Information Center ADHD, and other health concerns

Attention deficit hyperactivity disorder (ADHD) is a common developmental disorder in children. Studies suggest an association between consumption of low levels of polyunsaturated fatty acids especially omega 3 and an increased incidence of ADHD. An index of the level of omega 3 (EPA and DHA) in Red Blood Cell (RBC) has been developed by Harris and Von Schacky (HS Omega 3 IndexTM (O3I)).

ADHD children, in general, have lower omega 3 indices (1) Oxidized omega 3 is less effective in diseases that involve high oxidative stress (2,3). ADHD children, in general, have higher oxidative stress (4). Omega 3 supplementation studies with high DHA content have failed to show significant benefit (5).

We, therefore, hypothesized that inconsistent results of past omega 3 studies in ADHD may be due to:

Fixed omega 3 dose, not normalized to body mass
Insufficient dose
Inappropriate EPA to DHA ratio
Low antioxidant capacity in the blood
Oxidized (rancid) oil

We attempted to overcome these limitations by providing an omega 3 dose normalized to body mass (100 mg/kg/d) with an EPA:DHA ratio of 2:1 while ensuring low oil oxidation before consumption and low oxidative stress by vitamin E (VE) supplementation.

Target: In order to come up with a verified omega 3 treatment protocol (The Omega Protocol) for ADHD we tried to correlate 3 factors:

The severity of ADHD symptoms before during and after the trial
O3I at time 0, 3 and 6 months
Dose-response before during and after the trial

Methods: The study was authorized by the Ziv Helsinki Committee and the Israel Ministry of Health. The study was open-label self-controlled of ADHD children (n=33, ages 6-14) diagnosed according to DSM-5 and control group without ADHD or related neuropsychiatric syndromes (n=26, age and gender-matched). The ADHD group was supplemented with 100mg/kg of Fish Oil (FO) (400mg EPA+ 200mg DHA per capsule) plus 400 IU alpha-tocopherol per 3000 mg O3 to eliminate peroxidation in the lipoprotein in the serum. The FO was from a fresh 3 months old batch with initial oxidation values pAv 10, POv 2, TOTOX 14. The FO capsules were stored at 7°C to ensure freshness before and during the trial.

At 0, 3 and 6 months, each child had a clinical examination and provided a 3ml blood sample. RBCs were isolated at 2,500g for 10 min and frozen at -80°C immediately after collection.

Omega 3 Index was analyzed by GC according to O3I methodology.

ADHD severity was assessed by a psychiatrist based on CGI-S questionnaire on a scale of 1 to 7 where 1 is normal and 7 is extremely severe ADHD. Improvement was assessed by CGI-I also on a 1-7 scale.

Results: The initial omega 3 index in ADHD children's RBC was 4.45%, significantly lower (p=0.037) than the 5.1% in the children control group and 6.4% in the general population in Israel (Fig 1). The omega 3 index increased very significantly in the ADHD group after 3 months and leveled off after 6 months(Fig 2).