ARI Publication 40 – 2013 Version
Essential Fatty Acids
Rationale: Essential fatty acids (EFAs) are critical nutrients for humans. They exist in the cell
membrane of every cell, and roughly 20% of an infant’s brain is composed of essential fatty acids.
Mother’s milk is very rich in essential fatty acids, but some infant formulas lack this key ingredient
needed for brain development.
Two general categories of essential fatty acids are omega-3 and omega-6. Omega-3 fatty
acids have relatively short shelf lives, so commercial food processing often hydrogenates or partially
hydrogenates them, which provides long shelf life but eliminates their nutritional value. Thus, over
80% of the US population has low levels of omega-3 fatty acids – this is one of the most
widespread nutritional problems in the US.
Low levels of EFAs are associated with a wide range of psychological disorders, including
depression, post-partum depression, bipolar disorder (manic/depression), and Rett’s syndrome
(similar to autism). Most importantly, four published studies have found that children with autism
have lower levels of omega-3 fatty acids than the general population.
- S. Vancassel etal, Plasma fatty acid levels in autistic children, Prostaglandins Leukot Essent FattyAcids
2001 65:1-7. - Bell et al Essential fatty acids andphospholipase A2 in autistic spectrum disorders. Prostaglandins
Leukot Essent FattyAcids. 2004 Oct;71(4):201-4. - Wiest et al Plasma fatty acidprofiles in autism: a case-controlstudy Prostaglandins Leukot Essent
FattyAcids. 2009 Apr;80(4):221-7. - Bell et al 2010, 7The fatty acid compositions oferythrocyte andplasma polar lipids in children with
autism, developmental delay or typically developing controls and the effect offish oil intake. Br. J. Nutri.
103 1160-7.
Explanation of Treatment:
One of the best sources of omega-3 fatty acids is fish, which obtain them from algae and plankton
in the sea. Unfortunately, many fish are high in mercury and other toxins, especially the large
predators (shark, swordfish, and tuna) that are at the top of the food chain and consume smaller
fish. Smaller fish with shorter lifespans, such as salmon and shrimp, have lower levels of mercury,
but it depends where they come from. So, it is generally safer for children to obtain essential fatty
acids from fish oil from small fish, since little mercury is stored in the oil. Because fish oil (and fish)
spoil readily, it is important to obtain a high-quality oil that does not smell or taste rancid, and it
should be kept refrigerated. A high-quality fish oil should have only a mild taste.
Two of the major omega-3 fatty acids are eicosapentaenoic acid (EPA) &docosahexaenoic acid
(DHA). DHA is critical for early brain development, and EPA is useful for later development and is
an important anti-inflammatory mediator.
Recommended dosages (based on the amount of omega-3’s, not the total amount of oil which
will contain other oils):
Omega-3: 20-60 mg/kg (600-1800 mg for a 30 kg, or 60 lb, child). For younger children, use a
supplement richer in DHA, and for older children and adults, use a supplement richer in EPA.
Omega 6: ¼ as much omega-6 as omega-3; so, if taking 1000 mg of omega-3’s, then 250 mg of
omega-6. It is important to maintain a balance of omega-3 and omega-6. Most people eating a
typical western diet receive sufficient omega-6 but are lacking in omega-3; however, some may
need a little extra omega-6 when taking an omega-3 supplement.
Flax seed oil is also a source of omega-3 fatty acids, but the form it provides (alpha linolenic acid)
must be converted by the body to the active form (EPA and DHA), and that conversion process is
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