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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).