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ADHD & Omega-3 Nutritional Deficiency

briefed by Jule Klotter, Townsend Letter for Doctors & Patients, October, 2004

Retired public health scientists, Fred Ottoboni, MPH, PhD, and Alice Ottoboni, PhD, recently raised the question "Can Attention Deficit-Hyperactivity Disorder Result from Nutritional Deficiency?" in the Journal of American Physicians and Surgeons. They contend that major changes in the US diet over the last century have created a significant deficiency of omega-3 fatty acids and an excess of omega-6 fatty acids. The heavily-promoted vegetable oils sold in grocery stores contain high amounts of omega-6 fats and very little omega-3 - a ratio of about 20 to 1. Our bodies, however, evolved on diets that provided a maximum of 4 parts of omega­6 to 1 part of omega-3. Every year, Americans consume about 66 pounds of the manufactured vegetable oils (safflower, corn, canola, etc.) that began to replace traditional fats like butter about a hundred years ago.

This radical change in diet has major consequences for infants [as well as consequences for the remainder of the population later in life with Omega-3 deficiency linked to Alzheimer's]. Research has shown that high consumption of vegetable fats and oils by pregnant women corresponds to low blood levels of DHA in both mothers and babies. Healthy development of the eyes and the brain require plenty of DHA, an omega-3 fatty acid found primarily in the fat of cold-water fish, and arachidonic acid (AA), an omega-6 fatty acid found in meat and eggs. Brain growth speeds up during the third trimester of pregnancy and continues until the child is about two years old. Infants whose mothers lack DHA during pregnancy and/or while nursing or whose nourishment consists of infant formula devoid of DHA or AA do not have the necessary building blocks for healthy brain and eye development. DHA deficiency afflicts much of the US population. Average DHA levels found in the breast milk of US women rank among the world's lowest.

The negative effects of too little omega-3 and too much omega­6 is compounded by the excessive consumption of starches and sugar. The high insulin levels that result are known to disrupt essential fatty acid metabolism. The Ottobonis also point out that high levels of omega-6 fatty acids along with EPA and DHA deficiencies, and/or high and unstable insulin levels, stimulate the enzyme delta-5 desaturase, used to produce inflammatory eicosanoids. These eicosanoids tell the body to produce more corticosteroids, such as cortisol. Cortisol impairs short-term memory and increases feelings of stress. Inflammatory eicosanoids also reduce brain levels of the neurotransmitters serotonin and dopamine. Low levels of serotonin and dopamine are common among people diagnosed with ADHD.

The Ottobonis give several examples of research literature that link low levels of DHA and AA with ADHD. In a study of 56 children, for example, Dr. LJ Stevens and colleagues found that the children with the most severe ADHD symptoms had the lowest plasma levels of DHA and AA1. Despite the link between attention deficit disorder and DHA deficiency, not all studies of DHA supplementation have shown benefits. Dr. Barry Sears believes that some studies used insufficient supplement doses. In addition, he says that researchers need to control intake of high-glycemic carbohydrates that quickly raise insulin levels and, thereby, disrupt fatty acid metabolism and affect brain chemistry. He gave children with ADHD 10-15 grams of DHA and EPA each day via pharmaceutical grade fish oil. He also restricted their intake of high-glycemic carbohydrates. The children's ability to concentrate and their behavior improved within weeks.

"The choice seems clear," the Ottobonis warn. "We can either continue to depend on prescription drugs to mask the symptoms of ADHD, or consider preventing ADHD by modifying the American diet, particularly for childbearing women and their children. Should we decide to continue to depend on prescription drugs, which do not remedy the underlying causes of nutritional deficiency disease, we can look forward to a country in which there will be more and more children with undersized brains who cannot learn, use costly prescription drugs, drop out of school, commit crimes, cause anguish for their parents, and continue to suffer later in life."


Ottoboni, Fred, MPH, PhD & Ottoboni, Alice, PhD. Can Attention Deficit-Hyperactivity Disorder Result from Nutritional Deficiency? Journal of American Physicians and Surgeons, Summer 2003. pp 58-60.

1. Essential fatty acid metabolism in boys with attention-deficit hyperactivity disorder. Am J Clin Nutr 1995;62(4):761-768

Reprinted with exclusive permission from TOWNSEND LETTER for DOCTORS & PATIENTS www.townsendletter.com.

Key concepts: omega-3 fatty acids, DHA, EPA, ADHD, nutritional deficiency