The Brain on Lipids: A Different Approach to Managing ADHD through Nutrition

The prevalence of ADHD in the U.S. has been rising steadily. Rates of ADHD diagnosis increased an average of three percent each year from 1997 to 2006 and an average of about five percent each year from 2003 to 2011, according to the Centers for Disease Control and Prevention (CDC) [1]. The disorder is often found alongside many other disorders related to behavior, learning or mood, including, but not limited to, oppositional defiant disorder and anxiety disorder [2].

The brain loves healthy fats (or lipids). In fact, the brain is one of the organs richest in lipid content. Lipid imbalances occur when there is a change in the amount of lipids found in the body resulting from a health condition, disorder, or disease. These causes lead to lower production of lipids or rapid breakdown of lipids that inhibits normal bodily function. These changes may lead to harmful processes [3] that ultimately affect brain structure and function [4]. Various studies show that lipid imbalances are a factor associated with ADHD and other neurodevelopmental disorders, such as autistic and schizophrenic spectrum disorders [5-7]. Several studies demonstrate that patients with ADHD have lower levels of Omega-3s in their blood compared to individuals without the disorder [e.g. 8, 9].

Researchers continue to test the efficacy of omega-3s, mainly in the form of triglycerides – commonly known as fish oil [10,11] — as a nutritional approach to reducing ADHD-associated behaviors, including hyperactivity, restlessness, and emotional dysregulation. However, the data on the use of omega-3 fatty acids for ADHD is inconsistent, as some studies have shown a benefit and others have not [10,11]. The inconclusive results generally reported for omega-3 fatty acids seems to suggest that supplying omega-3s alone may not be enough, as there may be additional lipid imbalances that are not being addressed. In addition, research suggests that delivering omega-3s in phospholipid form may reach the brain more efficiently than omega-3s delivered in triglyceride (or triacylglycerol) form [e.g. 12,13].

A study published in the American Journal of Clinical Nutrition found that omega-3s delivered in a phospholipid composition (specifically phosphatidylserine attached to omega-3s, or commonly known as “PS-Omega-3s”) resulted in a greater reduction of ADHD symptoms versus omega-3s delivered in the triglyceride form [14]. In another double blind, placebo-controlled study, PS-Omega-3s was shown to significantly improve ADHD behaviors, especially in children with more pronounced emotional dysregulation [15]. Emotional dysregulation is characterized by rapid, poorly controlled shifts in emotion, mood swings, and behavioral outbursts.

The current body of research suggests that modifications in brain cell membrane phospholipid composition may play a key role in various neuronal disorders, including ADHD. In addition, increasing dietary intake of omega-3s from fish oil alone may not be sufficient to address complex lipid imbalances.

When exploring ways to safely manage ADHD behaviors, families should ask their physician about possible lipid imbalances and nutritional options to help rebalance the lipid levels in the brain.

1. Centers for Disease Control and Prevention. ADHD data & statistics. cdc.gov/ncbddd/adhd/data.html. Accessed December 19, 2013.
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