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8 O3 STUDIES
STUDIES on OMEGA-3
Australian Study
If you were still wondering whether there is scientific proof that Omega-3 fatty acids can have an effect on ADHD behaviour, here is a report on a large, well designed study by Dr Bryan Sinn and colleagues at the University of Adelaide. The researchers concluded: “This is the largest randomized, placebo-controlled trial published that examines PUFAs and ADHD. Its results support several previous smaller trials with LC-PUFAs. The findings confirm the potential benefits, without adverse side effects, of LC-PUFA supplementation in children with ADHD for whom safe and effective treatments remain elusive. As the authors note, it may take 2 to 3 months or longer for benefits to become apparent. Considering the alternatives, patience seems a low hurdle.” Go here for the full report.
Comment.
Note that there were some who did not respond at all and there are no reasons given for this. But it is an indication that we are all different and that not one thing works for everyone. But my suggestion is that considering the relative cost (see below) one should first try the fish oil supplement as part of a bigger strategy. I also maintain, with good feedback from the mothers I am in contact with, that the addition of the audio frequencies in my Settle and Grow set of CDs for the homework session. This will help the brain to become familiar with the ideal state for concentration. The combination of Omega-3 and the CDs seems to work very well.
Again, as in the study above, some will respond dramatically while others less so and some not at all. But it’s surely worth a good try.
Dr Sears' Informal Study
Dr Barry Sears in his book “The OMEGA Rx Zone”, Regan Books, 2002, outlines the key factors that a human brain needs for effective functioning. which are oxygen, DHA and a steady flow of glucose with the minimum of insulin.
Dr Sears had a long association with ADHD and the prospects of using ultra-refined fish oil to help the condition. He ran the following small study, which does not pretend to be peer-review quality but it had a placebo and was blind. From the book mentioned above I’ll let him tell the story himself:
“Many of my insights into ADD have come from my association with two colleagues, Rene Espy and Dan Amen. Dr Dan Amen did pioneering work with brain scans to identify the six types of ADD by determining differences in blood flow to the brain using a specialized imaging technique called SPECT. Another even more sophisticated imaging technique called PET, which measures the uptake of glucose (blood sugar) by brain cells, has shown that certain areas of the brain in patients with ADD aren't getting the appropriate amount of glucose. Patients with ADD have brains that are deprived of the two essential things the brain loves: oxygen and glucose.
No wonder people with ADD have such a tough time concentrating. My other collaborator, Rene Espy, who has expertise working with children, has used my program over the years with great success, and therefore has a large pool of potential patients. I knew that previous studies had demonstrated that children with ADD had lower levels of long-chain omega-3 fatty acids in their blood, and that the higher the ratio of AA/EPA in the blood, the more severe their ADD.
Rene and I decided that on the basis of the existing published data, coupled with her own experiences in treating numerous children with ADD, it was time to do an intervention trial with these children. Before I describe the results, let me point out some of the problems that had to be overcome.
We knew we needed to simultaneously control insulin and eicosanoid levels in the kids to provide their brains with a constant supply of glucose (by controlling insulin) and to increase blood flow and oxygen transfer (by controlling eicosanoids). Doing just one but not the other would not give us the best results. We knew how to control insulin: just give them a dietary plan to maintain the same ratio of protein to carbohydrate at every meal and snack. The real question was how much fish oil to use.
I determined how much to give on the basis of my previous work with Dan Ward's patients and the published research done at Harvard Medical School in treating depression. I estimated that a range of 10 to 20 grams of long-chain omega-3 fatty acids per day would be safe and effective. Since 2 tablespoons of pharmaceutical-grade fish oil provide 18 grams of long-chain omega-3 fatty acids, I decided that was a good starting point. Since we were dealing with kids, I also insisted that we never let the AA/EPA ratio drop below 1.5; we needed to be cautious, since the original research had been done on adults.
Getting kids to take 2 tablespoons of pharmaceutical-grade fish oil was actually pretty easy, especially when we used my Big Brain Shakes. Getting them to follow the insulin control part of my dietary program was more difficult, because it required strong parental support in the preparation of their meals - small kids aren't very good cooks. Rene and I knew that without insulin control, many of the potential benefits of high-dose fish oil would not be realized.
What were the results? In one word: spectacular. Within a few weeks, these children's ability to concentrate had increased dramatically. Their behavior improved both at home and in school. These behavioral changes were accompanied by a dramatic drop in the AA/EPA ratio in their blood. In fact, all the children had an abnormally high AA/EPA ratio before they began the study.
Even more important was the dramatic improvement in the children's behavior. We asked both parents and children to assess behavioral changes using a subjective scale. The results are shown below. ... [Results table omitted, but take his word for it.]
Interestingly, once these children left school for the summer and went back to their old dietary habits, their behavior rapidly deteriorated. Their follow-up blood test showed that their AA/EPA ratio had returned to the starting level. I wasn't surprised to see this effect, since long-chain omega-3 fatty acids don’t remain in the blood for more than a few days. This means that for ADD symptoms to remain under control, supplementation with high-dose fish oil must continue unabated.
What would account for the dramatic improvement in these children, with ADD? A likely reason is that high-dose fish oil increases dopamine production - the same effect that drugs like Ritalin have. However, it is also probably due to increased blood flow. Conversations with Dan Amen indicate that fish oil does appear to improve patterns of blood flow as viewed with SPECT scans. A third reason is the maintenance of a steady supply of glucose to the brain. All these effects can be achieved through my dietary program.
We know about the importance of controlling all these factors in the treatment of ADD because of an unsuccessful trial that was recently done at the Mayo Clinic. In that trial, the researchers used only very low doses of DHA (and no EPA) and made no effort to control insulin levels. We used much greater doses of both DHA and EPA, with very strict insulin control. They observed no benefits in four months, whereas we found spectacular changes in three weeks. So unless you combine high-dose fish oil with continual insulin control, you'll never get consistent results in reversing ADD. Either component of my dietary program (insulin control or eicosanoid modulation) will have a benefit, but together they provide an exceptionally strong synergy. This is a relatively small price to pay for your child's improved enjoyment of the world.” [End of Sears quote.]
For our practical use the important fact is that if you want to see a result using refined fish oil you have to use enough, particularly to start with. Perhaps not the amounts Dr Sears used but in the region of 3 to 4 grams a day. In addition you have to control the diet so there are no spikes of insulin.
The Durham Studies
It is a wonder to me that the much publicised research by Dr A. J. Richardson and colleague in the Oxford-Durham study, published in the American Academy of Paediatrics May 2005, yielded positive results. In the study they did not control for diet as, understandably with the sample size, it would be too difficult. And this has, I suspect, been at the root of the current research in Durham where the study seems to have changed from what it was originally intended to be.
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