The potential role of fatty acids in developmental dyspraxia

The potential role of fatty acids in developmental dyspraxia – can dietary supplementation help?

by Alexandra J. Richardson, D.Phil (Oxon), PCGE – Senior Research Fellow in Neuroscience, Mansfield College and University Lab. of Physiology, Oxford

Developmental dyspraxia shows substantial overlap with other developmental conditions including dyslexia, ADHD and the autistic spectrum, both within individuals and within families. This indicates some common predisposing factors at the biological level, and the proposal considered here is that these could involve aspects of fatty acid metabolism.

Certain HUFA of the omega-3 and omega-6 series are essential for normal brain development and function. Together they should make up around 20% of the dry mass of the brain, and adequate supplies are also crucial for efficient information processing within the brain and nervous system, as well as for many aspects of general health.

These key HUFA are often lacking from modern diets and must therefore be manufactured within the body from simpler essential fatty acids (EFA). However, this process is inefficient in humans, and can also be blocked by dietary and lifestyle factors. Furthermore, dietary intake of the necessary omega-3 EFA in particular is often low.

The predisposition to dyspraxia and related conditions may involve mild constitutional inefficiencies of fatty acid metabolism that increase the usual dietary requirements for HUFA. These could include (a) poor EFA-HUFA conversion, (b) difficulties in incorporating HUFA into brain cell membranes and/or (c) unusually high rates of HUFA breakdown and loss, although there are other possible mechanisms.

Many features associated with dyspraxia are consistent with HUFA deficiencies or imbalances. These include the core difficulties with motor coordination, attention and sensory processing, as well as the excess of males affected, proneness to allergic or autoimmune conditions, disturbances in temperature regulation and sleep, and irregularities of mood.

There is already some experimental evidence for fatty acid abnormalities in ADHD, dyslexia and the autistic spectrum. Although dyspraxia has never been ‘factored out’ in studies of these related conditions, no studies of dyspraxia per se have yet been reported although these are now underway.

If fatty acid deficiencies were a contributory factor in these developmental conditions then dietary supplementation with HUFA might be of benefit. In ADHD, a few controlled treatment studies have been reported, with mixed results; and in dyslexia, the first controlled trial has shown that treatment with omega-3 and omega-6 HUFA can reduce attentional problems, anxiety, and disruptive behaviour.

In dyspraxia, no properly controlled trials of HUFA supplementation have yet been reported. One small open study indicated possible benefits, but without a placebo control group these cannot be attributed to the treatment itself. A large-scale randomised controlled trial of HUFA treatment in dyspraxic children is now underway.

As yet there is therefore no firm evidence of benefits from HUFA supplementation in dyspraxia, although many people are already trying this approach. HUFA are generally safe and have many general health benefits, but medical advice is recommended before taking any food supplement. Furthermore, fatty acid supplements vary widely in their composition and quality. Available evidence indicates that omega-3 fatty acids – and particularly EPA – may be most effective, but this still requires confirmation.

Other aspects of diet may also merit attention, but nutritional intervention is obviously only one aspect to consider in the management of dyspraxia, and cannot be expected to benefit more a subset of affected individuals. Some features that may indicate a good response to HUFA supplementation have already been identified, but further research is needed to verify their predictive power.

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