Omega-3 Supplementation and Behavior Problems
Condition: Aggression; Antisocial Behavior; Antisocial Personality
MeSH terms: Aggression; Problem Behavior; Antisocial Personality Disorder
Study type: Interventional
Phase: Phase 2/Phase 3

Summary: 
      The objectives of this project are as follows:

        1. To assess whether omega-3 dietary supplementation for six months can reduce
           externalizing behavior problems (antisocial and aggressive behavior) in schoolchildren
           aged 8 to 18, both at the end of treatment and six months post-treatment

        2. To assess whether omega-3 supplementation is more effective in children with more
           psychopathic-like traits.
    

Detailed description: 
      Externalizing behavior problems (aggressive and antisocial behaviors) are widely recognized
      as predisposing to significant mental health problems and violence among adolescents in
      secondary schools. These in turn result in enormous economic and social costs to schools as
      well as to society. These costs include mental illness, crime, and violence. Similarly,
      violence is widely recognized as a major public health problem which has also largely defied
      successful intervention and prevention. Because an increasing body of research is documenting
      health and neurobiological risk factors for aggression and violence, part of this prevention
      failure may be due to intervention efforts ignoring biological contributory factors which
      include impaired neurocognitive and psychophysiological functioning. One benign biological
      intervention that may help attenuate behavior problems in children consists of omega-3
      supplementation of the diet, a long-chain fatty acid critical for brain structure and
      function.

      The overarching aim of this study is to assess whether omega-3 supplementation can reduce the
      base level of externalizing behavior problems in children and adolescents. A secondary but
      important aim is to assess whether any behavioral improvement may be greater in more
      psychopathic children. The specific aims are as follows:

        1. To assess the effectiveness of omega-3 dietary supplementation in reducing externalizing
           behaviors in adolescents.

        2. To assess whether omega-3 supplementation leads to greater improvement in children with
           psychopathic-like traits.

      Hypotheses will be tested in a placebo-controlled, double-blind, randomized trial involving 8
      to18 year-old adolescents drawn from primary and secondary schools in Hong Kong. Omega-3
      supplementation will be in the form of a Norwegian fruit juice drink. 300 adolescents will be
      randomly assigned into: (1) omega-3 supplemented drink, (2) placebo drink, (3)
      treatment-as-usual controls. Behavioral measures will be assessed at baseline (0 months), end
      of treatment (6 months), and 6 months post-treatment (12 months).
    

Intervention name(s): Omega-3 supplemented drink; Smartfish
Intervention type(s): Dietary Supplement; Dietary Supplement
Intervention description(s): The drink has apple/ pear/ pomegranate taste which is well accepted by children and adolescents, is rich in natural antioxidants to help prevent oxidation of omega-3. The drink can be taken at any time during the day.
1/3 of the participants will be assigned to the omega-3 group after randomization. They are going to take the treatment for 6 months. They will be assessed at baseline, end of treatment and 6 months post-treatment.; Treatment duration is 6 months. They will be assessed at baseline (0 months), end of treatment (6 months) and 6 months post-treatment (12 months).
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: 3 parallel groups: (1) omega-3 + fruit juice (2) fruit juice only (3) controls (no drink).
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Prevention
Keywords: Aggression; Omega-3 supplementation; Neurocognition; Attention; Antisocial