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GaryWatson
 
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ADHD: something's fishy

01 December 2014, 18:00

Anyone seen an advert for fish oil supplements lately?  There’s one I couldn’t actually believe.  It starts with a paragraph written by an either very young child, or someone with dyslexia.

According to the advert – after 3 months of “treatment” with their fish oil supplements (and other polyunsaturated fatty acids) handwriting goes from an almost illegible “to qay mrstwitGqck for theworms in his sqaghettNr …” to “To pay Mrs Twit back for the worms in his spaghetti…”.  It’s a remarkable improvement; in fact it’s nothing short of miraculous.  Perhaps snake oil is a better description…here’s why.

The sponsor of the advert then quotes a peer-reviewed randomized controlled trial, published in the journal, Paediatrics (2005), as proof of some sort.  But proof of what?

Let’s be clear here.  The advert states BEFORE using fish oil supplements the handwriting was a mess; and then AFTER using fish oil supplements handwriting had improved.  The ad then quotes a gold-standard study, as an unequivocal statement of their fish oil’s efficacy in treating challenges in handwriting.   The public can be left to make no other conclusion.

I have direct experience with ADHD – I know how real a problem it is and I know how desperate parents can get when ADHD presents in some cases.  I also know that fish oil supplementation alone is not the answer – to present it as such is disingenuous at best.

Here’s the problem I have with that advert – and with the sponsor of that advert.

  • The study they reference does not have anything to do with handwriting.  I quote the study’s results directly “No effect of treatment on motor skills was apparent, but significant improvements for active treatment versus placebo were found in reading, spelling, and behavior over 3 months of treatment in parallel groups”.  Ok so we saw some improvements in their limited study– the problem for the sponsor of this advert is that handwriting is a MOTORSKILL. I have sent a copy of this advert to the authors of the study because I am 100% certain they will not approve of their research being used to commercially dupe desperate parents into using a product that does not work as they have presented it.  I mean who can argue that 3 months of handwriting practice by a child in Grade 1 won’t yield similar improvements?  a.k.a. have nothing to do with poly unsaturated fatty oil supplements?  Yet the advert is presented in a BEFORE and AFTER context…

  • The study itself used 117 children with Development Coordination Disorder.  This is NOT ADHD.  It is in fact a chronic neurological condition that can affect co-ordination as a result of the brain’s messages being inaccurately transmitted to the body.  While ADHD may be a co-morbid condition – in other words it sometimes presents together – there is almost no literature by professionals that suggest fish oil supplementation as a primary (or even complementary) intervention.   In fact the research article the sponsor uses to create an air of authority and credibility itself concludes with “Fatty acid supplementation may offer a safe efficacious treatment option for educational and behavioural problems among children with DCD. Additional work is needed to investigate whether our inability to detect any improvement in motor skills reflects the measures used and to assess the durability of treatment effects on behavior and academic progress.”  Please look up the study by Googling “Richardson and Montgomery 2005” and read the Abstract yourself.  The study they quote comes to a very different conclusion…why use it if not to mislead?

  • The researchers say very clearly – “fatty acid supplements merit further investigation”.  Not proof.  They do NOT say, ever, not even once, that fish oil supplements improve ADHD symptoms or your child’s handwriting.  That’s a preposterous extrapolation designed to fool people into buying an overpriced product with very little proven efficacy.

Here’s how science works.  117 children is a very small sample size.  To generalize the findings of a study like this to the wider population is absurd.  It’s like saying that based on measuring the height of 117 North Koreans, the average height of the world’s population is 5 foot.  Secondly, 3 months is a very short time.  The probability that your results are purely the result a pure chance are much higher when you study a small group of people over a short time.  Nevertheless, the study used by this purveyor of fish oil, as evidence uses 117 children who suffer from DCD, not ADHD.  A real study on fish oil supplements would use a much larger cohort (group) of children selected randomly from the general population, not a targeted 117 children that are already suffering from a undoubtedly awful condition.  

No mention of ADHD is made in the Richardson & Murray (2005) study; yet the sponsor could certainly not allege no association was meant with ADHD.   Their advertorials only appear in the ADHD sections of many websites.   In fact they have also sponsored an article on the unpleasant side effects of ADHD medication, undoubtedly true, but then offer alternatives such as polyunsaturated fatty acids (PUFA) supplements such as fish oil.   The American National Resource Center on ADHD themselves say supplements such as fish oil have shown in two meta-analyses (studies of other studies) that there is at best “a small benefit for ADHD symptoms”, but likely “little evidence that PUFA supplementation provides any benefit at all”.   Now take a step back and consider this: The seller of fish oil supplements using a highly public platform to espouse their product as an alternative to FDA-approved medical interventions.   

Wow!  Am I the only person enraged by this wilful distortion of the facts?   This is grade-A bullshit.  The ethical issues here beggar belief.  Fish oil is NOT approved by the FDA as a treatment for ADHD – FDA being the Food & Drug Administration in the United States – arguably the biggest market for ADHD medication and treatment in the world.   Does anyone seriously think that in the world’s biggest market, with the most aggressive medical research teams in the world, fish oil supplements would not have been approved as a treatment for ADHD if they worked?  The FDA is the watch dog of US consumer health – they may not be perfect but they are not part of some conspiracy to suppress treatments that work.

This is an ethical disgrace.  If you want to give your children fish oil supplements that’s your prerogative.  Yours.   It’s not my place to tell you how to raise your kids or manage your ADHD.  But your choice to use them should be based on honest information, not outrageous distortions of the truth in nationwide advertising campaigns.

Selling a product that may or may not work as a miracle cure all; aimed squarely at desperate parents; and then on top of it suggesting your product as an alternative to real medicine - should not be allowed.  In fact it isn’t allowed. 

And unless I see some real evidence of the claims made by these fish oil salesmen, I’m going to the ASA – that’s the Advertising Standard’s Authority.  Their stated objective is to “ensure advertising is legal, decent, honest and truthful”.   And I’m happy to put that to the test.  

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