Long Chain Polyunsaturated Fatty Acids (LC-PUFAs) in ADHD Treatment

129 million kids throughout the world have attention-deficit hyperactivity disorder (ADHD). Children with ADHD have trouble staying focused and controlling their behavior. Although it's a neurological disorder, recent research has shown how important nutrition is for managing ADHD symptoms, particularly long-chain polyunsaturated fatty acids (LC-PUFAs).

This article discusses the correlation of polyunsaturated fatty acids and their deficiencies as it relate to ADHD neurodevelopment and mental health.

Overview of ADHD

ADHD is a complicated neurodevelopmental disorder that is manifested in inattention, hyperactivity, and impulsivity in children, teens, and adults. The symptoms in children diagnosed with ADHD can significantly affect their school work, relationships with their peers, and daily activities. It may be hard for them to sit still in class, obey instructions, or wait their turn to talk in a conversation.

In addition, pediatric patients may also display other neurodevelopmental disorders such as autism spectrum disorder or concurrent behavioral or mental disorders like conduct and anxiety disorders.

Traditional treatments like medicine and cognitive behavioral therapy help many people. However, between 20–40% of children with ADHD still need extra help to manage their symptoms, highlighting the importance of exploring alternative and more comprehensive approaches that include nutrition.

The Nutritional Needs of Children with Attention Deficit Disorder

Not all children with attention deficit disorder respond well to conventional treatments. Some children respond, but still have to manage reduced symptoms. Recent studies have identified a unique physiological profile in these children, marked by pronounced lipid imbalances and abnormalities in essential fatty acid metabolism. 

Researchers have consistently found that children with attention deficit disorder have low blood levels of polyunsaturated fatty acids, such as DHA and EPA, which are important for optimal brain function and development (Sjödin et al., 2024). This nutritional imbalance is now known to be a biological factor that may contribute to primary ADHD symptoms, making it an important area to target with nutritional supplements. Caregivers can concentrate on dietary supplementation with long-chain polyunsaturated fatty acids (omega-3s) that directly support brain health in order to help their children think clearly and behave better.

Limitations of Traditional Treatments

The primary pharmacological interventions for ADHD, such as methylphenidate and other stimulant medications, are well established and often highly effective at reducing symptoms. For many individuals, however, medication alone does not provide complete relief, and its effects may wear off over the course of the day. Nutrients provide round-the-clock support for brain health.

This is why researchers have been exploring additional approaches that can complement traditional therapies. Among the most studied nutritional options are long-chain polyunsaturated fatty acids (LC-PUFAs), particularly omega-3s, which play a vital role in supporting normal brain function and cognitive performance.[Footnote]  

Dietary Fatty Acids

The fats and oils we eat have dietary fatty acids in them. They are the tiny molecules that make up the fat in our food. They’re necessary in providing us with energy, helping us absorb vitamins, and keeping our bodies functioning properly. Fatty acids are grouped by their chemical structure, and this determines how they affect our health. Saturated and unsaturated (monounsaturated and polyunsaturated) fatty acids are the two main forms of dietary fatty acids.

Within the group of polyunsaturated fatty acids, two types are of particular importance for brain health: Omega-3s and Omega-6s. These fatty acids, particularly Omega-3s like DHA and EPA, are crucial structural components of the brain's cellular membranes. Research such as Chang et al. (2017) has consistently shown that children with ADHD often have lower levels of these essential fatty acids, and this deficiency is associated with more significant symptoms like inattention, impulsivity, and hyperactivity. By supporting healthy neural signaling and overall brain function, an adequate intake of these fatty acids is considered a vital part of a comprehensive approach to managing ADHD.

Types of Dietary Fats

Saturated Fatty Acids

Saturated fatty acids are a type of fat molecule characterized by a carbon chain that contains no double bonds. This unique chemical structure makes the fatty acid chain straight and rigid, which allows the molecules to pack tightly together. As a result, saturated fats are solid at room temperature.

Sources of Saturated Fats

Common sources of saturated fats include:

1. Animal-based products:

• Fatty cuts of red meat (beef, pork, lamb)

• Poultry with skin

• Butter and lard

• Full-fat dairy products like cheese, cream, and whole milk

2. Plant-based products:

• Coconut oil and coconut products

• Palm oil and palm kernel oil

• Cocoa butter (found in chocolate)

Polyunsaturated Fatty Acids

Polyunsaturated fatty acids are fatty acids that contain two or more double bonds in their carbon chain. The term "poly" means "many," highlighting the multiple double bonds present in their structure. These double bonds create curls in the fatty acid chains, which prevent them from packing tightly. For this reason, polyunsaturated fatty acids are liquid at room temperature.

Sources of Polyunsaturated Fats

Polyunsaturated fats (PUFAs) are essential fats that the body cannot produce on its own, making it vital to get them from your diet. The two main types of PUFAs are Omega-3 and Omega-6 fatty acids, both of which are found in a variety of foods.

Saturated Vs Polyunsaturated Fatty Acids

The way these fats work in our bodies is different because of their physical and chemical properties. Saturated fats can cause our cell membranes to be rigid, which can affect the way our brain works. In contrast, the fluidity of polyunsaturated fatty acids produces flexible cell membranes in our central nervous system. This fluidity allows our brain cells to communicate effectively. This special attribute of polyunsaturated fatty acids is why it's so important to focus on them when it comes to improving brain function and understanding neurodevelopmental diseases.

Essential Fatty Acids: Omega-3 and Omega-6

There are two important groups of polyunsaturated fatty acids: omega-3 and omega-6 fatty acids. The term 3 polyunsaturated fatty acids, or more commonly omega-3s or n-3, refers to a family of essential fats that are named for their chemical structure, where the first double bond appears at the third carbon from the methyl end of the molecule. 

In simple terms, Omega-3 fatty acids are named for their specific chemical structure. Alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) are the three most critical omega-3s for human health. Linoleic acid (LA) and gamma-linolenic acid (GLA) are two important omega-6 fatty acids.

Omega-3 Fatty Acids

Omega-3s are known for their anti-inflammatory properties and their role in our brain and heart health.

1. Marine Sources (High in DHA and EPA):

• Salmon

• Mackerel

• Sardines

• Herring

• Tuna

2. Plant Sources (High in ALA):

• Flaxseeds (and flaxseed oil)

• Chia seeds

• Walnuts

• Hemp seeds

• Soybeans and tofu

Omega-6 Fatty Acids

Omega-6s are also essential and are important for energy and cell function. They are common in Western diets.

1. Vegetable Oils:

• Oil from corn

• Oil from soybeans

• Oil from Sunflower

• Safflower oil

2. Nuts & Seeds:

• Walnuts

• Sunflower seeds

• Almonds

It is important that you maintain a healthy balance between the intake of Omega-3 and Omega-6 fatty acids for optimal health. Taking omega-3 supplements can help support brain health, reduce inflammation, and improve overall cellular communication in those with ADHD. It’s important to note that neither supplementation nor medication can cure ADHD. And omega-3 fatty acids are not an approved treatment for ADHD. 

The Structural Importance of Chain Polyunsaturated Fatty Acids

The brain needs long-chain polyunsaturated fatty acids because of their unique structure. Their long carbon chains and multiple double bonds give them a specific shape that allows them to easily fit into the cell membranes of neurons. This integration also makes the membranes more flexible and fluid. This fluidity enables efficient communication between neurons because it supports the release of neurotransmitters and makes synaptic plasticity easier. 

If you don't get enough of these fats, the central nervous system's health can suffer, which can cause problems with neuronal transmission. This is believed to contribute to the main symptoms of attention deficit hyperactivity disorder.

Explanation of Essential Fatty Acids Metabolism

Essential fatty acids (EFAs) are important for health, but how the body uses them depends on how they are metabolized. The body cannot make EFAs on its own, but it can change them into longer, stronger fatty acids through a series of enzymatic reactions.

The Conversion Pathways

There are two main metabolic pathways for EFAs: one for omega-3s and one for omega-6s. These pathways start with the polyunsaturated fatty acids that we eat in our diets:

• The Omega-3 Pathway: The first step is the plant-based omega-3 fatty acid alpha-linolenic acid (ALA). The body uses enzymes to convert it into eicosapentaenoic acid (EPA) and then into docosahexaenoic acid (DHA). However, this process is known to be slow, with only a small amount of ALA ever reaching the important DHA stage.

• The Omega-6 Pathway: The plant-based omega-6 fatty acid, linoleic acid (LA), follows a similar but separate pathway, being converted into gamma-linolenic acid (GLA) and then into arachidonic acid (AA). Unlike the omega-3 pathway, this conversion is generally much more efficient.

The Competition for Enzymes

An important aspect of EFA metabolism is that fatty acids compete for the same set of enzymes. When a diet is full of omega-6 fatty acids, these enzymes are busy breaking down linoleic acid (LA), leaving fewer enzymes to convert ALA into the more useful EPA and DHA. This can cause an imbalance that can lead to inflammation and mess up important bodily functions.

The Role of Arachidonic Acid (AA) in Brain Health

Much research focuses on the benefits of omega-3s. Arachidonic acid (AA), an omega-6 fatty acid, is also an important component of the brain (Delgado & Ramírez, 2021). Because it is present in high amounts, AA is important in synaptic signaling and cellular communication. ADHD is connected to impaired synaptic signaling and cellular communication, primarily due to deficits in key neurotransmitters like dopamine, which impacts the brain's ability to regulate attention and impulse control. However, it's important to have a healthy balance between AA and the omega-3s, DHA, and EPA. Too much AA compared to DHA and EPA can make inflammatory pathways more active, which could make ADHD symptoms worse. This shows why it's crucial for kids with an attention deficit disorder to keep a good balance of omega-3 and omega-6.

The Gut-Brain Axis and Fatty Acids

The gut-brain axis and its interesting connection with the brain have come to light in recent studies (Mousavi et al., 2024). This complicated network of communication is very important for both mental health and the metabolism of fatty acids. The microbiome, which is made up of trillions of microorganisms in the gut, is very important for making and absorbing essential nutrients. An imbalanced gut microbiome can lead to chronic inflammation, which can damage our blood-brain barrier and make it harder for the brain to absorb LC-PUFAs properly. This offers a new perspective on why some children with ADHD may have an altered fatty acid status. It suggests that a comprehensive strategy that includes both diet and gut health could be the key to getting the best results.

Docosahexaenoic Acid Supplementation in Brain Function

DHA is the most common long-chain polyunsaturated fatty acid in the brain and retina. It's found mostly in synaptic terminals, where it helps with neuronal signaling, cognitive function, and visual processing. 

Because children with ADHD often display lower DHA levels, which have been associated with more severe behavioral symptoms and deficits, docosahexaenoic acid supplementation has emerged as an important study focus. Studies such as Mousavi et al. (2024) are investigating whether increasing DHA levels can improve these behavioral and cognitive symptoms by supporting neural signaling and overall brain function in individuals with ADHD and other neurodevelopmental disorders.

Evidence from Clinical Trials

The Importance of the Double-Blind, Placebo-Controlled Study Design

In the field of nutritional research, establishing clear cause-and-effect relationships is important. This is where the double-blind, placebo-controlled study design proves invaluable. By ensuring that neither the participants nor the researchers know who is receiving the supplement and who is receiving an inactive substance (the placebo group), this methodology gets rid of bias and guarantees that any observed beneficial effects are genuinely due to the supplement. This rigorous approach makes clinical trials on fatty acid supplementation credible.

Summary of Studies on Omega-3 Supplementation

Several double blind and randomized placebo-controlled trials have examined the effect of LC-PUFA supplementation on ADHD symptoms, producing promising results (Chang et al., 2017; Del-Campo et al., 2021):

• EPA and DHA supplementation has been shown to improve parent-assessed attention in children with ADHD and those exhibiting usual developmental trajectories.

• Supplements with specific ratios of EPA, DHA, and GLA have demonstrated beneficial effects on hyperactivity, impulsivity, and cognitive function.

• Foods, such as DHA-enriched eggs, have shown improvements in erythrocyte fatty acid composition and attention metrics in children with ADHD.

Limitations of Randomized Controlled Trials (RCTs)

Even though the results are positive, many RCTs have problems:

• The study duration is short and may not allow fatty acids to fully integrate into brain membranes.

• Small sample sizes limit statistical power, affecting the reliability of the results.

• Differences in fatty acid composition and dosage, as well as mixed populations, can cause inconsistent findings.

Omega-3 Supplementation and Its Impact on Behavior

Parletta et al. (2016) found that children with lower amounts of DHA and EPA in their blood have worse ADHD symptoms, like hyperactivity, impulsivity, and inattention. Low DHA has been associated with high parent-assessed symptom scores, and children with low DHA and arachidonic acid levels often display diminished academic performance and cognitive function. Thankfully, docosahexaenoic acid supplementation and EPA can help with attention, learning, and controlling behavior.

Why Omega-3 Supplementation May Not Help Everyone with ADHD 

While research shows omega-3 fatty acids play an important role in brain health, ADHD is influenced by many different factors — including genetics, environment, and overall nutrition. Omega-3s are considered the most significant nutritional factor linked to ADHD, but they are not the only influence. Two important considerations include:

• Multiple Contributing Factors: ADHD symptoms are shaped by a combination of genetic predisposition, environmental exposures, and other biological pathways. Because of this, omega-3 supplementation alone may not address every underlying factor driving symptoms.

• Individual Differences in Metabolism and Baseline Status: Some individuals may already have adequate omega-3 levels, while others may metabolize or utilize fatty acids differently. In these cases, the impact of supplementation can vary significantly.

Side Effects of Omega-3 Supplementation

Omega-3 fatty acids are safe. Some people experience side effects from omega-3 supplements, though when reported, they are usually mild and have to do with stomach problems, like diarrhea, nausea, or a fishy taste in the mouth. The biggest issue is patient compliance. Many fish oil pills are large, and people just don’t take them. Compared to the more serious side effects of methylphenidate therapy and other stimulant drugs, omega-3 supplementation is far more tolerated and lacks serious adverse events.

Diet and Lifestyle

To ensure adequate intake of these essential nutrients, it's important to understand where to find them in food. Omega-3s and Omega-6s are found in both plant and animal sources, but their forms and benefits can differ.

• Omega-3 Fatty Acids (ALA, EPA, DHA): The most potent forms, EPA and DHA, are found primarily in marine life. Excellent sources include fatty fish like salmon, mackerel, and sardines, as well as marine algae and fortified foods. The plant-based form, ALA, is found in flaxseeds, chia seeds, walnuts, and hemp seeds. Remember, the body's conversion of ALA to the beneficial EPA and DHA is inefficient, so supplementing with fish oil or algal oil is often recommended.

• Omega-6 Fatty Acids (LA, GLA, AA): These are abundant in the modern Western diet. Common sources include vegetable oils like corn, soybean, and sunflower oil, as well as nuts, seeds, and animal fats.

The Role of a Whole-Foods Diet and Lifestyle

Supplementing with LC-PUFA is a great way to improve your health, but it works best when it's part of a more complete plan. Eating complete, unprocessed foods gives you different nutrients that work together to help your brain work better. 

Reducing the intake of processed foods, refined sugars, and artificial additives will help lower inflammation and keep blood sugar levels from rising too quickly, which can make ADHD symptoms worse. 

Also, frequent exercise and getting enough sleep are important for managing ADHD symptoms. 

• Exercise has been proven to improve mood and focus

• Getting enough sleep will help you maintain a good mood and control your emotions

 People can improve their mental and overall health by using LC-PUFA supplements in combination with a balanced diet and way of living.

Future Directions in ADHD and Omega-3 Research

The future of this research is focused on creating a more personalized approach to treatment. This includes:

Personalized Nutrition: Why One Size Doesn't Fit All

Omega-3 supplementation has its advantages, although the most effective strategy is one that’s personalized to the person. Genetic differences can affect how well the body breaks down polyunsaturated fatty acids. For example, common genetic differences in the Fatty Acid Desaturase (FADS) genes can determine how well a person converts ALA into the potent EPA and DHA. Because of this, a "one-size-fits-all" approach to supplements may not work for all kids with attention deficit. A simple blood test can tell you how much fatty acid a person has in their body. This makes it easier to figure out what they need and create a more personalized dietary supplement plan that will have the most effect and provide them with the best potential results.

LC-PUFAs and ADHD in Adults: A Growing Area of Research

When adults have ADHD, it typically looks different. For example, they may have more problems with executive function, emotional control, work, and their relationships. New studies show that LC-PUFAs might also be good for this group of people. 

Adding fatty acids to the diet could help keep neuronal membranes and neurotransmitter pathways healthy. These are important for adult cognitive performance, attention, and mood control. Since the brain needs these important fatty acids for the remainder of its life, finding ways to address such shortages in adults is an important part of the continuous search for successful complementary treatments.

Omega-3s as Adjunctive Treatments in Adults

Supplementation can complement stimulant medication, supporting brain function and mitigating ADHD symptoms without replacing pharmacotherapy. Stimulant medication improves focus by directly affecting brain signaling. Meanwhile, supplements like Omega-3s provide the essential nutrients needed to build and maintain healthy brain cells. This combined approach offers a more complete way to manage ADHD symptoms by addressing both the functional and nutritional aspects of brain health.

FAQs About LC-PUFA Supplementation and ADHD

What Fatty Acid Supplements are Good for ADHD?

Supplements containing a combination of EPA, DHA, and GLA are the most studied and have shown the most beneficial effects on ADHD-related symptoms. Check out our natural ADHD supplements for children and adults.

Which Long-Chain Polyunsaturated Fatty Acids are Found in Children With ADHD?

DHA, EPA, and arachidonic acid are the key long-chain polyunsaturated fatty acids that are typically found in lower levels in children with ADHD compared to neurotypical children.

What is the Most Effective Vitamin for ADHD?

While no single vitamin can support ADHD, but supplementation with essential fatty acids, especially omega-3 fatty acids, has shown the most consistent promise for improving symptoms.

Which Omega-3 is Best for the Brain?

Docosahexaenoic acid (DHA) is critical for brain function and cognitive health because it is a major structural component of brain cells. In contrast, eicosapentaenoic acid (EPA) is highly effective at supporting behavioral regulation.

Conclusion

Long-chain polyunsaturated fatty acids (LC-PUFAs) show significant potential as a safe and effective way to improve behavior, cognitive function, and fatty acid status in children with ADHD. There are inconsistencies in current research, so further studies that are more personalized and rigorous need to be done. In the end, adding LC-PUFA to a child's diet is a well-tolerated and complementary way to standard stimulant prescription, which can help children with attention deficit hyperactivity disorder get the best results.

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

References

• Chang, J. P., Su, K. P., Mondelli, V., & Pariante, C. M. (2017). Omega-3 Polyunsaturated Fatty Acids in ADHD: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Psychological Medicine, 47(16), 2898–2907.

• Del-Campo, N., Valdeolivas, J., & Gabilondo, A. (2021). The Role of Omega-3 Fatty Acids in the Pathophysiology and Treatment of Attention Deficit Hyperactivity Disorder (ADHD). Journal of Child Psychology and Psychiatry, 62(12), 1475–1485.

• Delgado, G. M. B., & Ramírez, M. F. (2021). Docosahexaenoic and Arachidonic Acids as Neuroprotective Nutrients throughout the Life Cycle. Nutrients, 13(3), 986.

• Mousavi, M. H., Esmaeilzedeh, M., Fesharaki, M., & Mousavi, H. F. (2024). The role of probiotics and prebiotics in modulating of the gut-brain axis. Journal of Basic & Applied Sciences, 13(1), 107–115.

• Parletta, N., Niyonsenga, T., & Duff, J. (2016). Omega-3 and Omega-6 Polyunsaturated Fatty Acid Levels and Correlations with Symptoms in Children with Attention Deficit Hyperactivity Disorder, Autistic Spectrum Disorder and Typically Developing Controls. PLOS ONE, 11(5), e0156432.

• Sjödin, M., Nordström, A., & Nordström, P. (2024). Plasma fatty acids and attention deficit hyperactivity disorder: A Mendelian randomization investigation. Translational Psychiatry, 14(1), 16.

• Sjödin, M., Bruna, M., Nordin, L., Håberg, P., & Persson, E. (2024). Polyunsaturated fatty acid supplementation for attention deficit hyperactivity disorder (ADHD) in children and adolescents. Cochrane Database of Systematic Reviews.