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Added August 16, 2004

The Role of Essential Fatty Acids in ADHD


There has been a lot of talk in the world lately about the role of fatty acids in health. Just to clear the air a little bit, I want to discuss briefly what fatty acids are and how they function.

Fats are made up of several different classes of fatty acids. There are three classes of fatty acids that occur in nature. The first class is the saturated fatty acids, which can be divided further into short, medium, and long-chain fatty acids. The second class is the monounsaturated fatty acids. The third class is the polyunsaturated fatty acids.

There is a fourth class called trans-fatty acids, which for the most part do not occur in nature. These are unsaturated fatty acids that have been chemically altered by food manufacturers in order to increase the shelf life of fat-containing products. This is what is produced when the manufacturer makes partially hydrogenated oils. Trans-fatty acids are shaped differently than their natural counterparts. This means that when the body incorporates them into body structures, they change the shape of that structure and do not function as well as their natural counterpart.

In the last forty years, there has been a tremendous amount of misinformation published about the role of fats in health. It is impossible to go over all the information at this time. However, to summarize briefly, probably everything you have ever heard about the dangers of saturated fat and dietary cholesterol is completely wrong. However, almost all of the ills that have been attributed to saturated fat and dietary cholesterol are in fact caused by dietary trans-fatty acids. Sure this is a sweeping generalization. However, it is surprisingly and unfortunately fairly accurate.

How did all this misinformation happen? It is actually a result of a very successful 40-year marketing campaign conducted by the commercial food industry. Lest you get the impression that I am a bleeding-heart liberal anti-establishment organic vegetarian health food fanatic freak (when actually I am not even a registered Democrat), you have to understand what happened.

If you check the processed foods in your house, you will find that almost all of them contain partially hydrogenated vegetable oils. The commercial food industry runs on partially hydrogenated vegetable oils. The reason is that these processed oils do not get rancid.

Regular vegetable oil goes bad very quickly. However, hydrogenated vegetable oil doesn’t go bad. Therefore, in order to give processed foods a long shelf life, the food industry uses hydrogenated vegetable oil. Without them, most foods would have a shelf life of only a few days.

How did the industry go about promoting the use of hydrogenated vegetable oils? When these oils first came out there were a few initial favorable studies that also condemned the evils of saturated fats. Armed with these studies, the commercial oil industry launched a campaign to promote vegetable oils as healthy. The results were that saturated animal fats and cholesterol were labeled bad, and polyunsaturated oils labeled good. The partial hydrogenation/trans-fatty acid issue was swept under the table. Now, forty years later, with the increase of obesity and chronic disease, we are beginning to realize that the real culprit is the trans-fatty acids provided by the commercial food industry.

Essential Fatty Acids

There are two essential fatty acids, linoleic acid and alpha-linolenic acid. They are classified as omega-6 and omega-3 fatty acids, respectively. The body needs these fatty acids, but is unable to manufacture them. They can only be obtained through diet. The minimum amount of linoleic acid thought to be required is 2-3% of the daily caloric intake. The minimum amount of alpha-linolenic acid required is .5-1.5% of the daily caloric intake.

There are other conditionally essential fatty acids that the body can make. However, there are a number of interfering factors, such as foods, health conditions or genetic dispositions, which make these fatty acids dietary essentials for some people. The conditionally essential fatty acids include gamma-linolenic acid, arachidonic acid, eicosapentaenoic acid, and docosahexaenoic acid.

Essential and conditionally essential fatty acids play a vital role in the body. They are chemical precursors to a number of hormone regulators, called prostaglandins. These, along with other fats, make up the structural matrix of every cell in the body. Cell membranes are made primarily of lipids. Dietary fat is essential for proper absorption of certain vitamins and other nutrients.

Fatty acids are a structural component of all brain cells, the blood-brain barrier, and the myelin sheath that wraps around nerves. All cell membranes, including nerve cell membranes, are composed of phospholipids, which contain large amounts of polyunsaturated fatty acids. Fatty acids help with nerve transmission. They are necessary for proper growth and are the basic building blocks of the prostaglandins that are essential for normal brain function. The brain is 25% fat. Much of this fat is in the form of essential fatty acids.

Essential Fatty Acid Deficiencies

So, why do we need to know all this? It is important to realize that the average person is deficient in essential fatty acids. It is also known that there is a relationship between brain function, mental health, and fatty acid intake. Depression is clearly related to fatty acid deficiencies. Low cholesterol is a risk factor for suicide. Since fatty acid deficiency plays a significant role in other psychiatric conditions, it was thought that it might be involved in ADHD.

There is good reason to suspect this. Symptoms of fatty acid deficiency include eczema, dry skin, asthma, thirst, frequent urination, and allergies. It just so happens that all of these symptoms are common in ADHD children. Also, males need more fatty acids than females. There is a 3:1 male to female ratio in ADHD. Therefore, it was thought there might be a relationship between fatty acid deficiency and ADHD. A number of studies have been done, and it does seem that such a relationship does exist in a certain segment of ADHD children.

Studies show that children who have deficiencies in omega-3 have more behavioral, learning, and health problems than do normal children. It is interesting to note that children with low levels of omega-6 fatty acids do not have these problems. They do, however, have more colds and used antibiotic more frequently than their normal peers.

Does Giving Essential Fatty Acid Supplements Help in ADHD?

This really is the question. Can we use essential fatty acids to treat our ADHD children? This question has been studied extensively. Though there is some disagreement among researchers the bulk of the evidence seems to indicate that fatty acid supplementation will not help relieve ADHD.

Does that mean that you should not give your ADHD child essential fatty acids supplements? It depends. If your child has any of the symptoms of fatty acid deficiency, such as eczema, dry skin, asthma, thirst, frequent urination, or allergies then I think it is worth a try. You may not see a big improvement in his ADHD, but you probably will see significant improvement in his other symptoms, particularly eczema and asthma. You certainly will not harm your ADHD child, or for that matter your other children, by giving extra essential fatty acids.

One thing I would stress is that you do not try to limit your child’s dietary intake of healthy fats. Also, remember what I wrote earlier about trans-fatty acids and hydrogenated oils. Your children should avoid them and you should avoid them. You should give your children whole milk rather than skim milk for milk drinkers and feed them plenty of eggs. Even though there has been a lot of bad press about saturated fat and cholesterol in these products, it is becoming clear that most of this information was incorrect. Your child needs healthy fats for the proper development of his brain. You should make sure he gets what he needs.


There are numerous other nutritional modalities that do make a difference both in ADHD and in general health.

I am unable to deal adequately in this article with the other nutritional modalities that would help so many children with ADHD. I address these thoroughly in How to Help the Child You LoveYou should realize, however, ADHD children suffer from nutritional deficiencies more than other children, and it is likely that these deficiencies have a lot to do with why they have ADHD.

Anthony Kane, MD

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