This guide was designed to be a definitive guide for parents with children who have ADD or ADHD type symptoms. If you’re short on time, I’ve posted a shorter version of this guide here.
Introduction
Attention Deficit/Hyperactivity Disorder, or ADHD, occurs in a fairly large subset of school-aged children. Over the years, numerous studies and news reports have asked the question “Is your teen’s diet giving them ADHD?“, and continue to explore the possible relationship between ADHD and Polyunsaturated fatty acids, in particular the omega-3s. There are two different types of omega-3s. They are short-chain and long-chain, both of which describe the length of the carbon chain on each acid. The two long-chain fatty acids are Eicosapentaenoic Acid (EPA), which contains 20 carbons, and Docosahexaenoic Acid (DHA), which contains 22 carbons. Together, er these long-chain fatty acids are the omega-3s that we take from fish oil for. The purpose of this guide is to focus on the relationship between omega-3s and ADHD symptoms.
What are the symptoms of ADHD?
While it may be harder to detect in very early childhood, the symptoms of hyperactivity, impulsivity, and inattentiveness characterizing this disorder are often pervasive and cause significant disruptions both at home and in school for many children. Although there is no simple and straightforward test for ADHD, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) has established specific criteria for diagnosing the disorder. These criteria include:
(1) Inattention (at least 6 required from category 1 or 2 for diagnosis)
- Failure to pay attention to details or carelessness at home or school
- inability to remain attentive during play or other tasks
- difficulty following instructions
- trouble with organization
- avoidance of tasks/activities requiring focus
- frequently losing things
- is distracted easily
- difficulty remembering daily tasks
(2) Hyperactivity-Impulsivity (at least 6 required from category 1 or 2 for diagnosis)
- fidgeting or squirming
- frequently getting up from the seat
- running or climbing excessively
- difficulty playing quietly
- high-energy
- extremely talkative
- answers questions prematurely
- inability to wait for his/her turn
- frequently interrupts others
In addition, some of these symptoms must be present in early childhood (before the age of 7, but not before the age of 3), must affect the child in multiple settings, and lastly, must cause significant disruptions in social, academic, or work performance
Prevalence
It is estimated that an average of 5% of school-aged children suffer from some form of ADHD. Unfortunately, this is not a disorder you can “grow out of”. Instead, many individuals carry the disorder with them into adulthood (DSM-IV-TR).
Causes
While ADHD appears to be more common among families with relatives who also have the disorder, a wide variety of external influences, such as home life, academic settings, and friends, appear to have some impact on the severity of the symptoms as well as the likelihood of another disorder being present (DSM-IV-TR). One of the external influences currently under intense scrutiny is that of omega-3 fatty acids.
Some researchers, like Stevens et al (1996), discovered in a clinical study of nearly 100 boys that those with lower levels of omega-3s demonstrated more learning and behavioral problems (such as temper tantrums and sleep disturbances) than boys with normal omega-3 levels.
Current Research
One of the reasons ADHD is so difficult to diagnose early in childhood is that very young children are often not expected to endure long periods of self-restraint and attention. As a result, when children enter a formal school setting, these attention-deficit and hyperactivity symptoms may seem to appear out of the blue, catching many parents off guard.
Frequently, these symptoms quickly escalate into behaviors that cause significant academic impairments. It is these types of problem behaviors that cause many parents to feel pressured into experimenting with treatments like stimulants so their children do not fall behind at school. Fortunately, current research suggests fish oil for kids may be a safer alternative parents can try first.
For example, one clinical study led by Richardson & Montgomery (2005) used omega-3 and omega-6 fatty acid supplementation in 117 children with DCD (a disorder very closely related to ADHD).
In another study by Richardson (2006), he concluded that both theoretical and applied research seem to suggest omega-3 plays a part in childhood pervasive developmental disorders such as ADHD. Controlled studies offer a variety of outcomes; however, many of these studies do not focus on the same populations and/or treatment details.
Long-term studies also seem to yield promising results. For instance, in a placebo-controlled study, 75 children and adolescents (age 8-18) were given an omega-3/6 supplement for 6 months. At the study’s conclusion, Johnson et al (2009) found that fish oil cuts ADHD symptoms by nearly half, as 47% of all participants“responded with meaningful reduction of ADHD symptoms”.
Another clinical study found that omega-3 fatty acid supplementation helped to decrease physical aggression in school children with ADHD. More studies, including comparisons with drug therapies (such as stimulants), should be performed (see review article by Kidd, 2007).
Diet & Nutrition
Research findings suggest that one of the reasons children with ADHD may have low levels of essential fatty acids (including EPA and DHA) in their bodies because they are deficient in the minerals needed to convert them into a usable form (Dufault et al, 2009).