Eicosapentaenoic and Docosahexaenoic Acids, Cognition, and Behavior in Children With attention-deficit/hyperactivity Disorder: A Randomized Controlled Trial

Nutrition. 2012 Jun;28(6):670-7. doi: 10.1016/j.nut.2011.12.009. Epub 2012 Apr 25.


Objective: To determine the effects of an eicosapentaenoic acid (EPA)-rich oil and a docosahexaenoic acid (DHA)-rich oil versus an ω-6 polyunsaturated fatty acid-rich safflower oil (control) on literacy and behavior in children with attention-deficit/hyperactivity disorder (ADHD) in a randomized controlled trial.

Methods: Supplements rich in EPA, DHA, or safflower oil were randomly allocated for 4 mo to 90 Australian children 7 to 12 y old with ADHD symptoms higher than the 90th percentile on the Conners Rating Scales. The effect of supplementation on cognition, literacy, and parent-rated behavior was assessed by linear mixed modeling. Pearson correlations determined associations between the changes in outcome measurements and the erythrocyte fatty acid content (percentage of total) from baseline to 4 mo.

Results: There were no significant differences between the supplement groups in the primary outcomes after 4 mo. However, the erythrocyte fatty acid profiles indicated that an increased proportion of DHA was associated with improved word reading (r = 0.394) and lower parent ratings of oppositional behavior (r = 0.392). These effects were more evident in a subgroup of 17 children with learning difficulties: an increased erythrocyte DHA was associated with improved word reading (r = 0.683), improved spelling (r = 0.556), an improved ability to divide attention (r = 0.676), and lower parent ratings of oppositional behavior (r = 0.777), hyperactivity (r = 0.702), restlessness (r = 0.705), and overall ADHD symptoms (r = 0.665).

Conclusion: Increases in erythrocyte ω-3 polyunsaturated fatty acids, specifically DHA, may improve literacy and behavior in children with ADHD. The greatest benefit may be observed in children who have comorbid learning difficulties.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attention / drug effects*
  • Attention Deficit Disorder with Hyperactivity / blood
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Australia
  • Child
  • Child Behavior / drug effects*
  • Cognition / drug effects*
  • Dietary Fats / blood
  • Dietary Fats / pharmacology
  • Dietary Fats / therapeutic use
  • Dietary Supplements
  • Docosahexaenoic Acids / blood
  • Docosahexaenoic Acids / pharmacology
  • Docosahexaenoic Acids / therapeutic use*
  • Eicosapentaenoic Acid / pharmacology
  • Erythrocytes / drug effects
  • Erythrocytes / metabolism
  • Female
  • Humans
  • Learning / drug effects*
  • Learning Disabilities / blood
  • Learning Disabilities / drug therapy*
  • Male
  • Parents
  • Reading
  • Safflower Oil
  • Severity of Illness Index
  • Treatment Outcome


  • Dietary Fats
  • Docosahexaenoic Acids
  • Safflower Oil
  • Eicosapentaenoic Acid