CoChat
Sign Up
Cited by 110Fatty Acid Research and HealthAttention Deficit Hyperactivity DisorderDevelopmental and Educational Neuropsychology

Reduced Symptoms of Inattention after Dietary Omega-3 Fatty Acid Supplementation in Boys with and without Attention Deficit/Hyperactivity Disorder

Open access
Bos, Dienke J, Oranje, Bob, Veerhoek, E Sanne, Van Diepen, Rosanne M, Weusten, Juliette MH, Demmelmair, Hans, Koletzko, Berthold, de Sain-van der Velden, Monique GM +3 more·2015·Neuropsychopharmacology
DOI 10.1038/npp.2015.73PMC PMC4538345
Open this paper in CoChat — free accountOpen PDF

Abstract

Attention deficit/hyperactivity disorder (ADHD) is one of the most common child psychiatric disorders, and is often treated with stimulant medication. Nonpharmacological treatments include dietary supplementation with omega-3 fatty acids, although their effectiveness remains to be shown conclusively. In this study, we investigated the effects of dietary omega-3 fatty acid supplementation on ADHD symptoms and cognitive control in young boys with and without ADHD. A total of 40 boys with ADHD, aged 8-14 years, and 39 matched, typically developing controls participated in a 16-week double-blind randomized placebo-controlled trial. Participants consumed 10 g of margarine daily, enriched with either 650 mg of eicosapentaenoic acid (EPA)/docosahexaenoic acid (DHA) each or placebo. Baseline and follow-up assessments addressed ADHD symptoms, fMRI of cognitive control, urine homovanillic acid, and cheek cell phospholipid sampling. EPA/DHA supplementation improved parent-rated attention in both children with ADHD and typically developing children. Phospholipid DHA level at follow-up was higher for children receiving EPA/DHA supplements than placebo. There was no effect of EPA/DHA supplementation on cognitive control or on fMRI measures of brain activity. This study shows that dietary supplementation with omega-3 fatty acids reduces symptoms of ADHD, both for individuals with ADHD and typically developing children. This effect does not appear to be mediated by cognitive control systems in the brain, as no effect of supplementation was found here. Nonetheless, this study offers support that omega-3 supplementation may be an effective augmentation for pharmacological treatments of ADHD (NCT01554462: The Effects of EPA/DHA Supplementation on Cognitive Control in Children with ADHD; http://clinicaltrials.gov/show/NCT01554462).

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1038/npp.2015.73

Cites

3 of 3 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Several clinical trials have shown beneficial effects of n-3 PUFA supplementation in ASD and ADHD, but not all results are consistent.

    “Several clinical trials have shown beneficial effects of n-3 PUFA supplementation in ASD and ADHD, but not all results are consistent and the ratio of EPA and DHA in n-3 PUFA supplements and the overall dietary intake of FAs may affect the clinical outcome62–65.”

    From An iPSC-derived astrocyte model of fragile X syndrome exhibits dysregulated cholesterol homeostasis (2023) · cites this paper as [64]

    The Introduction and Discussion report beneficial but inconsistent results for omega-3 supplementation in ADHD. The Discussion also suggests that the DHA-to-EPA ratio may help explain differing outcomes. The paper does not address ASD, and its dietary controls do not establish that overall fatty-acid intake affects clinical outcomes. Page numbers are unavailable in our copy. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 46

  1. Ahmad A Moriguchi T Salem N 2002 Decrease in neuron size in docosahexaenoic acid-deficient brain Pediatr Neurol 26 210 218 11955929
  2. Antalis CJ Stevens LJ Campbell M Pazdro R Ericson K Burgess JR 2006 Omega-3 fatty acid status in attention-deficit/hyperactivity disorder Prostaglandins Leukot Essent Fatty Acids 75 299 308 16962757
  3. Barragán E Breuer D Döpfner M 2014 Efficacy and safety of omega-3/6 fatty acids, methylphenidate, and a combined treatment in children with ADHD J Atten Disord(in press). 24464327
  4. Bauer I Hughes M Rowsell R Cockerell R Pipingas A Crewther S 2014 Omega-3 supplementation improves cognition and modifies brain activation in young adults Hum Psychopharmacol 29 133 144 24470182
  5. Bazinet RP Layé S 2014 Polyunsaturated fatty acids and their metabolites in brain function and disease Nat Rev Neurosci 15 771 785 25387473
  6. Bélanger SA Vanasse M Spahis S Sylvestre M-P Lippé S L'heureux F 2009 Omega-3 fatty acid treatment of children with attention-deficit hyperactivity disorder: a randomized, double-blind, placebo-controlled study Paediatr Child Health 14 89 98 19436468 PMC2661342
  7. Burgess JR Stevens L Zhang W Peck L 2000 Long-chain polyunsaturated fatty acids in children with attention-deficit hyperactivity disorder Am J Clin Nutr 71 327S 330SS 10617991
  8. Chalon S 2006 Omega-3 fatty acids and monoamine neurotransmission Prostaglandins Leukot Essent Fatty Acids 75 259 269 16963244
  9. Chen J-R Hsu S-F Hsu C-D Hwang L-H Yang S-C 2004 Dietary patterns and blood fatty acid composition in children with attention-deficit hyperactivity disorder in Taiwan J Nutr Biochem 15 467 472 15302081
  10. Colter AL Cutler C Meckling KA 2008 Fatty acid status and behavioural symptoms of attention deficit hyperactivity disorder in adolescents: a case-control study Nutr J 7 8 18275609 PMC2275745
  11. Dean AJ Bor W Adam K Bowling FG Bellgrove MA 2014 A randomized, controlled, crossover trial of fish oil treatment for impulsive aggression in children and adolescents with disruptive behavior disorders J Child Adolesc Psychopharmacol 24 140 148 24689967
  12. Dennis M Francis DJ Cirino PT Schachar R Barnes Ma Fletcher JM 2009 Why IQ is not a covariate in cognitive studies of neurodevelopmental disorders J Int Neuropsychol Soc 15 331 343 19402919 PMC3075072
  13. Durston S Mulder M Casey BJ Ziermans T van Engeland H 2006 Activation in ventral prefrontal cortex is sensitive to genetic vulnerability for attention-deficit hyperactivity disorder Biol Psychiatry 60 1062 1070 16712804
  14. Durston S Nederveen H van Dijk S van Belle J de Zeeuw P Langen M 2009 Magnetic resonance simulation is effective in reducing anxiety related to magnetic resonance scanning in children J Am Acad Child Adolesc Psychiatry 48 206 207 20040825
  15. Durston S Tottenham NT Thomas KM Davidson MC Eigsti I-M Yang Y 2003 Differential patterns of striatal activation in young children with and without ADHD Biol Psychiatry 53 871 878 12742674
  16. Eilander A Hundscheid DC Osendarp SJ Transler C Zock PL 2007 Effects of n-3 long chain polyunsaturated fatty acid supplementation on visual and cognitive development throughout childhood: a review of human studies Prostaglandins Leukot Essent Fatty Acids 76 189 203 17376662
  17. Gustafsson Pa Birberg-Thornberg U Duchén K Landgren M Malmberg K Pelling H 2010 EPA supplementation improves teacher-rated behaviour and oppositional symptoms in children with ADHD Acta Paediatr 99 1540 1549 20491709
  18. Hirayama S Hamazaki T Terasawa K 2004 Effect of docosahexaenoic acid-containing food administration on symptoms of attention-deficit/hyperactivity disorder - a placebo-controlled double-blind study Eur J Clin Nutr 58 467 473 14985685
  19. Horrocks La Farooqui AA 2004 Docosahexaenoic acid in the diet: its importance in maintenance and restoration of neural membrane function Prostaglandins Leukot Essent Fatty Acids 70 361 372 15041028
  20. Johnson M Ostlund S Fransson G Kadesjö B Gillberg C 2009 Omega-3/omega-6 fatty acids for attention deficit hyperactivity disorder: a randomized placebo-controlled trial in children and adolescents J Atten Disord 12 394 401 18448859
  21. Kirley A Hawi Z Daly G McCarron M Mullins C Millar N 2002 Dopaminergic system genes in ADHD: toward a biological hypothesis Neuropsychopharmacology 27 607 619 12377397
  22. Koletzko B Knoppke B Schenck U von, Demmelmair H Damli A 1999 Noninvasive assessment of essential fatty acid status in preterm infants by buccal mucosal cell phospholipid analysis J Pediatr Gastroenterol Nutr 29 467 474 10512410
  23. Kort W Schittekatte M Dekker PH Verhaeghe P Compaan EL Bosmans M 2005 Wechsler Intelligence Scale for Children - Third Edition, Dutch Version Psychological Corporation: London
  24. Mcnamara RK Able J Jandacek R Rider T Tso P Eliassen JC 2010 Docosahexaenoic acid supplementation increases prefrontal cortex activation during sustained attention in healthy boys: a placebo-controlled, dose-ranging, functional magnetic resonance imaging study Am J Clin Nutr 91 1060 1067 20130094 PMC2844685
  25. McNamara RK Jandacek R Tso P Weber W Chu W-J Strakowski SM 2013 Low docosahexaenoic acid status is associated with reduced indices in cortical integrity in the anterior cingulate of healthy male children: a 1H MRS Study Nutr Neurosci 16 183 190 23582513 PMC4101902
  26. Muthayya S Eilander A Transler C Thomas T Van Der Knaap HCM Srinivasan K 2009 Effect of fortification with multiple micronutrients and n 2 3 fatty acids on growth and cognitive performance in Indian schoolchildren: the CHAMPION (Children ' s Health and Mental Performance Influenced by Optimal Nutrition) Study 1–3 Am J Clin Nutr 89 1766 1775 19369376
  27. Oldfield RC 1971 The assessment and analysis of handedness: the Edinburgh inventory Neuropsychologia 9 97 113 5146491
  28. Osendarp SJM Baghurst KI Bryan J Calvaresi E Hughes D Hussaine M 2007 Effect of a 12-mo micronutrient intervention on learning and memory in well-nourished and marginally nourished school-aged children: 2 parallel, randomized, placebo-controlled studies in Australia and Am J Clin Nutr 86 1082 1093 17921387
  29. Plourde M Cunnane SC 2007 Extremely limited synthesis of long chain polyunsaturates in adults: implications for their dietary essentiality and use as supplements Appl Physiol Nutr Metab 32 619 634 17622276
  30. Raz R Carasso RL Yehuda S 2009 The influence of short-chain essential fatty acids on children with attention-deficit/hyperactivity disorder: a double-blind placebo-controlled study J Child Adolesc Psychopharmacol 19 167 177 19364294
  31. Richardson AJ Montgomery P 2005 The Oxford-Durham study: a randomized, controlled trial of dietary supplementation with fatty acids in children with developmental coordination disorder Pediatrics 115 1360 1366 15867048
  32. Richardson AJ Puri BK 2002 A randomized double-blind, placebo-controlled study of the effects of supplementation with highly unsaturated fatty acids on ADHD-related symptoms in children with specific learning difficulties Prog Neuropsychopharmacol Biol Psychiatry 26 233 239 11817499
  33. Schachter HM Pham B King J Langford S Moher D 2001 How efficacious and safe is short- acting methylphenidate for the treatment of attention-deficit disorder in children and adolescents? A meta-analysis CMAJ 165 1475 1488 11762571 PMC81663
  34. Schuchardt JP Huss M Stauss-Grabo M Hahn A 2010 Significance of long-chain polyunsaturated fatty acids (PUFAs) for the development and behaviour of children Eur J Pediatr 169 149 164 19672626
  35. Sinn N Bryan J 2007 Effect of supplementation with polyunsaturated fatty acids and micronutrients on learning and behavior problems associated with child ADHD J Dev Behav Pediatr 28 82 91 17435458
  36. Sonuga-Barke EJS Brandeis D Cortese S Daley D Ferrin M Holtmann M 2013 Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments Am J Psychiatry 170 275 289 23360949
  37. Spahis S Vanasse M Bélanger Sa Ghadirian P Grenier E Levy E 2008 Lipid profile, fatty acid composition and pro- and anti-oxidant status in pediatric patients with attention-deficit/hyperactivity disorder Prostaglandins Leukot Essent Fatty Acids 79 47 53 18757191
  38. Stevens L Zhang W Peck L Kuczek T Grevstad N Mahon A 2003 EFA supplementation in children with inattention, hyperactivity, and other disruptive behaviors Lipids 38 1007 1021 14669965
  39. Swanson JM Flodman P Kennedy J Spence Ma Moyzis R Schuck S 2000 Dopamine genes and ADHD Neurosci Biobehav Rev 24 21 25 10654656
  40. Vaisman N Kaysar N Zaruk-adasha Y Pelled D Brichon G Zwingelstein G 2008 Correlation between changes in blood fatty acid composition and visual sustained attention performance in children with inattention Am J Clin Nutr 87 1170 1180 18469236
  41. Vancassel S Blondeau C Lallemand S Cador M Linard A Lavialle M 2007 Hyperactivity in the rat is associated with spontaneous low level of n-3 polyunsaturated fatty acids in the frontal cortex Behav Brain Res 180 119 126 17397943
  42. Vickers AJ 2005 Parametric versus non-parametric statistics in the analysis of randomized trials with non-normally distributed data BMC Med Res Methodol 5 35 16269081 PMC1310536
  43. Voigt RG Llorente AM Jensen CL Fraley JK Berretta MC Heird WC 2001 A randomized, double-blind, placebo-controlled trial of docosahexaenoic acid supplementation in children with attention-deficit/hyperactivity disorder J Pediatr 139 189 196 11487742
  44. de Zeeuw P Schnack HG van Belle J Weusten J van Dijk S Langen M 2012 Differential brain development with low and high IQ in attention-deficit/hyperactivity disorder PLoS One 7 e35770 22536435 PMC3335015
  45. Zimmer L Delion-Vancassel S Durand G Guilloteau D Bodard S Besnard JC 2000 Modification of dopamine neurotransmission in the nucleus accumbens of rats deficient in n-3 polyunsaturated fatty acids J Lipid Res 41 32 40 10627499
  46. Zimmer L Vancassel S Cantagrel S Breton P Delamanche S Guilloteau D 2002 The dopamine mesocorticolimbic pathway is affected by deficiency in n-3 polyunsaturated fatty acids Am J Clin Nutr 75 662 667 11916751

Cited by

Sorted by citations

Authors
Bos, D. J., Oranje, B., Veerhoek, E. S., Van Diepen, R. M., Weusten, J. M., Demmelmair, H., Koletzko, B., de Sain-van der Velden, M. G., Eilander, A., Hoeksma, M., & Durston, S.
Affiliations
  • University Medical Center Utrecht (NL)
  • Ludwig-Maximilians-Universität München (DE)
  • Unilever Research and Development Vlaardingen (NL)
Corresponding author
Bos, Dienke J
ORCID
Venue
Neuropsychopharmacology
Publisher
Springer Science and Business Media LLC
Published
2015-03-19
Volume
40
Issue
10
Pages
2298-2306
ISSN
  • 0893-133X (ISSN-L)
  • 1740-634X
DOI
10.1038/npp.2015.73
PMC
PMC4538345
OpenAlex
W1986587428
Cited by
110
References
3
Citations by year
2026: 4 · 2025: 9 · 2024: 8 · 2023: 9 · 2022: 10 · 2021: 15 · 2020: 7 · 2019: 8 · 2018: 14 · 2017: 12 · 2016: 9 · 2015: 5
FWCI
12.85
Type
journal article
Language
en
Open access
Licence
Locations
  • Neuropsychopharmacology (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
Keywords
attention deficit hyperactivity disorder, omega-3 fatty acids, eicosapentaenoic acid, docosahexaenoic acid, dietary supplementation, inattention, cognitive control, boys, homovanillic acid, non-pharmacological treatment
MeSH terms
Adolescent, Analysis of Variance, Attention Deficit Disorder with Hyperactivity, Brain, Child, Docosahexaenoic Acids, Double-Blind Method, Follow-Up Studies, Homovanillic Acid, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Margarine, Neuropsychological Tests, Oxygen, Surveys and Questionnaires, Eicosapentaenoic Acid, Fatty Acids, Omega-3, Case-Control Studies, Treatment Outcome, Dietary Supplements

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review