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Omega-3 Fatty Acid Supplementation for the Treatment of Children With Attention-Deficit/Hyperactivity Disorder Symptomatology: Systematic Review and Meta-Analysis
Open accessAbstract
Objective Several studies have demonstrated differences in omega-3 fatty acid composition in plasma and in erythrocyte membranes in patients with ADHD compared to unaffected controls. Omega-3 fatty acids have anti-inflammatory properties and can alter central nervous system cell membrane fluidity and phospholipid composition. Cell membrane fluidity can alter serotonin and dopamine neurotransmission. The goal of this meta-analysis is to examine the efficacy of omega-3 fatty acid supplementation in children with ADHD. Method We searched PubMED for randomized, placebo-controlled trials examining omega-3 fatty acid supplementation in children with ADHD symptomatology. Our primary outcome measure was standardized mean difference in rating scales of ADHD severity. We conducted secondary analyses to determine the effects of dosing of different omega-3 fatty acids in supplements. Results Ten trials involving 699 children were included in this meta-analysis. Omega-3 fatty acid supplementation demonstrated a small, but significant effect in improving ADHD symptoms. Eicosapentaenoic acid (EPA) dose within supplements was significantly correlated with supplement efficacy. We found no evidence of publication bias or heterogeneity between trials. Conclusion Omega-3 fatty acid supplementation, particularly with higher doses of EPA, was modestly effective in the treatment of ADHD. The relative efficacy of omega-3 fatty acid supplementation was modest compared to currently available pharmacotherapies for ADHD such as psychostimulants, atomoxetine or alpha-2 agonists. However, given its relatively benign side-effect profile and evidence of modest efficacy, it may be reasonable to use omega-3 fatty supplementation to augment traditional pharmacological interventions or for families who decline other psychopharmacological options.
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“Omega-3 fatty acid supplementation was associated with small-to-medium improvements in ADHD symptoms in three meta-analyses (ten studies with 699 participants, 16 studies with 1,408 participants, 7 studies with 534 participants) (Bloch and Qawasmi, 2011; Chang et al., 2018; Hawkey and Nigg, 2014).”
From The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder (2021) · cites this paper as Bloch and Qawasmi, 2011
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Faraone, S. V., Banaschewski, T., Coghill, D., Zheng, Y., Biederman, J., Bellgrove, M. A., Newcorn, J. H., Gignac, M., Al Saud, N. M., Manor, I., et al. (2021) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2021.01.022 · Cited by 1,545
“1408 participants, 7 studies with 534 participants) (Bloch and Qawasmi, 2011; Chang et al., 2018; Hawkey and Nigg, 2014).”
Sonuga-Barke, E. J. S., Brandeis, D., Cortese, S., Daley, D., Ferrin, M., Holtmann, M., Stevenson, J., Danckaerts, M., van der Oord, S., Döpfner, M., et al. (2013) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2012.12070991 · Cited by 1,167
Association Between ADHD and Obesity: A Systematic Review and Meta-Analysis
Cortese, S., Moreira-Maia, C. R., St. Fleur, D., Morcillo-Peñalver, C., Rohde, L. A., & Faraone, S. V. (2016) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2015.15020266 · Cited by 606
Feeding the microbiota–gut–brain axis: Diet, microbiome, and neuropsychiatry
Sandhu, K. V., Sherwin, E., Schellekens, H., Stanton, C., Dinan, T. G., & Cryan, J. F. (2017) · Translational Research · doi:10.1016/j.trsl.2016.10.002 · Cited by 491
Nutritional psychiatry: Towards improving mental health by what you eat
Adan, R. A. H., van der Beek, E. M., Buitelaar, J. K., Cryan, J. F., Hebebrand, J., Higgs, S., Schellekens, H., & Dickson, S. L. (2019) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2019.10.011 · Cited by 454
Metadata
- Authors
- Bloch, M. H., & Qawasmi, A.
- Affiliations
- Yale University (US)
- Al-Quds University (PS)
- Corresponding author
- Bloch, Michael H.
- ORCID
- Bloch, Michael H.
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2011-10
- Volume
- 50
- Issue
- 10
- Pages
- 991-1000
- ISSN
- 0890-8567 (ISSN-L)
- PMC
- PMC3625948
- OpenAlex
- W2016086054
- Semantic Scholar
- f2c54a2404c193896c22b8342c2fc366c28f311c
- Cited by
- 417
- References
- 48
- Citations by year
- 2026: 15 · 2025: 15 · 2024: 21 · 2023: 17 · 2022: 15 · 2021: 18 · 2020: 77 · 2019: 26 · 2018: 32 · 2017: 26 · 2016: 36 · 2015: 36 · 2014: 37 · 2013: 25 · 2012: 19
- FWCI
- 3.17
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (K23MH091240, R25MH077823)
- National Center for Research Resources (UL1RR024139)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Agricultural and Biological Sciences › Aquatic Science › Aquaculture Nutrition and Growth
- Keywords
- omega-3 fatty acids, attention deficit hyperactivity disorder, children, eicosapentaenoic acid, dietary supplementation, ADHD symptom severity, cell membrane fluidity, phospholipid composition, non-pharmacological treatment
- MeSH terms
- Attention Deficit Disorder with Hyperactivity, Child, Humans, Eicosapentaenoic Acid, Fatty Acids, Omega-3
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