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Omega-6 to Omega-3 Fatty Acid Ratio in Patients with ADHD: A Meta-Analysis.

Abstract

OBJECTIVE

Omega-3 and omega-6 fatty acids have been shown to be deficient in individuals with attention deficit/hyperactivity disorder compared to controls (Hawkey & Nigg, 2014). Clinical trials of omega-3 and omega-6 supplements as treatment for ADHD have demonstrated minimal efficacy (Bloch & Qawasmi, 2011; Gillies, Sinn, Lad, Leach, & Ross, 2011; Hawkey & Nigg, 2014; Puri & Martins, 2014; Sonuga-Barke et al., 2013). Existing trials have analyzed omega-3 and omega-6 separately although the tissue ratio of these fatty acids (n6/n3) may be more important than absolute levels of either. The objective of this study was to determine the relationship between blood n6/n3 and arachidonic acid to eicosapentaenoic acid (AA/EPA), to ADHD symptoms.

METHOD

A systematic literature review identified original articles measuring blood n6/n3 or AA/EPA ratio in children and youth with ADHD, compared to controls without ADHD. Three databases were searched. Blood n6/n3, and AA/EPA ratios were compared between individuals with ADHD and controls. Results were pooled across studies using quantitative synthesis.

RESULTS

Five articles met inclusion criteria for the meta-analysis. The pooled mean difference between patients with ADHD and controls was 1.97 (0.90-3.04) for n6/n3 (n=5 studies, I(2) 83%) and 8.25 (5.94-10.56) for AA/EPA (n=3 studies, I(2) 0%).

CONCLUSIONS

Children and youth with ADHD have elevated ratios of both blood n6/n3 and AA/EPA fatty acids compared to controls. Thus an elevated n6/n3, and more specifically AA/EPA, ratio may represent the underlying disturbance in essential fatty acid levels in patients with ADHD. These findings have implications for the development of future interventions using essential fatty acids to treat ADHD, and for the use of these ratios as biomarkers for titrating and monitoring ADHD treatment with essential fatty acids.

Authors+Show Affiliations

University of Toronto, Department of Psychiatry, Toronto, Ontario.University of Toronto, Department of Psychiatry, Toronto, Ontario; Centre for Addiction and Mental Health, Social Aetiology of Mental Illness, Toronto, Ontario; Wellesley Institute, Toronto, Ontario.University of Toronto, Department of Psychiatry, Toronto, Ontario; Women's College Hospital and Women's College Research Institute, Toronto, Ontario.University of Toronto, Department of Psychiatry, Toronto, Ontario; Women's College Hospital and Women's College Research Institute, Toronto, Ontario.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27274744

Citation

LaChance, Laura, et al. "Omega-6 to Omega-3 Fatty Acid Ratio in Patients With ADHD: a Meta-Analysis." Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal De l'Academie Canadienne De Psychiatrie De L'enfant Et De L'adolescent, vol. 25, no. 2, 2016, pp. 87-96.
LaChance L, McKenzie K, Taylor VH, et al. Omega-6 to Omega-3 Fatty Acid Ratio in Patients with ADHD: A Meta-Analysis. J Can Acad Child Adolesc Psychiatry. 2016;25(2):87-96.
LaChance, L., McKenzie, K., Taylor, V. H., & Vigod, S. N. (2016). Omega-6 to Omega-3 Fatty Acid Ratio in Patients with ADHD: A Meta-Analysis. Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal De l'Academie Canadienne De Psychiatrie De L'enfant Et De L'adolescent, 25(2), pp. 87-96.
LaChance L, et al. Omega-6 to Omega-3 Fatty Acid Ratio in Patients With ADHD: a Meta-Analysis. J Can Acad Child Adolesc Psychiatry. 2016;25(2):87-96. PubMed PMID: 27274744.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Omega-6 to Omega-3 Fatty Acid Ratio in Patients with ADHD: A Meta-Analysis. AU - LaChance,Laura, AU - McKenzie,Kwame, AU - Taylor,Valerie H, AU - Vigod,Simone N, Y1 - 2016/05/01/ PY - 2015/06/15/received PY - 2016/01/15/accepted PY - 2016/6/9/entrez PY - 2016/6/9/pubmed PY - 2016/6/9/medline KW - attention deficit/hyperactivity disorder KW - omega-3 fatty acids KW - omega-6 fatty acids SP - 87 EP - 96 JF - Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent JO - J Can Acad Child Adolesc Psychiatry VL - 25 IS - 2 N2 - OBJECTIVE: Omega-3 and omega-6 fatty acids have been shown to be deficient in individuals with attention deficit/hyperactivity disorder compared to controls (Hawkey & Nigg, 2014). Clinical trials of omega-3 and omega-6 supplements as treatment for ADHD have demonstrated minimal efficacy (Bloch & Qawasmi, 2011; Gillies, Sinn, Lad, Leach, & Ross, 2011; Hawkey & Nigg, 2014; Puri & Martins, 2014; Sonuga-Barke et al., 2013). Existing trials have analyzed omega-3 and omega-6 separately although the tissue ratio of these fatty acids (n6/n3) may be more important than absolute levels of either. The objective of this study was to determine the relationship between blood n6/n3 and arachidonic acid to eicosapentaenoic acid (AA/EPA), to ADHD symptoms. METHOD: A systematic literature review identified original articles measuring blood n6/n3 or AA/EPA ratio in children and youth with ADHD, compared to controls without ADHD. Three databases were searched. Blood n6/n3, and AA/EPA ratios were compared between individuals with ADHD and controls. Results were pooled across studies using quantitative synthesis. RESULTS: Five articles met inclusion criteria for the meta-analysis. The pooled mean difference between patients with ADHD and controls was 1.97 (0.90-3.04) for n6/n3 (n=5 studies, I(2) 83%) and 8.25 (5.94-10.56) for AA/EPA (n=3 studies, I(2) 0%). CONCLUSIONS: Children and youth with ADHD have elevated ratios of both blood n6/n3 and AA/EPA fatty acids compared to controls. Thus an elevated n6/n3, and more specifically AA/EPA, ratio may represent the underlying disturbance in essential fatty acid levels in patients with ADHD. These findings have implications for the development of future interventions using essential fatty acids to treat ADHD, and for the use of these ratios as biomarkers for titrating and monitoring ADHD treatment with essential fatty acids. SN - 1719-8429 UR - https://www.unboundmedicine.com/medline/citation/27274744/full_citation L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/27274744/ DB - PRIME DP - Unbound Medicine ER -