Dyslexia, Dyspraxia and ADHD: The EFA Connection
By Diana Fatayerji, M.S., Ph.D.

Dyslexia affects 4% of the American population and is more common in boys than girls. There is a large inherited component, so if you have dyslexia your child is more likely to have dyslexia too.
Dyslexic children are usually extremely bright, yet they fail to reach their full potential academically. You may notice that your child’s ability to read and write falls short of her general ability. She may also experience other problems, such as difficulty with number work; poor short-term memory; a lack of concentration; poor sense of direction and time; clumsiness; and poor interpersonal skills.
Problems are usually first noticed when a child starts to read. She may experience a degree of difficulty, which seems unnatural for her general ability.
If your child’s dyslexia is mild and identified early, it may be resolved by spending more time reading with her and offering encouragement. When the problem is more severe, a formal diagnosis may be necessary in order to obtain extra help for her in school.

Is dyslexia related to other conditions?:

Many children who are dyslexic have other behavioral and learning difficulties such as attention-deficit / hyperactivity disorder (ADHD), dyspraxia or autism. As a group, these conditions are the most common neurodevelopment disorders of childhood, affecting 20% of all children.
Different health professionals manage each of these conditions. Trained educational psychologists who focus on specialist teaching treat dyslexia. Dyspraxic children have difficulty in planning and coordinating movement and are treated by physiotherapy. ADHD children have difficulty with sustained attention and hyperactivity, and are treated by psychiatry.
Nutrition is not considered as part of standard evaluation and management for any of these conditions, in spite of research that can explain a link.

Can nutrition help dyslexia?:

The number of children in America showing learning disorders trebled between 1976 and 1993. Dyslexia is involved in four out of five of these cases1.
Although there is a definite genetic component to dyslexia, only nutrition or environment could explain the large increase in the number of dyslexic children. A role in its etiology has been proposed for chemical toxicity, vaccinations, essential fatty acids (EFA) deficiency, zinc deficiency and food sensitivities. Of these, EFA deficiency is receiving the most recognition.
How could EFA be related to dyslexia? The brain is 60% fat, a quarter of which is derived from EFA. If our child does not receive enough EFA in her diet then we cannot expect her to build a healthy brain. Signs of EFA deficiency are common in dyslexic children and may contribute to their symptoms.
The recent increase in dyslexia is consistent with our nations decline in fish consumption. Fish is a good source of the EFA derivatives needed for brain structure. Our modern diet may be starving our children’s brain of essential fats.

What are Essential Fatty Acids (EFAs)?:

Essential Fatty Acids (EFAs) are a specific group of fats. They are called essential because they cannot be made by the body and, as such, must be provided by the diet. EFAs include linoleic acid and alpha-linolenic acid. Linoleic acid is found in most vegetable oils, whilst alpha-linolenic acid is only found in flax, hemp, walnuts, pumpkin seeds and black currant seed oil.
Under normal circumstances the body can convert the EFA into a variety of fatty acids. One group is known as highly unsaturated fatty acids (HUFA). The HUFA include EPA, DHA and GLA. They are needed for proper brain structure and function.
Fish is rich in both EPA and DHA. Evening primrose, black currant seed oil and borage oil are rich sources of GLA. As you can see, the foods they are found in are not commonly eaten in the American diet.
America has the lowest level of DHA in breast milk. This may be explained by the decline in fish consumption in recent years, or the fact that certain factors common to our modern lifestyle can reduce the amount of HUFA that the body makes. These factors include: high dietary intake of saturated, hydrogenated or trans fatty acids; nutritional deficiencies (particularly of zinc, magnesium vitamin C and B); smoking; alcohol; caffeine; viral infections; diabetes and stress.
Could low maternal levels of DHA contribute to dyslexia? Maternal deficiencies in DHA may have an irreversible effect on her fetus’s brain development. Subsequent low levels of DHA in breast milk and infant formula may further affect her baby’s brain, leading to ADHD and low IQ 2. America is the only country that does not fortify infant formula with DHA.

Research on Essential Fatty Acids:

Twenty years ago it was noticed that hyperactive children show signs of EFA deficiency more often than other children 3. This pattern is seen for ADHD children4 and dyslexic adults5. Supplementing with fish oils may be helpful in the management of ADHD difficulties, and EPA is believed to be more effective than DHA or GLA 6, 7.
Signs of EFA deficiency are common in dyslexic children. Correcting clinical and biochemical signs of EFA deficiency in dyslexic children is accompanied by an improvement in schoolwork 8.
Dyslexic children may have a genetic inability to convert EFA to the HUFA 4,5. This means that even if they eat enough EFA they cannot convert these into HUFA. They must rely on their diet to provide the HUFA.
In an exciting study, dyslexic children with signs of EFA deficiency were given fish oil and evening primrose oil supplements. Children with ADHD tendencies showed an improvement in behavioral and learning difficulties 9, 10. A larger study is now underway and preliminary results suggest that the supplements may also improve reading ability. These studies offer hope to families with dyslexia.

Signs of EFA deficiency:

• Allergies - lactose intolerance, eczema, asthma
  
• Course bumpy patches on the back and arms
  
• Sweaty palms and feet
  
• Emotional sensitivity
  
• Frequent urination
  
• Soft, broken nails
  
• Visual problems
  
• Excessive thirst
  
• Dull, dry hair
  
• Dandruff
  

Summary:

Fish oil supplements have been shown to help dyslexic children, especially those with signs of EFA deficiency and ADHD tendencies. Fish oil supplements are extremely safe and their only side effect is mild digestive upset.
Fish oils have many health benefits. We could all benefit from increasing the amount of oily fish such as wild salmon, sardines, trout and herring in the family diet. Unfortunately, farmed fish is low in these good fatty acids and is best avoided. Also to be avoided are larger fish from the top of the food chain such as tuna, shark and swordfish due to their high levels of toxic mercury.
For dyslexia start with a supplement providing 500 mg of EPA. After a few months you can reduce this dose. Good quality oils do not taste overly fishy and are tested for mercury and other heavy metal contamination. Cod liver oil is not a suitable alternative due to its high vitamin A content. You should take vitamin E supplement with the fish oil to prevent oxidation.
Dyslexia is a multi-factorial condition and a role has been proposed for chemical toxicity, vaccinations, essential fatty acids (EFA) deficiency, zinc deficiency and food sensitivities. By working with a qualified nutritionist you can address all these factors.
In summary, fish oil supplements are safe, affordable and could benefit thousands of children with dyslexia.

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2. Levine, Barbara s. Most frequently asked questions about DHA. Nutrition Today, Vol. 32, November/December 1997, pp. 248-249
   
3. Colquhoun and Bunday, 1981. A lack of essential fatty acids as a possible cause of hyperactivity in children. Medical Hypotheses, 7:673-679
   
4. Stevens et al. 1995. Essential fatty acid metabolism in boys with attention-deficit hyperactivity disorder. Am J Clin Nurt,62: 761-768
   
5. Taylor et al. 2000. Dyslexia in adults is associated with clinical signs of fatty acid deficiency. Prostaglandins Leukotr Essent Fatty Acids, 63: 75-78
   
6. Burgess JR. 1998. Attention-deficit hyperactivity disorder; observational and interventional studies. NIH workshop on omega-3 essential fatty acids in psychiatric disorder. National Institute of Health, Bethesda, USA, Sept 2-3
   
7. Voigt et al. 2001. A randomized, double-blind, placebo controlled trial of docosohexaenoic acid supplementation in children with attention-deficit/hyperactivity disorder. J Pediatr, 139: 189-196
   
8. Baker S M. 1985. A biochemical approach to the problem of dyslexia. Journal of Learning Disabilities, 18(10):581-584
   
9. Richardson et al. 2000. Reduced behavioral and learning problems in children with specific learning difficulties after supplementation with highly unsaturated fatty acids. European Journal of Neuroscience, 12 Suppl 11: 296
   
10. Richardson and Puri. A2002. A randomized double-blind, placebo-controlled study of the effects of supplementation with highly unsaturated fatty acids on ADHD-related symptoms in children with specific learning difficulties. Prog Neuropsychopharm Biol Psychiat, 26: 233-239