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A brief look at some of the evidence:

• A study by L.J. Stevens et al, entitled Essential fatty acid metabolism in boys with attention-deficit hyperactivity disorder, found lower plasma concentrations of fatty acids in many boys with ADHD when compared to control subjects. A follow-up study noted that subjects with low omega-3 concentrations had a much greater incidence of problems in behavior, learning, health, and sleep, as well as more temper tantrums.
• Paul Montgomery, researcher at the University of Oxford in England, proposed, “A lack of certain polyunsaturated fatty acids may contribute to dyslexia and attention-deficit/hyperactivity disorder.” He, along with Alexandra Richardson, published a study in a 2005 issue of Pediatrics which found substantial improvements in behavior, reading, and spelling after three months of fish oil supplementation.
• A double-blind placebo-controlled study by Alexandra Richardson and Basant Puri found that children given a highly unsaturated fatty acid (HUFA) supplement had significantly lower scores on assessments of ADHD-related cognitive and behavioral problems after 12 weeks on the supplement, while children on the placebo experienced no improvement.
• Research in the UK, by P. Montgomery and others, correlated lower blood DHA concentrations with worse reading skills and memory, as well as increased emotional and behavioral problems as reported by the parents. This study was published under the title, Low blood long chain omega-3 fatty acids in UK children are associated with poor cognitive performance and behavior.
• A study by Natalie Sinn and Janet Bryan on 132 Australian children with ADHD, found that those who supplemented with polyunsaturated fatty acids (PUFAs) had significantly greater improvements in attention and behavior (particularly inattention, hyperactivity and impulsivity) over the a placebo. After 15 weeks, all participants were switched over to receive the PUFA supplement, and after 30 weeks, 40-50% of the children showed improvements in ADHD symptom scores greater than 1 standard deviation.

Are there any concerns or precautions?

Very high doses of FCLO could cause vitamin A toxicity. While some vitamin A is necessary, and has even been shown to reduce mortality, too much can be dangerous, particularly if it is a manufactured form of vitamin A. Talk with your doctor to ensure safe dosing, and look for a product as close to its natural state as possible. Some cod liver oil supplements are overly processed with high heat or chemical solvents, leaving them stripped of nutrients, and thus the final product must be fortified with synthetic vitamins A and D. Make sure your FCLO is free of mercury, lead, or other contaminants, as well as any ingredients you may be allergic or intolerant to. Many brands of FCLO contain soy in the form of soybean oil, soy lecithin, or tocopherols, and some may contain artificial colors, sweeteners, or fillers. As with any supplement, consult your doctor before use, and do not start or stop using any medications or supplements without a doctor’s supervision.

Which FCLO does Nourishing World recommend?

Nourishing World recommends Green Pasture Fermented Cod Liver Oil as a pure, high-quality fermented cod liver oil supplement. Green Pasture FCLO is made from wild-caught Bering Sea/Aleutian Islands fish and is unadulterated. Sustainable, traditional practices are used in the procurement and processing of Green Pasture oils. Each lot of Green Pasture Fermented Cod Liver Oil is tested for purity. While the U.S. does not set standards for contaminants in fish oils, Green Pasture FCLO meets international standards including Norwegian Medical Standards (NMS), European Pharmacopeia Standards (EPS), and California Prop 65 for freshness, heavy metals (lead, mercury), and PCBs. Green Pasture is one of the only soy-free cod liver oil brands, and only pure essential oils are used for the flavored varieties.

By Ali Wetherbee