Increased erythrocyte eicosapentaenoic acid and docosahexaenoic acid are associated with improved attention and behavior in children with ADHD in a randomized controlled three-way crossover trial

Objective: To investigate effects of omega-3 polyunsaturated fatty acids (n-3 PUFA) docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) on attention, literacy, and behavior in children with ADHD. Method: Ninety children were randomized to consume supplements high in EPA, DHA, or linoleic acid (control) for 4 months each in a crossover design. Erythrocyte fatty acids, attention, cognition, literacy, and Conners’ Parent Rating Scales (CPRS) were measured at 0, 4, 8, 12 months. Results: Fifty-three children completed the treatment. Outcome measures showed no significant differences between the three treatments. However, in children with blood samples (n = 76-46), increased erythrocyte EPA + DHA was associated with improved spelling (r = .365, p < .001) and attention (r = −.540, p < .001) and reduced oppositional behavior (r = −.301, p < .003), hyperactivity (r = −.310, p < .001), cognitive problems (r = −.326, p < .001), Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) hyperactivity (r = −.270, p = .002) and DSM-IV inattention (r = −.343, p < .001). Conclusion: Increasing erythrocyte DHA and EPA via dietary supplementation may improve behavior, attention, and literacy in children with ADHD.Catherine M. Milte, Natalie Parletta, Jonathan D. Buckley, Alison M. Coates, Ross M. Young, and Peter R. C. How