Effect of Supplementation with Polyunsaturated Fatty Acids and Micronutrients on Learning and Behavior Problems Associated with Child ADHD

Sinn N and Bryan J. J Dev Behav Pediatr. 28: 82-91 (2007).
Commonwealth Scientific and Industrial Reasearch Organization Human Nutrition, Adelaide, South Australia

Summary:

This study evaluated the potential for supplementation with omega-3 fatty acids as DHA/EPA to influence parent and teacher ratings of attention and behaviour in a group South Australian children with various symptoms typically associated with ADHD (Attention-Deficit/Hyperactivity Disorder). A total of 132 children (age 7-12 years) assessed by scoring via the Conners ADHD Index participated in this randomized, placebo-controlled, double-blind intervention trial over a 15 week period where the three different groups received either placebo (control), omega-3 polyunsaturates (PUFAs) alone, or PUFAs plus a mixture of various vitamins and minerals (a multi-vitamin/mineral supplement taken as fruit-flavoured chewable tablets). The omega-3 PUFA supplementation required the daily intake of 6 active capsules per day (and 6 placebo capsules per day in the case of the control group) providing a total daily intake of 558 mg EPA + 174 mg DHA (a combined total of 732 mg/day) plus a small amount of the omega-6 fatty acid known as GLA (gamma-linolenic acid).

The Conners Parent Rating Scales conducted at baseline (entry) and after 15 weeks indicated a significant improvement in the omega-3 PUFA treatment groups after 15 weeks relative to controls such that improvements in cognitive problems/ inattention (by 17%), in hyperactivity (by 23%), in the Conners ADHD Index (by 19%), in global: restless/impulsive behaviour (by 20%), inattentiveness (by 20%), and hyperactive/impulsive behaviour (by 21%) were found. Interestingly, there were no significant treatment effects due to omega-3 supplementation on the Conners Teacher Rating Index Scales in contrast to the parental rating assessments.

The authors conclude that ADHD-related problems with inattention, hyperactivity, and impulsivity might respond to treatment with PUFAs. These researchers crossed the placebo group after 15 weeks onto omega-3 treatment for a further 15 weeks. These benefits were generally reproduced in the placebo group and maintained in the omega-3 treatment group when kept on EPA/DHA supplementation for a further 15 weeks with accompanying significant improvements in the Conners Parent Rating Scales.

Long-term fish consumption is associated with protection against arrhythmia in healthy persons in a Mediterranean region-the ATTICA study

Chrysohoou., et al.,Am J Clin Nutr., 85:1385-1391 (2007).

First Cardiology Clinic and the Unit of Nutrition, Department of Epidemiology, School of Medicine, University of Athens,Athens, Greece

Summary:

The ATTICA epidemiologic study from the Attica area of Greece surveyed 3042 men and women (mostly between the ages of 44 and 55 years) in relation to their intake of fish (source of DHA/EPA omega-3 fatty acids) as determined by a validated food-frequency questionnaire. All subjects entered were without known cardiovascular disease and underwent assessment via 12-lead electrocardiography (ECG) which included measurement of the QTc (see below). This particular measurement was of interest since prolongation of the QTc interval has been implicated as a major independent risk factor for cardiovascular-mediated mortality.

Compared to non-consumers of fish, those who consumed more than 300g of fish per week had a significantly lower QTc (by 14%) after adjusting for various lifestyle-related parameters (including physical activity, body mass index, smoking, etc) and other confounding variables. With respect to the likelihood of having QTc intervals > 0.45 seconds, those consuming = 300 g fish/week had a 29% lower likelihood as compared to non-consumers of fish. The authors conclude that the long-term consumption of fish is associated with a significantly lower QTc interval in those people without any evidence of cardiovascular disease and suggest that fish intake appears to provide anti-arrhythmic protection at the population level.

QT interval and QTc: The QT duration (interval) can be readily measured by the 12-lead electrocardiography (ECG) along with other parameters. Abnormal QT intervals are known to be implicated in an increased risk for serious ventricular arrythmias and sudden cardiac death. The QT interval is measured from the beginning of the so-called QRS complex to the end of the Trace. A heart rate connected QT (the QTc) can be calculated-connected by using Bazett's rate as done by the authors of the present paper.

Combining Fish-oil Supplements with Regular Aerobic Exercise Improves Body Composition and Cardiovascular Disease Risk Factors

Hill., et al.,Am J Clin Nutr., 85:1267-1274 (2007).

Nutritional Physiology Research Centreand the Australian Technology Network Centre for Metabolic Fitness , University of South Australia,Adelaide, Australia

Summary:

This research study from Australia evaluated the potential for regular anaerobic exercise plus omega-3 fatty acid supplementation from fish-oil to influence cardiovascular disease risk factors as well as body composition with an emphasis on body fat. The test subjects (male plus female combined) had an average age of approximately 50 yrs and were overweight/obese with body mass indices of approximately 34 kg/m 2 . Their body fat content upon initiation of the trial was approximately 43 %. The subjects were assigned to one of four groups prior to the twelve week intervention: supplementation with a control oil (sunflower oil) daily, sunflower oil plus exercise, fish oil supplementation daily (1560 mg of DHA +360 mg of EPA for a total DHA/EPA intake via supplementation of 1920 mg/day), or fish oil supplementation plus exercise. For those in the two exercise groups, the subjects were required to walk 3 days per week for 45 minutes at 75 % of their age-predicted maximal heart rate. Body composition was assessed by dual-energy Xray absorptiometry at initiation (time 0) and after the 12 weeks. Cardiovascular risk factors (plasma lipids, blood pressures, and arterial function assessed by ultrasound) were also measured at initiation and after 6 and 12 weeks.

Fish oil supplementation was found to reduce fasting blood plasma triglyceride levels by 14% overall in contrast to the control (sunflower oil) groups where no such lowering was observed. A moderate and significant increase in HDL-cholesterol levels (by 10%) was found also with fish oil supplementation (with or without the exercise intervention). Fish oil supplementation was also found to improve arterial function as measure by endothelium-dependent arterial vasodilation. Arterial compliance was also found to be improved by the exercise intervention. Interestingly, the combination of fish oil supplementation plus exercise provided an additive effect on body fat mass change with an overall reduction of 1.6 kgm or 4% lower than the initial fat mass (approximately 40 kgm). The authors conclude that the combination of DHA/EPA supplementation along with regular aerobic exercise can significantly reduce body fat while improving selective cardiovascular disease risk factors and overall metabolic health.

Fish consumption, n-3 fatty acids, and subsequent 5-y cognitive decline in elderly men: the Zutphen Elderly Study

van Gelder., et al.,Am J Clin Nutr., 85:1142-1147 (2007).

Centre for Prevention and Health Services Research, National Institute for Public Health and the Environment, Bilthoven, Netherlands. Julius Centre for Health Sciences and PRimary Care, University Medical Centre Untrecht, Utrecht, Netherlands. Wageningen University, Wageningen, Netherlands

Summary:

Since a progressive cognitive decline occurs before dementia and Alzheimer's disease in aging populations, there is much interest in dietary strategies that might retard or delay cognitive decline. In the present study, the authors studied the relationship between fish consumption and DHA /EPA omega-3 fatty acid intakes in elderly men age 70-89 years with associated measurements on cognitive functioning. Cognitive evaluation (including questions on orientation to time and place, attention and calculation, recall, language, visual construction) was measured by the Mini- Mental State Examination (MMSE) where the maximum score is 30 points and higher scores indicate better overall cognitive performance.

During the 5-year follow-up period of study, fish consumers exhibited a significantly lower 5-year cognitive decline as compared to those not consuming fish. The fish consumers (consuming up to 20 g of fish a day or more on average-i.e., up to 140 g (5 oz) of fish per week or more) showed a lesser decline in cognitive functioning by 1.0 point as compared to those who do not consume fish. Furthermore, a significant trend towards a lesser progression in cognitive decline was observed with progressively higher intakes of DHA/EPA per day (going from average intakes from 20 to 104 and up to 398 mg DHA/EPA per day).

The authors conclude that a moderate intake of DHA/EPA from fish may postpone cognitive decline in elderly men.

Reference:

1. Extracted from http://www.dhaomega3.org/