Supplementation of omega 3 fatty acids may improve hyperactivity, lethargy, and stereotypy in children with autism spectrum disorders: a meta-analysis of randomized controlled trials

This was a meta-analysis of randomized controlled trials in pediatric autism spectrum disorder populations. Included participants were mostly young boys with DSM-IV autistic disorder or related ASD subtypes, and several trials excluded severe intellectual disability or nonverbal participants.

Omega-3 fatty acid supplementation was tested against placebo across randomized trials in children with autism spectrum disorder. Active-arm doses ranged from 200 mg/day to 1.5 g/day, with commonly studied regimens of 1.3 g/day or 1.5 g/day, given orally.

Omega-3 supplementation was well tolerated and produced small but statistically significant improvements in some ABC behavioral symptoms. Compared with placebo, omega-3 was associated with lower hyperactivity (difference in means -2.692, 95% CI -5.364 to -0.020, P=0.048), lethargy (-1.969, 95% CI -3.566 to -0.372, P=0.016), and stereotypy (-1.071, 95% CI -2.114 to -0.029, P=0.044). No clear benefit was shown for clinical global improvement (OR 1.255, 95% CI 0.574 to 2.748, P=0.569) or social responsiveness (SRS difference in means 3.143, 95% CI -0.090 to 6.376, P=0.057; Hedges' g 0.367, 95% CI -0.025 to 0.758, P=0.066). Dropout was similar between groups (OR 0.853, 95% CI 0.257 to 2.830, P=0.795), and no serious adverse effects were reported.

The evidence is preliminary because the meta-analysis pooled only a small number of trials with small active-arm sample sizes and heterogeneous populations, doses, and outcome measures. Several outcomes were not significant, and the review noted that larger, more rigorous trials are needed to confirm any benefit.