Effects of n-3 fatty acids, EPA v. DHA, on depressive symptoms, quality of life, memory and executive function in older adults with mild cognitive impairment: a 6-month randomised controlled trial

First published online 20 September 2011Depressive symptoms may increase the risk of progressing from mild cognitive impairment (MCI) to dementia. Consumption of n-3 PUFA may alleviate both cognitive decline and depression. The aim of the present study was to investigate the benefits of supplementing a diet with n-3 PUFA, DHA and EPA, for depressive symptoms, quality of life (QOL) and cognition in elderly people with MCI. We conducted a 6-month double-blind, randomised controlled trial. A total of fifty people aged >65 years with MCI were allocated to receive a supplement rich in EPA (1·67 g EPA + 0·16 g DHA/d; n 17), DHA (1·55 g DHA + 0·40 g EPA/d; n 18) or the n-6 PUFA linoleic acid (LA; 2·2 g/d; n 15). Treatment allocation was by minimisation based on age, sex and depressive symptoms (Geriatric Depression Scale, GDS). Physiological and cognitive assessments, questionnaires and fatty acid composition of erythrocytes were obtained at baseline and 6 months (completers: n 40; EPA n 13, DHA n 16, LA n 11). Compared with the LA group, GDS scores improved in the EPA (P=0·04) and DHA (P=0·01) groups and verbal fluency (Initial Letter Fluency) in the DHA group (P=0·04). Improved GDS scores were correlated with increased DHA plus EPA (r 0·39, P=0·02). Improved self-reported physical health was associated with increased DHA. There were no treatment effects on other cognitive or QOL parameters. Increased intakes of DHA and EPA benefited mental health in older people with MCI. Increasing n-3 PUFA intakes may reduce depressive symptoms and the risk of progressing to dementia. This needs to be investigated in larger, depressed samples with MCI.Natalie Sinn, Catherine M. Milte, Steven J. Street, Jonathan D. Buckley, Alison M. Coates, John Petkov, and Peter R. C. How

Oiling the Brain: A Review of Randomized Controlled Trials of Omega-3 Fatty Acids in Psychopathology across the Lifespan

Around one in four people suffer from mental illness at some stage in their lifetime. There is increasing awareness of the importance of nutrition, particularly omega-3 polyunsaturated fatty acids (n-3 PUFA), for optimal brain development and function. Hence in recent decades, researchers have explored effects of n-3 PUFA on mental health problems over the lifespan, from developmental disorders in childhood, to depression, aggression, and schizophrenia in adulthood, and cognitive decline, dementia and Alzheimer’s disease in late adulthood. This review provides an updated overview of the published and the registered clinical trials that investigate effects of n-3 PUFA supplementation on mental health and behavior, highlighting methodological differences and issues

A multicentre randomised controlled trial of levetiracetam versus phenytoin for convulsive status epilepticus in children (protocol): Convulsive Status Epilepticus Paediatric Trial (ConSEPT) - a PREDICT study

Background: Convulsive status epilepticus (CSE) is the most common life-threatening childhood neurological emergency. Despite this, there is a lack of high quality evidence supporting medication use after first line benzodiazepines, with current treatment protocols based solely on non-experimental evidence and expert opinion. The current standard of care, phenytoin, is only 60% effective, and associated with considerable adverse effects. A newer anti-convulsant, levetiracetam, can be given faster, is potentially more efficacious, with a more tolerable side effect profile. The primary aim of the study presented in this protocol is to determine whether intravenous (IV) levetiracetam or IV phenytoin is the better second line treatment for the emergency management of CSE in children. Methods/Design: 200 children aged between 3 months and 16 years presenting to 13 emergency departments in Australia and New Zealand with CSE, that has failed to stop with first line benzodiazepines, will be enrolled into this multicentre open randomised controlled trial. Participants will be randomised to 40 mg/kg IV levetiracetam infusion over 5 min or 20 mg/kg IV phenytoin infusion over 20 min. The primary outcome for the study is clinical cessation of seizure activity five minutes following the completion of the infusion of the study medication. Blinded confirmation of the primary outcome will occur with the primary outcome assessment being video recorded and assessed by a primary outcome assessment team blinded to treatment allocation. Secondary outcomes include: Clinical cessation of seizure activity at two hours; Time to clinical seizure cessation; Need for rapid sequence induction; Intensive care unit (ICU) admission; Serious adverse events; Length of Hospital/ICU stay; Health care costs; Seizure status/death at one-month post discharge. Discussion: This paper presents the background, rationale, and design for a randomised controlled trial comparing levetiracetam to phenytoin in children presenting with CSE in whom benzodiazepines have failed. This study will provide the first high quality evidence for management of paediatric CSE post first-line benzodiazepines.Stuart R. Dalziel, Jeremy Furyk, Megan Bonisch, Ed Oakley, Meredith Borland … Kochar Amit … et al

Dietary PUFA intakes in children with attention-deficit/hyperactivity disorder symptoms

Research has shown associations between attention-deficit/hyperactivity disorder (ADHD) and erythrocyte long-chain n-3 PUFA (LC n-3 PUFA) levels, with limited evidence for dietary LC n-3 PUFA intake and ADHD. The aims of the present study were to assess dietary PUFA intakes and food sources in children with ADHD, to compare these intakes to previously published Australian National Nutrition Survey (NNS) data and determine any relationships between intakes and ADHD symptoms. Eighty-six 3-d-weighed food records (FR) were analysed from children with ADHD. The median (interquartile range) daily intakes of fatty acids (mg/d) were: linoleic acid (18 : 2n-6), 7797 (6240–12 333); arachidonic acid (20 : 4n-6), 55 (27·0–93); total n-6 PUFA, 7818 (6286–10 662); a-linolenic acid (18 : 3n-3), 1039 (779–1461); EPA (20 : 5n-3), 18 (6·0–32·0); docosapentaenoic acid (22 : 5n-3), 17 (6·3–39·3); DHA (22 : 6n-3), 16 (8·5–445); total LC n-3 PUFA (addition of 20 : 5n-3, 22 : 5n-3 and 22 : 6n-3), 65 (28·3–120·1); total n-3 PUFA, 1151 (876–1592). In comparison to the NNS data, 18 : 3n-3 intakes were higher and 20 : 4n-6 were lower (P,0·05). Children with ADHD consumed half the amount of fish/seafood, meat and eggs when compared to the NNS (P,0·05). No significant correlations were found between fatty acids and ADHD symptoms. Children with ADHD met the adequate intake for LC n-3 PUFA, but fell short of other recommendations

Nutrition and ADHD

Saarbrucken, German

Cognitive behavioural therapy: a treatment for overweight and obese adolescents

There is growing concern worldwide regarding the rising prevalence of overweight and obesity in children and adolescents whereby many of the adverse health effects associated with adult obesity are now being seen in adolescents. Of further concern is the strong tracking of adolescent weight into adulthood which has added consequences for long-term health. Whilst the prevention of overweight and obesity should be at the forefront, it is evident that effective treatment programs for already obese teens are urgently needed to prevent them from becoming obese adults. This book provides an overview of adolescent overweight/obesity and possible treatment options, before reporting on the results of a scientific trial utilising Cognitive Behavioural Therapy (CBT) to treat overweight and obese adolescents. The CBT program focussed on sustainable lifestyle changes to diet and activity to bring about improvements in weight status, body fat and dietary habits. Therefore, this book would provide a useful reference for health professionals, physical educators, researchers, academics or other individuals with an interest in obesity

Diet and sleep in children with attention deficit hyperactivity disorder: preliminary data in Australian children

Sleep disturbances are common and consequential in children with attention deficit hyperactivity disorder (ADHD). Diet also influences ADHD symptoms. Interrelationships between diet, sleep and behaviour in children diagnosed with ADHD are little studied. We investigated, via parental report, the relationships between sleep and diet in 88 Australian children aged 6–13 years old (M ¼ 8.94, SD ¼ 1.78). This pilot data shows that 30 per cent of the children had sleep disturbance ( 2 standard deviations above the mean) with significant relationships between ADHD symptoms, sleep disturbance and diet. Parents who reported more sleep disturbance also reported a higher intake of carbohydrate, fats, and, most particularly, sugar which was also a significant predictor of night time sweating. These findings suggest an interrelationship between diet and sleep in children with ADHD. Given that both sleep and dietary intake are potentially modifiable behaviours within treatment regimes of children with ADHD, further investigation is needed.