It's too early to tell if omega-3s can help kids with ADHD

Q.

I hear that using omega-3 supplements might help my child in school. Is this true?

A.

I can give you a resounding "maybe" to that.

Let me give you a crash course on the substances that the brain is made of. Eighty percent of the brain is made of fat. Fat makes membranes. Membranes are like plastic bags that contain the inside of the cells. Cell membranes are wonderful conduits of bio-electric energy. All of the communication that occurs from nerve cell to nerve cell depends on the composition and positioning of these membranes. They couldn't work well if they weren't made of fat. The next time someone calls you a fathead, say, "Why, thank you."

A very important fat, called docosahexaenoic acid, or DHA, is an omega-3 fatty acid. DHA makes up about 15% of all the fatty acids in the brain. It seems to rapidly accumulate in the area where there is a lot of activity in the brain and is also a key component of the retina, the neurological part of the eyeball.

The brain takes in most of its DHA in the last trimester before birth, and it seems to be incorporated into brain tissue more slowly during childhood. Breast milk is high in DHA, and nearly all of the baby formulas are now supplemented with it. Your body can make DHA from other omega-3 fatty acids, although how much is a bit uncertain. Many nutritionists now feel that omega-3 supplementation during pregnancy, especially late pregnancy, is useful. Nursing babies may benefit from maternal supplementation as well.

Kids with attention deficit hyperactivity disorder, or ADHD, have low levels of long-chain fatty acids in the membranes of their red blood cells as compared with kids without ADHD. Does this mean that they have less in their brains as well? Possibly, since one of the areas that is richest in these fatty acids is the brain's frontal lobe. This is also the problem area for ADHD children.

If we give these kids omega-3 supplements, their red blood cell membranes accrue more of these fatty acids and become more like the red blood cells of other kids. Does this happen in the brain as well?

No one knows, but some of the evidence is tantalizing. There are seven studies that have looked at this, but they all have a few methodology problems. Some have shown promising results, some have not.

Still, I would not mind if any of my ADHD patients try some omega-3 supplements. However, I know of no evidence showing that you can get off medication by using supplements.

Also I have no idea whether this would help other kids. What dose should you use? I'm not sure. Also, it may not be just the intake of omega-3s that is important, but also the ratio with other fatty acids called omega-6s. It appears that omega-6s may interfere with the activities of omega-3s. How often should you take them? Too much omega-3 can be toxic, mostly causing abnormal bleeding. How can we monitor this?

The best sources for omega-3 fatty acids are flax seeds, walnuts and fish oils, particularly salmon. (Maybe your mom was right. Fish may be brain food.). Canola oil, soybean oil and rapeseed oil have some omega-3 as well. Surprisingly, most other types of vegetable oils, including olive oil, have little or none.

As I have stated previously, when it comes to nutrition, nothing seems cut and dried. I find much of this information exciting and full of possibilities. But I suggest you take all the claims of wonderful expectations with supplements with a big grain of salt.

(6/10/07)

Dr. Norton's column appears on the second Monday of each month in the Milwaukee Journal Sentinel and is reposted here. Contact Dr. Norton by phone at (414) 228-4800 or via e-mail.

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