Fatty acids and reading ability replicated

I'm a fan of scientific replication on this blog. Y'know, when one group comes out with some new marvellous research findings and another [independent] group says 'yep, we found that too'.

It is with that sentiment in mind that I'm talking about the results published by Mats Johnson and colleagues [1] who suggested that "3 months of Omega 3/6 treatment improved reading ability" following a "3-month parallel, randomized, double-blind, placebo-controlled trial" with schoolchildren aged 9-10 years old. The trial was actually a little longer than 3 months given that it also included a 3-month active treatment period for all subjects. The replication angle harks back to another study [2] that has been mentioned on this blog (see here) and that concluded: "DHA [docosahexaenoic acid] supplementation appears to offer a safe and effective way to improve reading and behavior in healthy but underperforming children from mainstream schools."

The Johnson paper, whose ClinicalTrials.gov records can be found here, utilised a gold-standard methodology when it came to testing whether a particular fatty acid formulation - "a daily dose of 558 mg EPA [eicosapentaenoic acid], 174 mg DHA, and 60 mg gamma-linolenic acid" - could improve the reading ability of mainstream schooled children. The primary outcome being measured were any changes to the LOGOS test as well as whether fatty acid intervention also impacted on attention-deficit hyperactivity disorder (ADHD) symptoms, bearing in mind those formally diagnosed with ADHD were supposed to have been excluded from the study. The behavioural side of things also coming from some history with fatty acids there too (see here).

Results: "Compared with placebo, 3 months of Omega 3/6 treatment improved reading ability – specifically the clinically relevant ‘phonologic decoding time’ and ‘visual analysis time’ – in mainstream schoolchildren. In particular, children with attention problems showed treatment benefits." The placebo by the way, was palm oil. Importantly too, side-effects described during the study were fairly rare and mild: "mainly stomach pain/diarrhea (active n = 9, placebo n = 2)." I should also mention that the participant size was over a hundred when it came to those who completed the study so these results are not to be sniffed at.

I'd like to think that these and the various other results out there on this topic will start to be taken seriously some time soon. I know that there has been a lot of hype associated with fatty acids down the years, but the science is growing ever stronger to suggest that such preparations probably do more good than harm. Health promotion messages to eat more oily fish (a good source of fatty acids) for example, are important but unfortunately as per other occasions, are unlikely to provide the same levels of such nutrients as artificial supplementation delivers. That and the fact that oily fish is probably not going to be to everyone's taste.

Insofar as the 'where next?' of this area of research, well, longer-term follow-up is perhaps an important goal to see whether positive changes to reading ability and/or potential amelioration of behavioural issues translates into more favourable academic and other outcomes as a function of fatty acid intake. Accepting that for example, ADHD and/or ADHD-type behaviours might place someone at varying degrees of disadvantage (see here for example), the onus is also on providing the best chances for a person and if that includes a daily fatty acid supplement to help in some way, I don't see too many people quibbling about it [3].

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[1] Johnson M. et al. Omega 3/6 fatty acids for reading in children: a randomized, double-blind, placebo-controlled trial in 9-year-old mainstream schoolchildren in Sweden. J Child Psychol Psychiatry. 2016 Aug 22.

[2] Richardson AJ. et al. Docosahexaenoic Acid for Reading, Cognition and Behavior in Children Aged 7–9 Years: A Randomized, Controlled Trial (The DOLAB Study). PLoS ONE. 2013; 7(9): e43909.

[3] Königs A. & Kiliaan AJ. Critical appraisal of omega-3 fatty acids in attention-deficit/hyperactivity disorder treatment. Neuropsychiatr Dis Treat. 2016 Jul 26;12:1869-82.

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Johnson M, Fransson G, Östlund S, Areskoug B, & Gillberg C (2016). Omega 3/6 fatty acids for reading in children: a randomized, double-blind, placebo-controlled trial in 9-year-old mainstream schoolchildren in Sweden. Journal of child psychology and psychiatry, and allied disciplines PMID: 27545509