These cod liver oil capsules are part of an increasingly topical debate over the value of getting Your Omega 3 and Omega 6 balance right. Sylvia Thompson reports
If you were told that 75 per cent of a group of children on medication for Attention Deficit Hyperactivity Disorder no longer showed oppositional defiant behaviour (a clinical definition for bad behaviour) following four months on a fish oil supplement, you would be impressed.
Similarly, if you were told that another group of children with specific learning disabilities (mainly dyslexia) showed significant improvements in cognitive problems and general behaviour following 12 weeks on a fish oil supplement, you would also be impressed. Both studies which were randomised, double blind placebo controlled trials, are currently used as "proof" that new fish oil supplements now on sale in Ireland work.
Dr Sarah Brewer, in Dublin recently to promote the latest magic bullet to enhance attentiveness, alertness and overall good behaviour in children, also claimed that fish oil supplements may be beneficial as a complementary therapy for depression and schizophrenia.
We already know that a diet rich in Omega 3 and Omega 6 fats will reduce the likelihood of heart disease, diabetes and inflamatory conditions such as rhematoid arthritis and ezcema. But why the sudden raft of studies focussing on mental health and more specifically, children's behavioural problems?
And, if the evidence is so convincing, shouldn't we really be emphasising the dietary changes first and foremost before pushing supplements on children or on a vulnerable section of the adult community?
"Diet should always come first," says Dr Brewer. "But most people only eat oily fish once a week and now, with the worries about mercury and other pollutants in the sea, it is even more difficult to get Omega 3 from the diet. Eating 30 grams of nuts and seeds a day alongside dark green vegetables is not so easy either."
But, surely we should be seriously campaigning to have our seas and oceans cleaned up rather than replacing salmon, tuna, mackerel and other fish with capsules taken four times a day?
Dr Jacqueline Stordy, a nutritional scientist who does promotional work for another fish oil supplement, argues that that there is no difference between providing nutrients from supplements than from food.
By this she means that the body does not suffer if it receives the supplements in a processed form as opposed to receiving them when the food constituents break down into the required nutrients.
"People don't change their diets readily enough. It's not secure but when there is a nutritional deficiency disorder, at least we know that supplements help," she says.
But isn't there a risk of people overdosing on nutrients by taking supplements without keeping an adequete check on their dietary intake of such nutrients as well?
"I have come across parents giving their children both cod liver oil supplements and fatty acid supplements and that is not wise," says Dr Stordy. There is a potential danger of people overdosing on fat soluble vitamins by taking fish oil supplements with Vitamin E and Vitamin A added alongside a multivitamin supplement.
There is also some evidence to suggest that children taking some forms of fish oil supplements will bruise more easily because some such supplements extend the clotting time of blood.
Dr Patrick Wall, of the Centre for Food Safety, University College Dublin, argues that we should aim to get the correct nutritional balance from the food we eat and not from supplements.
"There is the issue of food providing roughage, energy and protein as well as the nutrients found in such supplements. Taking supplements is an opt out from taking responsibility for a balanced diet. One shouldn't be supplementing a bad diet, one should be promoting a good, balanced diet. Supplements are also more expensive if you compare the nutrients you'll get from a similar amount of food," he says.
Dr Wall also believes that the marketing of such supplements is "selling hope" to people while "absolving them of the responsibility for giving their children the right foods".
"Establishing a good pattern of eating is something that will stay with children for life. You'll also get more enjoyment and feel fuller from eating salmon steak than from taking a fish oil supplement," he says, adding that the introduction of Omega 3 enriched eggs is another good source of these nutrients.
And what about children (or indeed adults) who don't like the Omega 3 and Omega 6 rich foods? "Many children with autism, for example, don't eat normal diets and some of these children have shown improvements when put on fish oil supplements. These is some evidence that essential fatty acids are important for the brain growth and development of premature babies. But, we have to question how controlled some of these new studies (on children with ADHD) are." (WHo said this?)
Dr Sheila Macken, consultant in developmental paediatrics at The Children's Hospital, Temple St, Dublin, says that "there can be a placebo effect of between 20 per cent and 40 per cent."
Dr Macken continues: "This is very new science. Parents feel it helps their children but the case hasn't been proven yet. These fish oil supplements don't do any harm (although there can be toxic overload from too much Vitamin A and D) and they may have fewer side effects than other medicines. But, if parents are giving supplements, they need to be sure that they are from a reputable company using safe sources of the fish oils."