The Promise of Omega-3 for Improving Autism

Autism is a multi-faceted, perplexing and nuanced disorder characterized by challenges with social skills, repetitive behaviors, and speech. While conventional treatment involves different types of approaches such as occupational, speech, physical and pharmacological therapies, growing evidence suggests that a nutritional approach should be considered as well.

Autism was first identified in 1960 and now affects around 1% of the world’s population. Recent statistics show that 1 in 54 children in the US is considered on the autism disorder spectrum (ASD), representing a 200% increase from 2000. Despite the dramatic rise in diagnosis of autism in the US and across the globe, medical experts are still unclear how the disability arises.

Diagnosing:

Unlike other disorders, ASD is difficult to diagnose since there are no genetic or other standalone medical tests that conclusively establish a diagnosis of autism. Instead, medical professionals often look to the child’s developmental and behavioral history. Other theories suggest that autism is brought about from a cluster of factors involving genes, brain function/metabolism, autoimmune processes, and inflammation. However, what is clear includes the following:

• Boys develop ASD at a higher rate than girls, about 4x greater.

• Genetics are involved as children born to older parents are at a higher risk for having autism and parents who have one child with ASD have a greater chance of having a second child who is also affected.

• Early intervention is one of the best opportunities to promote long term development and future independence of the child.

Early diagnosis is key to improving a child’s prognosis. This is because a child’s brain is more malleable at a younger age and early intervention services can have a greater impact. Early intervention affords the best opportunity to support healthy development and change the trajectory of the child’s emotional and cognitive functioning in the long term.

Interventional Methods:

Applied behavior analysis and the therapies mentioned earlier are the most researched and commonly used behavioral interventions for autism, however, an integrative approach which uses traditional therapies in conjunction with dietary modification and nutritional supplementation should be considered. Providing nutritional supplements that boost antioxidant levels and alleviate inflammation can foster behavioral improvement. One of the most important of these supplements is omega-3.

Several studies have revealed that low blood levels of omega-3 fatty acids have been found in most children with autism. Meta-analysis of the randomized trials (the gold standard for assessing effectiveness and safety of a therapy) testing omega-3 for autism found that social interaction, communication, and repetitive and restrictive interests and behavior can be improved by supplementing with EPA and DHA, the two most critical omega-3 fatty acids.

In a systematic review of 33 trials, 12 in which participants had a disorder such as autism or attention‐deficit‐hyperactivity disorder, the authors concluded that, “daily supplementation with greater than 450 mg DHA + EPA per day makes it more likely to show efficacy on cognition in children and adolescents.” This conclusion is supported by more recent studies, including a 23‐week randomized intervention trial of children with undernutrition, which found that a supplement containing 171 mg EPA and 255 mg DHA per day improved brain blood flow, and parameters of complex brain function like executive function

A 2007 pilot study investigated the effects of 1.5 grams per day of omega-3 fatty acids supplementation in 13 children (aged 5 to 17 years) with autistic disorders accompanied by severe tantrums, aggression, or self-injurious behavior. Using the Aberrant Behavior Checklist as an outcome measure, the researchers observed a noticeable improvement in hyperactivity and stereotypy (repetitive behavior such as rapid flapping of the hands) in the group given omega-3 fatty acids compared with the placebo group. This led researchers to the conclusion that, “Omega-3 fatty acids may be an effective treatment for children with autism.”

If we break down omega-3, we can see that both EPA and DHA omega-3 fatty acids play a role in brain function and behavioral development. DHA is essential for brain development during pregnancy and early childhood. It accounts for most of the omega-3 fatty acids found in the brain and 25% of the brain's total fat content. Inadequate levels of DHA are associated with cognitive impairment including the loss of mental clarity and worsening restlessness.

EPA’s effect is targeted more towards reducing inflammation. Inflamed nerves may lead to neurocognitive issues and psychiatric conditions, whereas EPA may be able to cool down this inflammation. Both DHA and EPA are readily taken up by the cell membranes of brain cells, optimized cell membrane health and facilitating communication between brain cells. As brain cells continually use omega-3 fatty acids, it is crucially important replenish EPA and DHA with a steady supply via diet and supplementation.

Another way that omega-3 impacts brain chemistry is through its impact on dopamine. Dopamine, known as the feel-good chemical, plays a role in memory processing, motivation, pleasure-seeking and attention. Research suggests that autism and related brain disorders might be linked to dopaminergic dysfunctions and that these imbalances in specific brain regions may be a factor in autistic-like behavior. Low levels of omega-3 in the brain can affect the brain dopamine systems and, when combined with appropriate genetic and other factors, increase the risk of developing these disorders and possibly the severity of the disease.

Given their importance for healthy brain development and the fact that they are natural, safe and well-tolerated essential nutrients, omega-3 fatty acids may benefit autistic patients and help to improve the long-term mental and social functioning for people with this increasingly prevalent disorder.

In Good Health,

James O'Keefe, MD, FACC

 

 

 

 

 

 

 

 

 

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