The question: was it all down to fish oil?
Below is a copy of recent Report in the Guardian which was made on Wednesday January 14, 2004
The question: was it all down to fish oil?
Since a compelling experiment was shown on the BBC's Child of Our Time last
week, sales of Omega-3 supplements have rocketed. But, asks Ian Sample, are
behavioural problems so easily solved?
It must have made fascinating viewing for anyone bringing up a child with
learning or behavioural problems. Last week's Child of Our Time, the BBC
programme that follows the trials and tribulations of children born at the beginning
of the new millennium, told the story of James and Ruben, boys with very
different behavioural problems. James was aggressive in the extreme, his day a blur
of punching, beating and demolition. Ruben's problem was less visible: he was
uncommunicative and struggling to make friends. As a test, the two were given
fish oil as a daily supplement. Three months later, we saw James as a
different child: he was popular with other children, sharing his toys rather than
clubbing people with them. Ruben had also changed. He was chattering away and had
worked out how to make friends. The question: was it all down to fish oil?
It is impossible to say, of course. In the same three months, other factors
changed in both children's lives: James's mum split from her partner, and his
home life became more stable; Ruben switched schools. But the message many
parents took away from the programme was that if your child is struggling, fish
oils may be the answer.
"Can anyone remember what the fish oils were called in the programme? I'm
interested in trying my three-year-old on them 'cause he is a right handful at
the moment," was typical of the hundreds of postings left on the BBC's online
message board after transmission last week. Perhaps unsurprisingly, sales of
fish oil have leapt since the programme went out. Boots recorded a 300% increase
in demand in the days afterwards. One fish-oil manufacturer, BR
Pharmaceuticals, says the recent rush for fish oils is part of a long-term trend - it claims
sales of its own oils have risen by 3,000% in the past year.
But is there any real evidence that fish oils can help children with learning
or behavioural problems? So far, only a handful of good scientific studies
have been done. What evidence there is suggests that while some children with
certain difficulties may benefit from fish oil, it is not a magic bullet that
will bring every difficult child into line.
"You can't yet say it is an accepted therapy, much less how it might work,"
says Professor Eric Taylor, a child neuropsychiatrist at King's College,
London. "There is preliminary evidence about it but we cannot yet say it is a
recognised therapy. It's too early to tell parents to give this to their children.
Until scientists have unequivocal proof of the beneficial effects or otherwise
of fish oils on struggling children, parents should stick with traditional
psychological treatments. The big message is that if you want help for your
child, there really are very good psychological interventions which are free on the
NHS - and they work."
Researchers who have studied the effects of fish oils say they are most
likely to have an impact on children whose difficulties are at least in part due to
disorders such as attention deficit hyperactivity disorder (ADHD), dyslexia,
autism and dyspraxia (dyspraxics often have difficulty carrying out complex,
sequenced activities or may be mildly clumsy). There is some scientific
evidence that an imbalance of certain fatty acids, which happen to be found largely
in fish oils, may contribute to many of these. Further studies have found that
dyslexia and the inattentiveness and impulsiveness associated with ADHD can be
improved by fish-oil supplements. A study into the effect of fish-oil
supplements on more than 100 dyspraxic children in Durham is nearing completion.
There are some tell-tale signs that can indicate an imbalance of Omega-3
fatty acids in the diet. Allergy-related conditions such as eczema, asthma and
hayfever are more common, as are poor concentration, depression, excessive mood
swings and undue anxiety. Others with imbalances can experience difficulty
getting to sleep at night and visual disturbances when reading, such as words and
letters moving around.
Fish oils seem to help because they are rich in a particular type of Omega-3
fatty acid called Eicosapentaenoic acid (EPA), which is vital for the proper
chemical functioning of the brain, mediating hormones, the immune system and
blood flow. Just how EPA might be helping struggling children is poorly
understood though. "All we know is that if people take these capsules, their
behaviour, learning and mood can sometimes improve quite dramatically," says Dr Alex
Richardson, an Oxford University-based expert on the effect of food on behaviour
and lead scientist on the Durham study. "But Omega 3 can affect many aspects
of brain function, so these benefits could reflect more efficient chemical
signalling, or just an increase in blood flow to the brain."
Thanks to processed foods, most modern diets are now woefully lacking in
Omega-3 fatty acids and this may be where the problem lies. Oily fish and seafood
are the only foods that contain ready-made EPA and while the body can make the
compound from other Omega-3 fatty acids found in leafy vegetables, walnuts,
brazil nuts and flax oil, it is an extremely inefficient process.
One difficulty is that to have a beneficial effect, high doses of EPA are
required - children in the Durham study received 500mg of EPA a day, the
equivalent of around 30g of pilchards. Try getting a child to eat fish every day and
it will become clear why a supplement might be the answer.
But isn't this just a further step down the road towards a
supplement-obsessed society? Richardson says not: "I'm not someone who says, 'Just pop a pill'.
People should first make dietary changes and make them in a sensible
direction. Get rid of the junk fat, and ensure they're eating whole foods."
How to choose the right fish oil
Picking the right supplement is crucial. The main thing to look for in a
fish-oil supplement is that it contains a high dose of Eicosapentaenoic acid
(EPA). But, as last week's Scottish salmon health scare proved, there are other
factors to take into account too. "In the same way that our fish are now polluted
with PCBs, dioxins, heavy metals and everything else because of the
environment they swim in, so are many fish oil supplements," says Dr Alex Richardson.
It is important, then, to check that the oil has been purified. If it has,
the manufacturer will be likely to boast about it on the packaging. For example,
MorEPA is one such pharmaceutical-grade supplement, which costs less than
half that of some high-street brands (available from smaller pharmacies, or
online at www.healthyandessential.co.uk). It costs about £9 a month, as does eye q,
the product used in the Child of Our Time experiment.
Generally, oils made from fish bodies are preferable to those made from
livers as the liver is the detox organ and so holds more toxins than any other. Cod
liver oil is also best avoided as it is rich in vitamin A and taking large
doses for an extended period could lead to vitamin A poisoning. Fresh fish oil
should not give you fishy burps - if they do, the oil has been hanging around a
while and the EPA may well have been oxidised.
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