The Efficacy of Omega 3 Supplements in Improving Symptoms of Attention-Deficit/Hyperactivity Disorder in Children: A Systematic Review

Abstract

Introduction: Attention-deficit/hyperactivity disorder (ADHD) is characterized by symptoms of inattention, hyperactivity, and impulsivity, impacting daily functioning in children. Genetic and environmental factors contribute to its prevalence, affecting about 8% of children. Treatment typically involves medication and behavioral therapy. Dietary factors, including omega-3 fatty acids, have been studied for their impact on ADHD. While some evidence suggests omega-3s may help, systematic reviews show insufficient support for their effectiveness in treating ADHD symptoms. This research aims to evaluate omega-3 supplements' effectiveness in improving ADHD symptoms in children.
Method: A search strategy using PubMed and Medline with keywords "ADHD," "children," and "omega 3 fatty acid" followed PRISMA guidelines (2020). The PICO model targeted children with ADHD, comparing omega-3 fatty acids to placebo, measuring improvement in ADHD-RS-IV scores by parents. Inclusion criteria: RCTs from 2017-2024, children with ADHD, and English-language studies. Exclusion criteria: non-RCTs, studies before 2017, on adolescents/adults, and non-English studies. Primary outcome was changes in ADHD parent ratings, and secondary outcome was side effects.
Results: All five randomized studies showed reductions in ADHD scores (ADHD-RS-IV) after their trials, with varying degrees of improvement between intervention and placebo groups. One study reported a larger reduction in the placebo group compared to the intervention group. Another found no significant differences between DHA supplementation and placebo. A third study saw similar decreases in ADHD scores for both groups without significant differences. In another trial, there was an improvement in the DHA group and worsening in the placebo group. One study reported significant reductions in both groups. For secondary outcomes, side effects like decreased appetite, restlessness, headaches, nausea, vomiting, and diarrhea were noted, with no significant differences between groups.
Conclusion: The extensive research into omega-3 supplements for managing ADHD has shown they are not effective as a primary treatment. This systematic review of five RCTs consistently found no significant difference between omega-3 supplementation and placebo in reducing ADHD symptoms in children.