Colter AL, Cutler C, Meckling KA. Fatty acid status and behavioural symptoms of attention deficit hyperactivity disorder in adolescents: a case-control study. Nutr J 7: 8

Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, N1G 2W1, Canada. .
Nutrition Journal (Impact Factor: 2.6). 02/2008; 7(1):8. DOI: 10.1186/1475-2891-7-8
Source: PubMed


Most studies of Attention-deficit hyperactivity disorder (ADHD) have focused on either young children or older adults. The current study compared 11 ADHD adolescents with 12 age-matched controls. The purpose was to examine differences in dietary intake, particularly of essential fatty acids, and determine whether this could explain the typical abnormalities in red blood cell fatty acids observed in previous studies of young children. A secondary purpose was to determine if there were relationships between circulating concentrations of essential fatty acids and specific ADHD behaviours as measured by the Conners' Parent Rating Scale (CPRS-L).
Eleven ADHD adolescents and twelve age-matched controls were recruited through newspaper ads, posters and a university website. ADHD diagnosis was confirmed by medical practitioners according to DSM-IV criteria. Blood, dietary intake information as well as behavioural assessments were completed.
Results showed that ADHD adolescents consumed more energy and fat than controls but had similar anthropometry. ADHD children consumed equivalent amounts of omega-3 and omega-6 fatty acids to controls, however they had significantly lower levels of docosahexaenoic acid (DHA, 22:6n-3) and total omega-3 fatty acids, higher omega-6 fatty acids and a lower ratio of n-3:n-6 fatty acids than control subjects. In addition, low omega-3 status correlated with higher scores on several Conners' behavioural scales.
These data suggest that adolescents with ADHD continue to display abnormal essential fatty acid profiles that are often observed in younger children and distinctly different from normal controls of similar age. Further these red blood cell fatty acid differences are not explained by differences in intake. This suggests that there are metabolic differences in fatty acid handling between ADHD adolescents and normal controls. The value of omega-3 supplements to improve fatty acid profiles and possibly behaviours associated with ADHD, need to be examined.

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    • "Deficits in omega 3 fatty acids have been linked to different health and neurodevelopmental problems including ADHD, and a deficiency in omega 3 fatty acids produces symptoms such as a lack of attention or hyperactivity. Indeed, children with ADHD have been found to have reduced red blood cell omega 3 fatty acids compared to typically developing children [12] [13] [14] [15]. Deficits in dietary omega 3 fatty acid have also been linked to alterations in glutamatergic and serotoninergic neurotransmission, as well as mesocortical and mesolimbic dopaminergic system dysfunction [16] [17]. "
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    ABSTRACT: Attention-deficit hyperactivity disorder (ADHD) is a heterogeneous psychiatric disorder affecting 5–10% of children. One of the suggested mechanisms underlying the pathophysiology of ADHD is insufficient energy supply to neurons. Here, we investigated the role of omega 3 fatty acids in altering neural energy metabolism and behavior of spontaneously hypertensive rats (SHR), which is an animal model of ADHD. To this end, we employed Proton Magnetic Resonance Spectroscopy (1H MRS) to evaluate changes in brain neurochemistry in the SHR following consumption of one of three experimental diets (starting PND 21): fish oil enriched (FOE), regular (RD) and animal fat enriched (AFE) diet. Behavioral tests were performed to evaluate differences in locomotor activity and risk-taking behavior (starting PND 44). Comparison of frontal lobe metabolites showed that increased amounts of omega 3 fatty acids decreased total Creatine levels (tCr), but did not change Glutamate (Glu), total N-Acetylaspartate (tNAA), Lactate (Lac), Choline (Cho) or Inositol (Ino) levels. Although behavior was not significantly affected by different diets, significant correlations were observed between brain metabolites and behavior in the open field and elevated plus maze. SHR with higher levels of brain tCr and Glu exhibited greater hyperactivity in a familiar environment. On the other hand, risk-taking exploration of the elevated plus maze's open arms correlated negatively with forebrain tNAA and Lac levels. These findings support the possible alteration in energy metabolites in ADHD, correlating with hyperactivity in the animal model. The data also suggest that omega 3 fatty acids alter brain energy and phospholipid metabolism.
    Full-text · Article · Aug 2014 · Behavioural Brain Research
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    • "Three studies in children[101112] and one in adolescents[14] showed that ADHD participants had lower DHA concentrations in plasma and/or red blood cells compared to normal controls. "
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    ABSTRACT: Although most of the ADHD (Attention Deficit Hyperactivity Disorder) patients respond to stimulant drugs very well, alternative drugs are required for non respondents. It has been revealed that subgroups of patients with ADHD have omega-3 fatty acid deficiency. So, the present study was planned to illustrate the effect of omega-3 supplementation, as an add-on to methylphenidate, on ADHD patients. In this double-blind RCT, ADHD children without any co morbidity, who had been diagnosed by a child and adolescent psychiatrist in child and adolescent university clinic, participated and were randomly divided into 2 groups. The experimental group methylphenidate plus omega-3 capsule (2000mg/d), while control group took methylphenidate plus placebo. Severity of ADHD symptoms were assessed by ADHD rating scale at the baseline and after 2, 4 and 8 weeks of treatment. 69 patients (experimental = 36, control = 33) aged 7 to 15 participated. A significant reduction of both parent's and teacher's ADHD rating scale scores in both groups was observed. Bu t it couldn't show any difference between two groups. Difference score of parent's at baseline was 1.86+- (5/40), Pv 0.262, after 2 weeks -.70+- (4/30), Pv 0.668,4 weeks. 19+- (5/60), Pv 0.902 and 8 weeks. 30+- (4/42), Pv 0.845. Difference score of Teacher's at baseline was -1.56+- (3/45), Pv 0.541, after 2 weeks -.46+- (6/24), Pv 0.888, 4 weeks. 45+- (5/41), 0.868 and 8 weeks. 73+- (4/18), Pv 0.748. Omega-3 did not enhance the therapeutic results of methylphenidate in ADHD patients.
    Full-text · Article · Aug 2013 · Journal of research in medical sciences
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    • "However, comparable studies that have recruited smaller sample sizes of 23 (i.e., 11 ADHD and 12 controls) [15] or even 12 in each group [13] reported group differences in plasma EPA levels uncorrected for multiple testing. Of note, the previous study by Colter et al. [15] examined differences in red blood cells and not plasma between ADHD and healthy controls. The main limitation of the present study is arguably that plasma measures are not as robust as red blood cell measures. "
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    ABSTRACT: A number of research studies have reported abnormal plasma fatty acid profiles in children with ADHD along with some benefit of n-3 to symptoms of ADHD. However, it is currently unclear whether (lower) long chain-polyunsaturated fatty acids (LC-PUFAs) are related to ADHD pathology or to associated behaviours. The aim of this study was to test whether (1) ADHD children have abnormal plasma LC-PUFA levels and (2) ADHD symptoms and associated behaviours are correlated with LC-PUFA levels. Seventy-two, male children with (n=29) and without a clinical diagnosis of ADHD (n=43) were compared in their plasma levels of LC-PUFA. Plasma DHA was higher in the control group prior to statistical correction. Callous-unemotional (CU) traits were found to be significantly negatively related to both eicosapentaenoic acid (EPA), and total omega-3 in the ADHD group. The findings unveil for the first time that CU and anti-social traits in ADHD are associated with lower omega-3 levels.
    Full-text · Article · May 2013 · Prostaglandins Leukotrienes and Essential Fatty Acids
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