2ND STUDY TO EXPAND UPON THIS PHENOMENON

DATELINE-WEST LAFAYETTE, INDIANA, ISSUED TO MEDIA ON DECEMBER 16 1996

Purdue University researchers found in a June, 1996 study that boys with low blood levels of essential omega-3 fatty acids, have a greater tendency to have problems with behavior, learning, and health consistent with attention deficit hyperactivity disorder (ADHD). In response to this breakthrough, a second Purdue University study has been launched to expand upon the hypothesis (1) that oral supplementation of specific fatty acids will increase the concentrations of long chain n-6 and n-3 fatty acids in the blood and (2) that increased blood fatty acid levels will improve behavior of ADHD children.

"There are two types of fatty acids that musts be obtained from the foods-- such as fish, seafood and polyunsaturated oils-- we eat because the body cannot synthesize them," commented John R. Burgess, assistant professor of food and nutrition at Purdue University, who led the first study and is heading up the follow-up research as well. He added, "Omega-3 and omega-6 fatty acids are both essential to the body. However evidence is accumulating that a deficiency of omega-3 fatty acids may be tied to behavior problems, learning, and health problems."

THIRST FOR KNOWLEDGE

Previous studies have focused on essential fatty acid metabolism in children with ADHD. These children were found to exhibit greater thirst and symptoms of eczema, asthma, and other allergies which are associated with essential fatty acid deficiency. (11)

ADHD Profile

ADHD is the most common behavioral disorder in children, affecting between 3% and 5% of school age youngsters (6). ADHD is diagnosed more often in boys than girls. The diagnosis is used to describe children who are inattentive, impulsive, hyperactive. ADHD children have problems paying attention, listening to instructions, completing tasks, fidgeting and squirming, hyperactivity, blurting out answers and interrupting others. These behaviors often severely affect school performance, family relationships, and social interaction with peers. Approximately 20-25% of children with ADHD show one or more specific learning disabilities in math, reading, and spelling. (5)

DRUGS & OTHER STRATEGIES

The cause is unknown and thought to be biological and multifactorial. Psycho-stimulant drugs, such as Ritalin, Cylen and Dexedrine are often used to calm children with ADHD at about 75% effectiveness rate (8). The advantages of using these medications include rapid response, ease of use, effectiveness, and relative safety. Disadvantages include possible side effects, such as decreased appetite and growth, insomnia, increased irritability, and rebound hyperactivity when the drug wears off (9). These medications do not address the underlying cause(s) of ADHD. Thus, this study to elucidate the potential contributors to the behaviors problems in ADHD may lead to more effective treatment strategies for some children.

METHODOLOGY

Ninety children with symptoms of essential fatty acid deficiencies have been recruited for this study. Children were chosen on the basis of parents and teachers completing the Disruptive Behavior Disorders (DAD) Rating Scales (27), a health questionnaire, and a three day diet record. Additionally, a control group of 20 children with no essential fatty acid deficiency and no behavioral problems were recruited. Four months was chosen as a sufficient time period of supplementations to see improvement in fatty acid status based on previous studies in both animals and humans. (17, 18)

A supplement containing the specific essential fatty acid derivatives that are depleted in the 90 children is being used in a double-blind intervention study with a 3-group parallel (noncrossover) design. The supplement being used in the study is Efalex Focus, a patented dietary supplement which combines tuna oil, evening primrose oil, vitamin E and thyme oil and produced by Efamol Ltd.

The 90 subjects have been randomly assigned to three groups:

Group A: To receive a high does of the supplement

Group B: To receive a low dose of the supplement

Group C: To receive placebo capsules

The control group of 20 children with no essential fatty acid deficiency and no behavioral problems were not given any supplementation or placebo, but were subjected to a similar battery of tests.

The three groups are balanced with respect to initial behavioral assessment, math achievement, age, gender, socio-economic an medication status. Blood samples are being drawn at baseline, two and four months of supplementation for analysis of fasting plasma and red blood cell fatty acids. Behavioral and learning changes were assessed before supplementation using the Teacher 10-Item Conners evaluation and will also be reviewed during and at the end of the four month intervention.

Drop out rate was anticipated to be low due to heightened public concern over stimulant drug use and a desire by parents to explore alternative therapies for ADHD.

TITLE: Omega-3 Fatty Acids in Boys with Behavior, Learning, and Health Problems

AUTHORS: L.J. Stevens, S.S. Zentall, M.L. Abate, T. Kuczek, J.R. Burgess

SOURCE: Physiol Behav 59(4/5) 915-920. 1996

ABSTRACT: The purpose of the study reported here was to compare behavior, learning and health problems in boys ages 6-12 with lower plasma phospholipid total omega-3 or total omega-6 fatty acid levels with those boys with higher levels of these fatty acids. A greater frequency of symptoms indicative of essential fatty acid deficiency was reported by the parents of subjects with lower plasma omega-3 or omega-6 fatty acid concentrations than those with higher levels. A greater number of behavior problems, accessed by the Conners' Rating Scale, temper tantrums, and sleep problems were reported in subjects with lower total omega-3 fatty acid concentrations. Additionally, more learning and health problems were found in subjects with lower total omega-3 fatty acid concentrations. (Only more colds and more antibiotic used were reported by those subjects with lower total omega-6 fatty acids.) These findings are discussed in relation to recent findings for omega-3 experimentally deprived animals.

TITLE: Essential Fatty Acid Metabolism in Boys with Attention-Deficit Hyperactivity Disorder.

AUTHORS: L.J. Stevens, S.S. Zentall, J.L. Deck, M.L. Abate, B.A. Watkins, S.R. Lipp, J.R. Burgess

SOURCE: American Journal of Clinical Nutrition, 1995 Oct; 62(4): 761-8

ABSTRACT: Attention-deficit hyperactivity disorder (ADHD) is the term used to describe children who are inattentive, impulsive, and hyperactive. The cause is unknown and is thought to be multifactorial. Based on the work of others, we hypothesized that some children with ADHD have altered fatty acid metabolism. The present study found that 53 subjects with ADHD had significantly lower concentrations of key fatty acids in the plasma polar lipids (20:4n-6, 20:5n-3, and 22:6n-3) and in red blood cell total lipids (20:4n-6 and 22:4n-6) than did the 43 control subjects. Also, a subgroup of 21 subjects with ADHD exhibiting many symptoms of essential fatty acid (EFA) deficiency had significantly lower plasma concentrations of 20:4n-6 and 22:6n-3 than did 32 subjects with ADHD with few EFA-deficiency symptoms. The data are discussed with respect to cause, but the precise reason for lower fatty acid concentrations in some children with ADHD is not clear.

TITLE: Benefit of docosahexaenoic acid supplements to dark adaptation in dyslexics

AUTHORS: B. Jacqueline Stordy

SOURCE: Lancet 5th August 1995, 346:8971

ABSTRACT: Sir-Makrides and colleagues (June 10, p 1463) provide strong evidence that docosahexaenoic acid (DHA) is an essential nutrient for the optimum neural maturation of term infants as assessed by visual evoked potential acuity. I have data indicating that DHA supplementation in adult dyslexics improves dark adaptation (scotopic vision) and thus DHA may also be a dietary essential for this condition.

We measure dark adaptation with a Friedmann Visual Field Analyser 2, set for the dark adaptation function, in ten adults with dyslexia and ten controls. Dyslexics showed poorer dark adaptation than controls, especially in the second part of the curve, which corresponds with rod dark adaptation (figure a: repeated measures Anova p,0.05). We subsequently tested the possibility that dark adaptation might be influenced by DHA. For 1 month five dyslexics and five controls were given 480 mg of DHA daily with no additional vitamin A or vitamin D. Dark adaptation was then retested (figure, b and c). In four controls DHA had no effect on dark adaptation, although in one (a strict vegetarian) adaptation clearly improved. By contrast, in the dyslexics with poor scotopic vision DHA consistently and significantly improved dark adaptation (figure, b: paired t-rest on final rod threshold, p<0.04).

It has been recognized that dyslexics have both retinal and central processing defects,* but defective dark adaptation has to my knowledge not previously been reported. DHA is a key fatty avid in both retina and brain and is usually present in large quantities in these tissues. In these studies I show the benefit of DHA supplementations for one aspect of retinal function. I have found that DHA supplements given to dyslexics can also be associated with improvement is reading ability and behavior. These reports are anecdotal and subjective but more formal controlled studies are in preparation.

* Grosser GS, Spafford CS. Light Sensitivity in Peripheral Retinal Fields of Dyslexic and Proficient Readers. Perceptual Motor Skills 1990; 71:467-77.

Galaburda A. Livingstone M. Evidence for a Magnocellular Defect in Developmental Dyslexia.Ann NY Acad Aci 1993: 71-81