Efficacy and Safety of Polyunsaturated Fatty Acids Supplementation in the Treatment of Attention Deficit Hyperactivity Disorder (ADHD) in Children and Adolescents: A Systematic Review and Meta-Analysis of Clinical Trials.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 33917727 · doi:10.3390/nu13041226
What was done
Authors conducted a systematic review and meta-analysis of randomized controlled trials searching Medline, Embase, CINAHL, PsycInfo, and the Cochrane Library through June 2020. They evaluated polyunsaturated fatty acid (PUFA) supplementation in children and adolescents with ADHD. Primary outcome was ADHD core symptoms; secondary outcomes were behavioral difficulties, quality of life, and side effects. Evidence certainty was graded using GRADE.
What was found
The review included 31 randomized controlled trials with 1,755 patients. PUFA showed no effect on ADHD core symptoms rated by parents (k = 23; SMD: -0.17; 95% CI: -0.32, -0.02) or teachers (k = 10; SMD: -0.06; 95% CI: -0.31, 0.19). There was no effect on behavioral difficulties rated by parents (k = 7; SMD: -0.02; 95% CI: -0.17, 0.14) or teachers (k = 5; SMD: -0.04; 95% CI: -0.35, 0.26), or on quality of life (SMD: 0.01; 95% CI: -0.29, 0.31). PUFAs did not increase side effects.
Why it matters
Despite popular interest and observational rationale, evidence from clinical trials indicates that PUFA supplementation does not provide clinically meaningful improvement in ADHD symptoms or related behavioral outcomes in youth.
Limits
The abstract notes that overall certainty of evidence was questionable by GRADE assessment, preventing definitive clinical guidance. Dosing, specific fatty acid compositions (such as EPA vs. DHA ratios), trial durations, and adherence details are not reported in the abstract.
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