as working memory, inhibition and problem-solving.

To conclude, these results indicate that fatty acid status in breast-milk at birth affect general cognitive function in children at 6.5 years of age, including ToM. Short-term intervention with omega-3 fatty acids does not affect cognition in children with ADHD, but improves clinical symptoms as assessed by means of teacher ratings. These results further indicate that hot executive function and social cognition may be an area of interest for future research.

Abstract [sv]

Syftet med denna avhandling var att undersöka möjliga effekter av omega-3 fettsyror för barns kognition och beteende. Både kortsiktiga och långsiktiga effekter undersöktes och studierna involverade både barn med typisk utveckling och barn med ADHD.

De specifika syftena var att undersöka; (1) amning i relation till barns kognitiva utveckling; (2), relationen mellan långa fleromättade fettsyror (LCPUFA) i mammans bröstmjölk och barns kognition; (3) effekter på kognition och beteenden hos barn med ADHD av ett EPA tillskott; (4) om LCPUFA hade några differentiella effekter på arbetsminne, inhibering eller Theory of Mind (ToM).

De huvudsakliga slutsatserna var följande; (1) amningslängden var positivt korrelerad med barnens intelligenskvot (IK); (2) LCPUFA i bröstmjölken var associerad med barnens ToM och IK, kvoten DHA/AA, tillsammans med amningslängd och graviditetslängd förklarade 76% av variansen i totala IK; (3) subgrupper av barn med ADHD svarade på EPA behandlingen med signifikant reducerade symptom, men för hela gruppen med ADHD hittades inga effekter; (4) ToM var relaterat till LCPUFA, men inga andra kognitiva mått som arbetsminne, inhibering eller problemlösning.

Sammanfattningsvis indikerar dessa resultat att fettsyrestatus i bröstmjölk påverkar generell kognitiv förmåga, samt ToM, hos barn 6,5 år gamla. Korttidsintervention med omega-3 fetter påverkar inte kognition hos skolbarn med ADHD, men minskar kliniska symptom skattade i lärarskattningsskalor. Vidare indikerar resultaten att ”heta” exekutiva funktioner och social kognition kan vara av intresse för framtida forskning.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2011. 119 + studies 1-4 p.
Linköping Studies in Arts and Science, ISSN 0282-9800 ; 530Linköping Studies in Behavioural Science, ISSN 1654-2029 ; 158Studies from the Swedish Institute for Disability Research, ISSN 1650-1128 ; 37
Cognition, Omega-3 Fatty Acids, Children, ADHD, Executive Functions, kognition, omega-3 fettsyror, barn, ADHD, exekutiva funktioner
National Category
urn:nbn:se:liu:diva-68081 (URN)978-91-7393-164-9 (ISBN)
Public defence
2011-06-07, Key 1, Hus Key, Campus Valla, Linköpings universitet, Linköping, 13:00 (Swedish)
Available from: 2011-05-10 Created: 2011-05-10 Last updated: 2014-10-07Bibliographically approved

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Gustafsson, PerBirberg Thornberg, UlrikaDuchén, KarelKarlsson, Thomas
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Child and Adolescent PsychiatryFaculty of Health SciencesDepartment of Child and Adolescent PsychiatryDepartment of Behavioural Sciences and LearningFaculty of Arts and SciencesPediatricsDepartment of Paediatrics in Linköping
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