There’s a reason the American Psychiatric Association recommends that every man, woman, and child in America eat fish two or more times a week – especially oily fish like salmon and tuna. And why they recommend people with “impulse control disorders” such as attention deficit hyperactivity disorder (ADHD) to supplement their daily diet with at least 1 gram of fish oil. The reason: Omega-3 fatty acids really help the brain, especially ADHD, to function better.
The right fat to optimize the ADHD brain
Sixty percent of your brain is made up of fat – which means that your brain relies on a constant supply of dietary fat for its health and well-being. Specifically, it depends on essential fatty acids (EFA), the building blocks of fat. Oily fish and fish oil provide two of the most important essential fatty acids for your brain: EPA or eicosapentaenoic acid; and DHA or docosahexaenoic acid. Both fatty acids are omega-3 fatty acids, a chemical label that indicates the placement of carbon atoms in a fat molecule. But omega is also the Greek word for great – because when enough omega-3s do their job, they do a great job of protecting your brain. But if the values are low:
- The outer shell (membrane) of the brain cells (neurons) degenerates.
- Neurons produce less serotonin, a neurotransmitter that helps control mental activity and mood.
- Cellular receptors for the neurotransmitter dopamine are malformed, which leads to lower dopamine levels.
- Dendrites, the branched extensions that route messages in and out of neurons, make fewer branches.
- There are fewer synapses, the bridges between neurons.
In short, almost every aspect of neurotransmission – the transmission of information from brain cell to brain cell that supports every thought, emotion, and action – is influenced by omega-3 fatty acids. Omega-3s also protect the brain by reducing low-level inflammation, the chronic cell fire that can scorch brain cells.
Bottom line: A lack of omega-3 fatty acids is bad news for a child or adult’s brain. Our ancestors as hunter-gatherers ate with a ratio of about 2 to 1 omega-6 to omega-3. Today we’re eating a 15-to-1 diet. That one-two punch – an omega-6 flood and an omega-3 deficiency – is a little-known factor in the symptoms of ADHD.
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Little recognized by doctors, but not by scientists. More studies have been done on the association between ADHD and omega-3 fatty acids than any other nutrient. Let’s look at some of the best research.
The power of omega-3 fatty acids to affect the ADHD brain
From prevention to treatment, omega-3 fatty acids play a key role in ADHD.
- Eating fewer omega-3 fatty acids increases the risk of developing ADHD. In a study of nearly 200 school children, those who ate a low-omega-3 diet were 31 percent more likely to be diagnosed with ADHD.
- Children diagnosed with ADHD have lower blood levels of omega-3 fatty acids. According to an analysis of nine studies by researchers at Oregon Health & Science University, blood levels of omega-3 fatty acids in children with ADHD are on average 38 percent lower than in children who do not have the disease. In a study of 493 school children, those with lower blood DHA levels had more defiance, hostility, mood swings, and learning difficulties. And a study by English scientists showed that children with ADHD and low omega-3 levels had poor “emotion processing” (the ability to understand and respond to emotions) and poor emotion regulation.
- Low omega-3 fatty acids in children with ADHD can be genetic. Remember, ADHD is not a behavioral problem. It is a medical disorder, usually with a genetic component, that leads to deficiencies in dopamine, norepinephrine, and serotonin. Scientists at the MRC Social, Genetic & Developmental Psychiatry Center in London decided to find out if the genetic profile of ADHD extends to essential fatty acids. They looked at 180 children with ADHD and 180 without the disease and found that the ADHD children were 60 to 70 percent more likely to have a variation in a gene that is necessary for the metabolism of fatty acids.
- Disordered brain waves – low in omega-3 fatty acids. ADHD children with low blood DHA levels have a type of impaired brain activity associated with ADHD, according to a study in the journal Neuropharmacology.
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Studies showing the benefits of omega-3s for the ADHD brain
- Supplementing with omega-3 fatty acids alleviates hyperactivity. When analyzing data from 16 studies on ADHD and omega-3 fatty acids, researchers at Oregon Health & Science University found that supplementing the diet with omega-3 fatty acids consistently reduced hyperactivity, as rated by parents and teachers. “There is enough evidence to establish omega-3 fatty acids as a possible supplement [medication and behavioral] Therapies “for ADHD, the researchers concluded in the Clinical Psychology Review.
- Less inattention, less hyperactivity, less disobedience, less hostility – and better spelling too. According to Australian researchers, these were among the symptom-relieving benefits of children with ADHD who took an omega-3 supplement daily for four months.
- Better memory, better learning. When examining 95 children diagnosed with ADHD, German researchers found that omega-3 fatty acid supplementation improved “working memory” – the short-term memory that is key to learning.
- Bringing sleep problems to bed – with omega-3 fatty acids. Israeli researchers looked at 78 ADHD children (ages nine to 12) with sleep problems and gave them either an omega-3 / omega-6 supplement or a placebo. (The supplement contained gamma-linolenic acid, or GLA, an essential omega-6 fatty acid found in evening primrose oil, borage oil, and currant oil.) After 10 weeks, the children taking the supplement slept better and did better during the day collaborate with others.
Does Your Child Need An Omega 3 Supplement?
Parents often ask me: “Does my child need to take an omega-3 supplement?” Unfortunately, this is not always easy to answer. For one thing, there are no clear, obvious signs of omega-3 deficiency like there are other nutrients like magnesium (trouble sleeping, anxiety, and constipation). My clinical experience has shown that months or years of taking a high-dose omega-3 supplement (more than four grams per day) can actually lead to an essential fatty acid imbalance. Too much of the omega-3 fatty acids DHA and EPA can lower omega-6 GLA levels.
That doesn’t mean there aren’t any tell-tale signs of essential fatty acid deficiency. A child with frequent thirst, frequent urination, and / or allergies is likely to need a high dose (over two grams per day) of omega-3 fatty acids. A child with a skin condition – eczema, or “chicken skin” (the bumps dermatologists call keratosis pilaris) – may have GLA deficiency and will need supplementation.
The best no-test strategy for supplementation
If your child has no obvious signs of omega-3 deficiency, and you and your doctor don’t plan to test for a deficiency, I suggest that your child take a fish oil supplement that provides 1 to 1 liter of two grams a day DHA and EPA. In my practice, I use a supplement that combines EPA / DHA and GLA for a total of three grams of essential fatty acids per day. If the dietary supplement you choose contains 800 mg EPA, 400 mg DHA, and 100 mg GLA per capsule or serving size, you would take it two to three times a day.
[Read This Next: 6 How-Tos About Omega-3 Fatty Acids]
Adapted from Final Focused: The groundbreaking natural treatment plan for ADHD that restores alertness, minimizes hyperactivity, and helps eliminate medication side effects (#Commissions Earned). Copyright © 2017 by JAMES GREENBLATT, MD, and BILL GOTTLIEB, CHC. Published by Harmony Books, an imprint of Penguin Random House LLC.
Add omega-3 fatty acids and subtract sugars for better behavior
Some experts believe that chronic sugar consumption causes ADHD, but my clinical experience with thousands of children with ADHD does not confirm it. But sugar contributes to the symptoms of ADHD in many children – and reducing sugar usually helps.
If you can help your child with ADHD reduce or remove sugar-sweetened beverages (SSBs) – soft drinks, fruit drinks, sports drinks, energy drinks – reduce or eliminate the largest source of sugar in their diet. A recent study by the Yale School of Public Health found that the risk of hyperactivity and inattentiveness increased by 14 percent for every sweetened drink consumed daily.
Research has shown that your child’s blood sugar levels are balanced as the key to keeping their brain and behavior in balance. Do your best to keep your child eating high protein foods – nut butters, whole grain breads, lean meats, etc. – throughout the day. This steady supply of slowly digestible protein helps keep blood sugar levels constant. Some example foods include nut butters; Whole grain bread; Eggs; Greek yogurt; lean chicken, turkey, or tuna; Hummus; and protein-fortified cereals that are low in sugar.
Turbocharger for omega-3 fatty acids – with phosphatidylserine
Parents giving omega-3 supplements to their child with ADHD often ask me what else they can do. One supplement that I often suggest is Phosphatidylserine (PS).
This nutrient compound is a type of phospholipid, a fat that helps build the outer covering (membrane) of cells, including brain cells. Neurons with healthy membranes communicate better with each other – which leads to more balanced emotions and better behavior.
Studies show that adding PS to omega-3 fatty acids improves ADHD symptoms, but it can work on its own. Children who took PS alone had better alertness, less impulsiveness and restlessness, and better short-term memories. My recommendation is 200 to 300 mg. daily of PS, in 100 mg. Doses taken with two or three meals. (Example: 100 mg for breakfast and 100 mg for dinner.)
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Updated May 5, 2021
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