Diets rich in omega-3 fatty acids have been shown to decrease inflammation in the body, reduce symptoms of ADHD, and lower levels of depression — but could they help curb childhood aggression and other behavioral problems as well? To investigate, psychology researchers from the University of Pennsylvania wondered if changing the brain could make people behave better. Their findings, published in The Journal of Child Psychology and Psychiatry, demonstrate how a diet rich in omega-3s, which are naturally found in salmon, tuna, avocado, and seeds, influences a child’s behavior on the short and long-term basis.

“No matter what program you use, could adding omega-3s to your treatment help? This [study] suggests it could,” said the study’s lead author Adrian Raine, a psychology professor at the University of Pennsylvania, in a statement. “We can’t oversimplify the complexity of antisocial behavior. There are many causes. It’s not just the brain. Is it a piece of the jigsaw puzzle? I think it is.”

To assemble the puzzle, Raine and his research team recruited 290 children between the ages of 11 and 12 years old and randomly divided them into four groups. One group received omega-3 supplements, in the form of juice, multivitamins, and calcium for three months while the second group didn’t receive omega-3 but instead participated in cognitive behavioral therapy (CBT). A third group took the supplements and participated in CBT, and the last group was just given information on how to reduce aggressive behavior. The therapy involved weekly hour-long meetings that rotated between the child and parent individually and together. Researchers also took blood samples from each participant at the beginning of the study and at the end in order to track their levels of omega-3s.

“Sessions focused on the links between thoughts, feelings and behaviors and also practicing alternative actions the children could take to deal with difficult situations rather than to emotionally react to something,” said the study’s co-author Therese Richmond, the dean of research and innovation at The University of Pennsylvania School of Medicine who observed the clinical trials. In her statement, she said, “It’s helping the child build a toolbox of ways to interact with others. For example, if I’m angry, how might I cope with anger other than physically striking out?”

“Immediately after three months of the nutritional intervention rich in omega-3s, we found a decrease in the children’s reporting of their aggressive behavior,” Richmond said. Those who had a combination of CBT and omega-3s and an omega-3s-only intervention, reported less aggression compared to the groups receiving only CBT or information on aggression. However, by the end of the study, the benefits of omega-3s diminished to mimic those derived from CBT-only intervention, leaving researchers to wonder why the benefits would wear off over time. They’ll need to investigate further to understand the underlying neurological factors at play.

According to The American Institute for Cognitive Therapy, CBT is a goal-focused treatment approach that explores how the child’s emotions, thoughts, and behaviors intertwine. Psychotherapists identify problematic behaviors and patterns in order to unlock a way for the child to cope and be guided to a healthier place emotionally.

Researchers wanted the children to experience the standard treatment for behavior problems, such as aggression and antisocial tendencies, in order to have an effective comparison for the omega-3s dietary intervention.

This isn’t the first time omega-3s were linked to lower aggression levels. In 2015, Raine and his team studied children at the ages of eight, 11, and 17 to figure out the mechanisms behind behavioral improvement. Omega-3 regulates the brain’s neurotransmitters and enhances the life of a neuron, but because the brain does not produce omega-3s on our own, humans must seek them out through diets or supplements.

“As a protective factor for reducing behavior problems in children, nutrition is a promising option,” said the 2015 study’s co-author Jianghong Liu, an associate professor at Pennsylvania University’s School of Nursing. “It is relatively inexpensive and can be easy to manage.”

Source: Richmond TS, Raine A, and Cheney RA, et al. Nutritional supplementation to reduce child aggression: a randomized, stratified, sing-blind, factorial trial. The Journal of Child Psychology and Psychiatry. 2016.