Abstract
Objective: To investigate whether docosahexaenoic acid (DHA) supplementation was able to ameliorate attention-deficit/hyperactivity disorder(AD/HD) symptoms in AD/HD children.
Design and subjects: A placebo-controlled double-blind study with 40 AD/HD (including eight AD/HD-suspected) children of 6–12 y of age who were mostly without medication. Subjects of a DHA group (n=20) took active foods containing fish oil (fermented soybean milk, bread rolls and steamed bread; 3.6 g DHA/week from these foods) for 2 months, whereas those of a control group (n=20) took indistinguishable control foods without fish oil. The following items were measured at the start and end of the study: (1) attention deficit, hyperactivity and impulsivity (AD/HD-related symptoms according to DSM-IV criteria); (2) aggression assessed by both parents and teachers; (3) visual perception (finding symbols out of a table); (4) visual and auditory short-term memory; (5) development of visual–motor integration; (6) continuous performance; (7) impatience.
Results: Changes in tests 1, 2, 3, 5 and 7 over time did not significantly differ between the two groups. However, visual short-term memory and errors of commission (continuous performance) significantly improved in the control group compared with the changes over time in the DHA group (P=0.02 and 0.001, respectively). Recalculation without AD/HD-suspected subjects (n=4 each group) showed similar P-values with regard to both measures.
Conclusions: DHA supplementation did not improve AD/HD-related symptoms. Treatment of ADHD with fatty acids deserves further investigation, but careful attention should be paid as to which fatty acid(s) is used.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Adam O, Beringer C, Kless T, Lemmen C, Adam A, Wiseman M, Adam P, Klimmek R &, Forth W (2003): Anti-inflammatory effects of a low arachidonic acid diet and fish oil in patients with rheumatoid arthritis. Rheumatol. Int. 23, 27–36.
Aman MG, Mitchell EA &, Turbott SH (1987): The effects of essential fatty acid supplementation by Efamol in hyperactive children. J. Abnorm. Child Psychol. 15, 75–90.
Arnold LE (1999): Treatment alternatives for attention deficit hyperactivity disorder. J. Attention Disord. 3, 30–48.
Beery KE (1967): Developmental Test of Visual–Motor: Administration and Scoring Manual. Chicago: Follett Publishing Co.
Biederman J &, Spencer T (1999): Attention-deficit/hyperactivity disorder (ADHD) as a noradrenergic disorder. Biol. Psychiatry 46, 1234–1242.
Brue AW &, Oakland TD . (2002): Alternative treatments for attention-deficit/hyperactivity disorder: does evidence support their use? Altern. Ther. Health Med. 8, 68–70.
Burgess JR (1998): Attention deficit hyperactivity disorder, observational and interventional studies. NIH Workshop on Omega-3 Essential Fatty Acids and Psychiatric Disorders. Abstract book 22.
Carter CM, Urbanowicz M, Hemsley R, Mantilla L, Strobel S, Graham PJ &, Taylor E (1993): Effects of a few food diet in attention deficit disorder. Arch. Dis. Childhood 69, 564–568.
Cooper JR, Bloom FE &, Roth RH (2003): Noradrenaline and adrenaline. In Biochemical Basis of Neuropharmacology, 8th Edition, pp 181–224. New York: Oxford University Press.
Corkum PV &, Siegel LS (1993): Is the continuous performance task a valuable research tool for use with children with attention-deficit hyperactivity disorder? J. Child Psychol. Psychiatry. 29, 1217–1239.
Frostig M, Lefever DW &, Whittlesey JRB (1966): Administration and Scoring Manual for the Marianne Frostig Developmental Test of Visual Perception. Palo Alto: Consulting Psychologists Press.
Gesch CB, Hammond SM, Hampson SE, Eves A &, Crowder MJ (2002): Influence of supplementary vitamins, minerals and essential fatty acids on the antisocial behaviour of young adult prisoners. Br. J. Psychiatry 181, 22–28.
Goldman LS, Genel M, Bezman RJ &, Slanetz PJ (1998): Diagnosis and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Council on Scientific Affairs, American Medical Association. JAMA 279, 1100–1107.
Haller J, Makara GB &, Kruk MR (1998): Catecholaminergic involvement in the control of aggression: hormones, the peripheral sympathetic, and central noradrenergic systems. Neurosci. Biobehav. Rev. 22, 85–97.
Hamazaki K, Itomura M, Huan M, Nishizawa H, Watanabe S, Hamazaki T, Sawazaki S, Terasawa K, Nakajima S, Terano T, Hata Y &, Fujishiro S (2003): n-3 long chain fatty acids decrease serum levels of triglycerides and remnant-like particle-cholesterol in humans. Lipids. 38, 353–358.
Hamazaki T &, Okuyama H (2003): The Japan Society for Lipid Nutrition recommends to reduce the intake of linoleic acid. A review and critique of the scientific evidence. In Omega-6/Omega-3 Essential Fatty Acid Ratio: The Scientific Evidence, Volume eds AP Simopoulos & LG Cleland. World Review of Nutrition and Dietetics, Vol 92, pp 109–132. Basel: Karger.
Hamazaki T, Sawazaki S, Itomura M, Asaoka E, Nagao Y, Nishimura N, Yazawa K, Kuwamori T &, Kobayashi M (1996): The effect of docosahexaenoic acid on aggression in young adults, a placebo-controlled double-blind study. J. Clin. Invest. 97, 1129–1133.
Hamazaki T, Thienprasert A, Kheovichai K, Samuhaseneetoo S, Nagasawa T &, Watanabe S (2002): The effect of docosahexaenoic acid on aggression in elderly Thai subjects — a placebo-controlled double-blind study. Nutr. Neurosci. 6, 37–41.
Hulme C &, Mackenzie S (1992): Working memory: structure and function. In Working Memory and Severe Learning Difficulties, pp 17–37. Hillsdale: Lawrence Erlbaum Associates Publishers.
Itomura M, Sawazaki S, Terasawa K, Hamazaki K, Watanabe S &, Hamazaki T (2002): Aggression and the fatty acid composition of red blood cells (RBCs) in schoolchildren. 5th Congress of the International Society for the Study of Fatty Acids and Lipids, Montreal. Abstract book 128.
Marangell LB, Martinez JM, Zboyan HA, Kertz B, Kim HF &, Puryear LJ (2003): A double-blind, placebo-controlled study of the omega-3 fatty acid docosahexaenoic acid in the treatment of major depression. Am. J. Psychiatry 160, 996–998.
Miller GA (1956): The magical number seven plus or minus two: some limits on our capacity for processing information. Psychol. Rev. 63, 81–97.
Mitchell EA, Aman MG, Turbott SH &, Manku M (1987): Clinical characteristics and serum essential fatty acid levels in hyperactive children. Clin. Pediatr. 26, 406–411.
Nemets B, Stahl Z &, Belmaker RH (2002): Addition of omega-3 fatty acid to maintenance medication treatment for recurrent unipolar depressive disorder. Am. J. Psychiatry 159, 477–479.
Peet M &, Horrobin DF (2002): A dose-ranging study of the effects of ethyl-eicosapentaenoate in patients with ongoing depression despite apparently adequate treatment with standard drugs. Arch. Gen. Psychiatry 59, 913–919.
Puri BK &, Richardson AD (2000): The effects of olive oil on ω3 fatty acids and mood disorder. Arch. Gen. Psychiatry 57, 715.
Rapport MD, Denney C, DuPaul GJ &, Gardner MJ (1994): Attention deficit disorder and methylphenidate: normalization rates, clinical effectiveness, and response prediction in 76 children. J. Am. Acad. Child Adolesc. Psychiatry 33, 882–893.
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. Neuro-Psychopharmacol. Biol. Psychiatry 26, 233–239.
Rothman RB, Baumann MH, Dersch CM, Romero DV, Rice KC, Carroll FI &, Partilla JS (2001): Amphetamine-type central nervous system stimulants release noradrenaline more potently than they release dopamine and serotonin. Synapse 39, 32–41.
Sawazaki S, Hamazaki T, Yazawa K &, Kobayashi M (1999): The effect of docosahexaenoic acid on plasma catecholamine concentrations and glucose tolerance during long-lasting psychological stress: a double-blind placebo-controlled study. J. Nutr. Sci. Vitaminol. 45, 655–665.
Stevens LJ, Zentall SS, Deck JL, Abate ML, Watkins BA, Lipp SR &, Burgess JR (1995): Essential fatty acid metabolism in boys with attention-deficit hyperactivity disorder. Am. J. Clin. Nutr. 62, 761–768.
Terano T, Hirai A, Tamura Y, Kumagai A &, Yoshida S (1987). Effect of dietary supplementation of highly purified eicosapentaenoic acid and docosahexaenoic acid on arachidonic acid metabolism in leukocytes and leukocyte function in healthy volunteers. Adv. Prostaglandin Thromboxane Leukotriene Res. 17B, 880–885.
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.
Wilens TE, Biederman J &, Spencer TJ (2002): Attention deficit/hyperactivity disorder across the lifespan. Annu. Rev. Med. 53, 113–131.
Acknowledgements
This work was partly supported by a grant from Japan Fisheries Association and Foundation for Total Health Promotion.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Hirayama, S., Hamazaki, T. & Terasawa, K. 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 (2004). https://doi.org/10.1038/sj.ejcn.1601830
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.ejcn.1601830
Keywords
This article is cited by
-
Reduced Symptoms of Inattention after Dietary Omega-3 Fatty Acid Supplementation in Boys with and without Attention Deficit/Hyperactivity Disorder
Neuropsychopharmacology (2015)
-
Essential Fatty Acids for Childhood Mental Health Disorders
Current Treatment Options in Psychiatry (2015)
-
The effects of nutritional polyunsaturated fatty acids on locomotor activity in spontaneously hypertensive rats
ADHD Attention Deficit and Hyperactivity Disorders (2014)
-
Childhood diet and behavioural problems: results from the ALSPAC cohort
European Journal of Clinical Nutrition (2011)