Table 5.
Supplementation During Childhood and Adolescence: Study Type and Participant Characteristics.
| Study type | Type/dosage of PUFAs | N | Length of intervention | Participant age range | Population Characteristics | |
|---|---|---|---|---|---|---|
| Åberg et al. (2009) | Highly powered observational | Food frequency questionnaire data | 3972 | Non-intervention; cognitive performance assessed 3 years after questionnaire data collected | 15 at time of questionnaire | 15-year-old males in western Sweden |
| Baumgartner et al. (2012) | 2-by-2 factorial trial | 420 mg DHA/80 mg EPA; iron; placebo; or combination | 321 | 8.5 months | 6-11 | Children with iron deficiency |
| Bos et al. (2015) | RCT | 650 mg EPA and 650 mg DHA | 40 | 16 weeks | 8-14 | Boys with ADHD |
| Brew et al. (2015) | Secondary analysis of the Childhood Asthma Prevention Study RCT | Tuna fish oil with 37% LC PUFAs (added to formula or food) | 239 | From the age of 6 months through age 5 | 8-14 years at follow-up | History of asthma |
| Cornu et al. (2018) | RCT | DHA and EPA (dosage in alignment with age group guidelines/previous studies) or placebo | 71 in treatment group; 77 in placebo | 3 months | 6-15 | Children with ADHD |
| Crippa et al. (2019) | RCT | 500 mg algal DHA/day | 50 | 6 months | 7-14 | Confirmed ADHD diagnosis; drug-naïve; no n-3 or n-5 supplement consumption in the previous 3 months |
| Dalton et al. (2009) | RCT | Fish-flour bread spread | 193 | 6 months | 7-9 | Students in grade 2 at a primary school serving a community with low socioeconomic status and of mixed ancestry from the Northern Cape Province of South Africa |
| Darcey et al. (2019) | Longitudinal | Food frequency questionnaire | 87 | Non-intervention | 13.3 ± 1.1 years | — |
| de Groot et al. (2012) | Observational | Non-intervention; fish consumption data | 700 | Non-intervention | 12-18 | Dutch high school students |
| Demmelmair et al. (2018) | RCT | Between 0 and 127 mg of DHA (from algal oil) per day | 109 | 6 months | 5-13 | Diagnosis of phenylketonuria (PKU) |
| Devlin et al. (2017) | RCT | 200 mg of DHA per day and 200 mg of ARA per day | 133 | 1 year | 12-24 months of age | Healthy term toddlers |
| Handeland et al. (2017) | RCT | Either fatty fish meals three times per week (90 g fish per serving), meat meals three times per week, or fish oil supplementation (158 mg EPA, 105 mg DHA, and 13 mg DPA | 426 | 14-15 years of age | 9th-graders at 8 participating schools | |
| Kean et al. (2017) | RCT | Green-lipped mussel extract | 144 | 14 weeks | 6-14 | DSM-IV ADHD rating score of greater than 15 |
| Keim et al. (2018) | RCT | 200 mg of DHA (from Schizochytrium species algal oil) and 200 mg of AA (from fungal Mortierella alpina oil) | 377 | 6 months | 12-24 months | Preterm children (born at less than 35 weeks’ gestation) |
| Kim et al. (2010) | Observational | Food frequency questionnaire | 10 837 | Non-intervention | 15 | Living in Västra Götaland region of Sweden |
| Kennedy et al. (2009) | RCT | 400 mg or 1000 mg DHA/day | 90 | 8 weeks | 10-12 | Healthy |
| Kirby et al. (2010) | RCT | 400 mg fish oil; 260 mg of which provided v-3 nutrients, including DHA (200 mg) and EPA (28 mg) | 450 | 16 weeks | 8-10 | Typically developing |
| Mazahery et al. (2019) | RCT | Vitamin D3 (2000 IU/day), DHA (722 mg/day), both, or placebo | 73 | 1 year | 2.5-8 | Medical diagnosis of ASD |
| Milte et al. (2012) | RCT | 4 capsules/day with either: EPA-rich fish oil (EPA 1109 mg; DHA 108 mg); DHA-rich fish oil (EPA 264 mg and DHA 1032 mg), or safflower oil (LA 1467 mg) | 90 | 4 months | 7-12 | Over 90th percentile score for ADHD symptoms |
| Milte et al. (2015) | RCT | EPA-rich fish oil, providing a total of 1109 mg EPA and 108 mg DHA or DHA-rich fish oil, providing 264 mg EPA and 1032 mg DHA | 87 | 4 months | 6-13 | Diagnosis of ADHD or parent-rated symptoms >90th percentile on the Conners’ Parent Rating Scale (CPRS; Conners, 2000) and parent-reported learning difficulties (described as literacy performance behind their year level at school) |
| Montgomery et al. (2013) | Observational | Non-intervention; whole blood fatty acid levels assessed | 493 | Non-intervention | 7-9 | Children from mainstream Oxfordshire schools with below average performance in reading |
| Øyen et al. (2018) | RCT | Herring or mackerel for lunch three times a week, while the control group received chicken, lamb, or beef; the meals included a mean concentration of .21 mg/g EPA + DHA in the meat group and 15.2 in the fish group | 218 | 16 weeks | 4-6 | Children at the 13 participating schools from ages 4-6 with sufficient Norwegian language skills for cognitive testing |
| Parletta et al. (2013) | RCT | 750 mg docosahexaenoic plus eicosapentaenoic acids, and 60 mg gamma linolenic acid/school day | 409 | 20 weeks; one way crossover (assessed at baseline, 20, and 40 weeks) | 3-13 | Indigenous Australian children |
| Portillo-Reyes et al. (2014) | RCT | 3 capsules with 60 mg of DHA and 90 mg of EPA | 59 | 3 months | 8-12 | Mild to moderate malnutrition |
| Raz et al. (2009) | RCT | 600 mg EFA/day | 73 | 7 weeks | 7-13 | ADHD diagnosis from a child psychiatrist |
| Richardson and Montgomery (2005) | RCT | Food supplement with n-3 and n-6 fatty acids | 117 | 3 months | 5-12 | Children with developmental coordination disorder (DCD) |
| Richardson et al. (2012) | RCT | 600 mg/day DHA (from algal oil) | 362 | 16 weeks | 7-9 | Children underperforming in reading |
| Ryan and Nelson (2008) | RCT | 400 mg DHA/day | 175 | 4 months | 4 | Healthy; normal developmental milestones; did not consume more than 3 oz of fish more than twice per week or take omega-3 supplements |
| Sheppard and Cheatham (2013) | Observational | Non-intervention (three 24-hour diet recalls | 70 | n/a | 7-9 | 7-9 years old, English speaking; no pervasive developmental issues |
| Sinn et al. (2008) | RCT | EPA (93 mg), DHA (29 mg) from 400 mg fish oil; alongside evening primrose oil | PUFA group = 129; placebo group = 104 | 15 weeks | 7-12 | Connors’ ADHD index score |
| Sørensen et al. (2015) | Secondary analysis of the Optimal Well-Being, Development and Health for Danish Children through a Healthy New Nordic Diet School Meal Study | 2 fish meals per week | 726 | 3 weeks | 8-11 | Danish second- and third-grade children |
| Widenhorn-Müller et al. (2014) | RCT | 600 mg EPA, 120 mg DHA | 95 | 16 weeks | Average age of participants at the beginning of treatment was 8.86 years old for boys and 9.10 for girls | 6-12 years of age, meeting DSM-IV criteria for the ADHD combined subtype (hyperactive–inattentive), the primarily inattentive or the hyperactive/impulsive subtype |
| van der Wurff et al. (2016) | Secondary analysis of the Food2Learn RCT | Non-intervention; Omega-3 index determined via finger prick blood sample | 266 | Non-intervention | 13-15 | Typically developing |
| van der Wurff et al. (2019) | RCT | 400 mg EPA + DHA per day in cohort I; 800 mg EPA + DHA per day in cohort II | 267 | 1 year | Mean = 14 | Omega-3 index ≤5% |
| Vesco et al. (2018) | Secondary analysis of two RCTs | 1.87 g n-3s daily (or two 50-minute psychoeducational psychotherapy sessions per week) | 95 | 12 weeks | 7-14 | Diagnosis of depressive, cyclothymic, or bipolar disorder |
| Voigt et al. (2011) | RCT | 345 mg DHA/day | 63 | 4 months | 6-12 | Children with ADHD receiving effective maintenance therapy |