Most young children would turn up their noses at a dose of fish oil. But the latest trial results from Durham Local Education Authority suggest that taking regular fish oil supplements that are rich in essential fatty acids is well worth the effort.
Scientists have long been aware of the benefits of fish consumption to human health. The flesh of oil-rich fish, such as sardines, salmon and mackerel, is an important source of omega-3, which has been found to reduce the risk of coronary heart disease and depression, and offer relief from inflammatory conditions such as arthritis and psoriasis.
More recently, researchers have turned their attention to the impact of fish oils on young children's concentration and behaviour.The results are impressive.
In April 2005, the Durham Trials research team launched a study into the effect of fish oil supplementation on pre-school children. It was designed to build on the success of previous research in County Durham, which had found that daily doses of supplements containing both omega-3 fish oil and omega-6 evening primrose oil, in a product called eye-q, dramatically improved primary school children's reading and spelling skills and their behaviour.
The pre-school trial will run until April 2006, but preliminary findings announced in December are already showing positive results. Now experts and educationalists are calling on the Government to make fish oil supplements available free for pre-school children nationwide.
Early intervention
The trial involves 65 children from three Sure Start centres in Peterlee, East Durham. The children were selected for their challenging behaviour and were identified through Sure Start Peterlee's award-winning Child Progress Model (CPM).
'The model is an early intervention programme that aims to identify children experiencing delayed developmental progress,' explains Sure Start manager Brian Brown. 'We screen all children at six-month intervals between the ages of 18 months and three years to identify those who have problems with attention and concentration. Durham Local Education Authority approached us with the idea of offering fish oil supplements as part of the CPM, and we were keen to take the opportunity.'
Manufacturer Equazen provided the trial organisers with eye-q smooth, a fruit-flavoured paste which is easier to swallow than capsules or liquid.
Children took the supplement every day and the first assessments were made after five months.
At the start of the trial, 47 per cent of the children were rated as having 'poor' or 'very poor' behaviour. This figure fell to 4 per cent after they took the fish oil, and the behaviour of 91 per cent of the children improved to either 'moderate' or 'good'. Similar improvements were noted in concentration. All the children who were rated as poor concentrators at the start of the trial improved to 'moderate' or 'good' after five months.
Sure Start workers also assessed the children's language development against a control group who were not taking eye-q smooth. After five months, the eye-q group had made a 7.1 month improvement in receptive language ability (listening to and understanding instructions) and an 8.8 month improvement in expressive language ability (communication through spoken word). These gains were 2.0 and 4.7 months better respectively than the control group.
Dr Madeleine Portwood, senior educational psychologist and lead researcher on the trial, is delighted with the preliminary findings. 'Many educationalists are saying that the concentration levels of children coming to nursery are worse than ever,' she says. 'In Peterlee, many pre-school children are below average in terms of language skills, but the fish oil supplements had such a huge impact they almost caught up to normal ability.
'The impact of the supplement in reducing children's excitability and improving concentration caused a fundamental shift towards more qualitative time spent at home. Parents were better able to engage their children in activities such as role play, doing jigsaws and, most importantly, sitting with them to read books.'
Dr Portwood adds, 'I believe that it is the improvement in the child-parent bond in these crucial early years which has facilitated the remarkable changes in the development of the children's language skills.'
Expensive option
Angela Froud has seen a dramatic change in her three-year-old son, Dylan, who took part in the trial. 'Dylan used to be very over-active and couldn't focus on anything,' says Angela. 'But now he's a lot calmer and his concentration has improved. We can go to the shops without him kicking off and he will sit and watch the TV for a long time. He also loves doing jigsaws now and he's learning to ride a bike.'
Angela was sceptical about fish oils at first, but she was so impressed with Dylan's progress that she now gives her eight-year-old daughter, Rebecca, eye-q as well. 'I have to buy Rebecca's eye-q myself. I don't mind because it's definitely worth the investment, but it can be expensive,' she says.
'I think every parent should have the chance to try it for free. The Government complains that kids are skipping school and not doing well, but children should be given more of a chance. If taking fish oils means children learn more at school, then I think it's 100 per cent worth it.'
At Sure Start Peterlee, Brian Brown is also keen for the Government to make fish oil supplements available nationally, either on prescription or through health visitors. 'If our cohort of 65 children is representative of the whole population, then we predict that about 75 per cent of children would benefit from taking supplements,' he claims.
'There is still another four months of the trial, but it is clear that we have very robust, quantitative data. Ultimately it is up to politicians to decide whether to fund supplementation more widely.But in the meantime we will continue to offer omega-3 supplements to children in Sure Start Peterlee settings.'
As the pre-school trial approaches its conclusion, a number of new studies look set to add even more weight to the argument in favour of fish oils.
Earlier this month, Norfolk County Council revealed that 38 pupils from Eaton Hall Special School in Norwich will take fish oil capsules in a six-month trial.
The children, aged between ten and 16 years old, suffer from conditions including ADHD, autism, Asperger's Syndrome and dyslexia. As well as investigating the effects of fish oils on the children's behaviour, the trial will test whether omega-3 can reduce the side effects of certain drugs prescribed to children with behavioural problems, including Ritalin.
The Eaton Hall trial results will be analysed by Dr Portwood, who is also overseeing a study involving pregnant women. She says, 'When babies are developing during the last three months of pregnancy, omega-3 is essential for nerve growth and early visual development. If pregnant women do not consume enough omega-3 in their diet, the baby will draw on the mother's omega-3 body stores, which are found in her brain. It is possible that the subsequent lack of omega-3 is responsible for post-natal depression.
'Our study will track vulnerable mothers in Sure Start areas in the late stages of pregnancy and after they give birth. We will take measurements of the new babies to see how supplementation affects body weight, head circumference and levels of prematurity. I also hope taking supplements will lead to a reduction in mental health problems for the mothers.'
Clearly Dr Portwood is confident that the latest set of trials will yield even more positive results. And as the body of evidence backing fish oil supplementation continues to grow, it will surely place more pressure on the Government to make it available for children across the country.
Further information
* www.durhamtrial.org.uk
* www.equazen.com Manufacturers of eye-q supplement
* www.nutrition.org.uk British Nutrition Foundation for information on omega-3
Case study: Ethan Boreland (two years and nine months)
At Ethan's two-year check, the health visitor discovered that his speech and language development was below average. He began weekly speech therapy sessions but found it hard to concentrate, quickly becoming bored and running away.
About six weeks after he started speech therapy, Ethan joined the local Sure Start nursery. Staff suggested to Ethan's mother, Lisa, that he take part in the Child Progress Model they had developed. All children identified with concentration, behaviour or developmental difficulties were offered daily supplements of eye-q smooth.
A few weeks after taking eye-q, Lisa noticed that Ethan was much calmer than before. He became enthusiastic about his speech therapist's visits and was excited to find out what games they were playing. He managed to concentrate for much longer during sessions and his speech improved very quickly.
Ethan is now a more relaxed child and will play happily and safely on his own. He is doing much better at nursery and has almost caught up with the other children in terms of his speech and language development.
