ABSTRACT
INTRODUCTION: Incidental reports collected in clinical trials suggest that amongst participants, omega-3 fatty acids derived from fish oil ('omega-3') may be difficult to blind. MATERIALS AND METHODS: We conducted a systematic evaluation of blinding success in a 24-week trial of omega-3 versus an oil-based placebo. Within 1 week of supplement commencement (Week 1), a blinding questionnaire was completed by 131 children enrolled in a trial of omega-3 for the treatment of disruptive behaviour disorders. A version of the questionnaire was also completed by their parents at Week 1, and by the children at the end of supplement administration (Week 24). RESULTS: Participants were unable to differentiate omega-3 from placebo, and accuracy did not improve as a function of: the confidence of guesses, reason for guesses, notice of any change, beliefs about what should change, or time. Child and parent guesses also showed high concordance. CONCLUSION: Taken together, these data provide strong evidence that the identity of omega-3 can be blinded to participants.
Subject(s)
Attention Deficit and Disruptive Behavior Disorders/diet therapy , Dietary Supplements , Fatty Acids, Omega-3/therapeutic use , Single-Blind Method , Adolescent , Child , Female , Humans , Male , Parents , Surveys and QuestionnairesABSTRACT
OBJECTIVE: Epidemiological research links aggression to low serum concentrations of omega-3 fatty acids, such as those found in fish oil. However, no studies have specifically examined whether fish oil supplementation can reduce the frequency and severity of impulsive aggression in children with disruptive behavior disorders. METHODS: Children presenting with impulsive aggression and meeting research criteria for diagnosis of disruptive behavior disorders were randomized to receive either: 1) Fish oil capsules (4 g daily) for 6 weeks followed by placebo (identical-looking capsules) for 6 weeks; or 2) placebo for 6 weeks, followed by fish oil for 6 weeks, in a double-blind, crossover design. Primary outcomes were the Children's Aggression Scale and the Modified Overt Aggression Scale. Secondary outcomes included emotional and behavioral functioning (Strengths and Difficulties Questionnaire [SDQ]), hyperactivity symptoms (Attention-Deficit/Hyperactivity Disorder [ADHD] Rating Scale), family functioning (Family Assessment Device), and cognitive functioning (Stop Signal Task, Trail-Making Task, and Eriksen Flanker Task). Serum concentrations of omega-3 and omega-6 fatty acids were measured at baseline, and at 6 and 12 weeks. RESULTS: Twenty-one children participated (81% male; mean age 10.3±2.2 years; range 7-14). Fish oil treatment increased serum concentrations of eicosapentanoic acid (F=14.76, p<0.05) and total omega-3s (F=20.56, p<0.05), but did not influence primary ratings of aggression. In fact, a trend suggested that fish oil worsened a secondary measure of aggression (SDQ Conduct Subscale, F=4.34, p=0.06). Fish oil treatment was associated with an improvement in one rating of hyperactivity (SDQ Hyperactivity Subscale, F=2.22, p<0.05), but did not influence any other outcome measures. CONCLUSIONS: These findings suggest that fish oil treatment does not improve aggression in children with disruptive behavior disorders.
Subject(s)
Aggression/drug effects , Attention Deficit and Disruptive Behavior Disorders/diet therapy , Fish Oils/pharmacology , Fish Oils/therapeutic use , Impulsive Behavior/drug effects , Adolescent , Attention Deficit and Disruptive Behavior Disorders/blood , Attention Deficit and Disruptive Behavior Disorders/complications , Child , Cognition/drug effects , Cross-Over Studies , Double-Blind Method , Fatty Acids, Omega-3/blood , Fatty Acids, Omega-6/blood , Female , Fish Oils/adverse effects , Humans , Male , Treatment OutcomeABSTRACT
Introducción. El trastorno por déficit de atención/hiperactividad (TDAH) ha recibido en los últimos años gran atenciónpor parte de las especialidades pediátricas. A pesar de los avances en el conocimiento de su etiopatogenia, fundamentalmenterelacionados con la genética y la neuroimagen, su causa última todavía se desconoce. Desarrollo. El TDAH se ha relacionadocon multitud de factores, algunos concernientes a la dieta, como algunas alergias a aditivos, la toxicidad a metales pesadosy otros tóxicos ambientales, dietas bajas en proteínas con alto contenido en carbohidratos, desequilibrios minerales, déficitde ácidos grasos esenciales y fosfolípidos, déficit de aminoácidos, trastornos de tiroides y déficit del complejo vitamínico B y fitonutrientes.Los cambios en el estilo de vida en general y en la dieta se barajan como hipótesis de numerosos trastornos y problemasde salud, pero, ¿y para el TDAH? Uno de los cambios más destacables se da en las grasas vegetales y los aceites que hoydía dominan el consumo humano, ya que están desprovistos de lípidos de la familia de los ácidos grasos esenciales omega-3, comoácido alfa-linoleico, ácido eicosapentanoico y ácido docosahexanoico. Esto se ha podido agravar al aumentar las cantidadesde omega-6 y alterar la ratio entre ambos. Conclusiones. Está bien documentado que este tipo de nutrientes desempeña unpapel importante en el desarrollo, principalmente del sistema nervioso. Este trabajo revisa el papel de los ácidos grasos esencialesen los trastornos neuropsiquiátricos en general y en el TDAH en particular(AU)
Introduction. Attention-deficit/hyperactive disorder (ADHD) has received in the past years a lot of attention fromthe paediatricians specialties. Even though the studies of its etiopathology have advanced, mainly the ones related withgenetics and neuroimaging, the final cause today is still unclear. Development. It has been related to many factors such asdiet, like some allergies to additives, toxicity to heavy metals and other toxic substances from the environment, due to lowprotein diets with a high carbohydrate content, unbalanced minerals, essential fatty acids and phospholipid deficit, aminoacid deficits, thyroid disorders, and vitamin B complex disorders and phytochemicals. The way our lifestyle has changed ingeneral and the diet in particular nowadays is being considered as a hypothesis for many disorders and health problems, butwhat about ADHD? One of the changes that we want to emphasize is related to vegetable fat and oils that dominate humanconsumption and the reduction income of fatty acids from the omega-3 family, including alpha-linolenic acid,eicosapentaenoic acid and docosapentaenoic acid. The fact is even worse when the amount of omega-6 increases and the ratiobetween both changes. Conclusions. It is a fact that these kinds of nutrients play an important role in the nervous systemdevelopment. In this paper the essential fatty acids in neuropsychiatric disorders in general, ADHD in particular, is reviewed(AU)
