Omega-3 polyunsaturated fatty acids in children with Attention Deficit Hyperactivity Disorder: A systematic review

Abstract

Abstract Introduction: Attention Deficit-Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that affects a significant population of children. Omega-3 supplementation is being explored since standard pharmacological treatments cause bothersome side effects. Our objective is to examine the impact of Omega-3 fatty acids on the symptoms of ADHD in children.

Methods: We conducted a systematic review, searching for randomized clinical trials in MEDLINE, Embase, and Web of Science from April 17th until May 1st, 2024. Studies were included if they involved children aged 6–18 with ADHD who consumed Omega-3 fatty acids through diet or supplementation. Studies were excluded if they included individuals without an ADHD diagnosis, used animal models, or supplements alongside Omega-3. Data extraction and Cochrane Risk-of-Bias (RoB2-tool) analysis were performed using Covidence. Findings were described in tables and analyzed.

Results: A total of thirty-one eligible randomized clinical trials were included, evaluating 2,494 individuals with an average age of 8.93 years (SD = 1.39). Most studies (90.3%) followed a two-arm design comparing Omega-3 supplementation to placebo. While fourteen studies (45.1%) reported statistically significant benefits of Omega-3 supplementation in overall ADHD symptoms, the sub-analysis on hyperactivity/impulsivity and inattention symptoms showed no significant effects or differences between groups. Studies were highly heterogeneous in design, interventions, trial duration, dosage, and outcome measurement tools.

Conclusion: Overall, Omega-3 may not have a significant effect on ADHD symptoms to recommend its use. Future research should address the limitations, such as the main dose and comparator and also ideal treatment time.