In addition to a diverse diet, sufficient sleep and adequate physical activity, there are two supplements that I often recommend to youth struggling with emotional distress, distractibility or hyperactivity: omega-3 fatty acids and vitamin D3.
In this, the first of two posts on 3-D health, we’ll focus on omega-3 fatty acids.
Brains rely on fatty acids for facilitating intercellular communication, regulating gene expression, modulating inflammatory responses and insulating neurons to promote signal conduction. Fatty acids also are essential for the growth and strengthening of neurons and neuronal connections.
One-third of the fatty acids in the brain are omega-3 and omega-6. Regulating the amount of fatty acids consumed changes the amount of fatty acids available for brain development. The primary omega-3 fatty acids are DHA (docosahexaenoic acid) and EPA (icosapentaenoic acid) which are found in fatty cold water fish, such as salmon, tuna and mackeral. The body can also transform ALA (alpha-linolenic acid), found in seed oil such as flax, canola, soy, and walnuts, into DHA.
Omega-3 supplementation has been associated with:
- Less inflammation
- Reduced anxiety, even in those without an anxiety disorder
- Less severe depression in those with existing depression symptoms
- Increased reaction time, fewer total attention-deficit hyperactivity disorder symptoms
- Improved attention and less hyperactivity.
In contrast, omega-6 fatty acids, which are found in meat and dairy as arachidonic acid, or in vegetable oils such as corn, safflower, and sunflower as linoleic acid, are associated with triggering an inflammatory response.
There is emerging evidence that omega-3 fatty acids improve attention and executive function in children as young as toddlers.
It is not known yet whether early supplementation with omega-3 fatty acids can prevent attention-deficit hyperactivity disorder or anxiety disorders in children with risk factors. Controversy remains about which fatty acid, DHA or EPA, is more important for reducing symptoms; it likely depends on the symptoms. EPA in particular has been associated with the reduction of ADHD symptoms.
Finally there is little consensus on the optimal dose of omega-3s, with recommendations ranging between 200mg to 3000mg of each DHA and EPA daily.
Numerous ongoing studies are investigating the efficacy of omega-3 fatty acid supplementation in reducing a host of symptoms. While awaiting new information, omega-3 fatty acids are generally safe, well-tolerated and have a high likelihood of providing benefit, particularly to those with psychiatric symptoms.
The risks of omega-3s are intolerability of the taste, gastric upset and, at high doses, risk of reduced blood clotting. Product safety monitoring has reduced the risk of heavy metal contaminates, though care should be taken to choose a reputable brand. (see links ).
Omega-3s now are infused with child-friendly flavors and available in liquid or capsule formulations. There is vegan omega-3 made from algae. Those maintaining Halal or Kosher must be careful to avoid pork-based gelatin capsules.
For more information about omega-3 safety, visit the following product safety organizations:
Margaret Cary, M.D., M.P.H.
Assistant Professor of Pediatrics, Division of Child & Adolescent Psychiatry
OHSU Doernbecher Children’s Hospital