Nutrition, DHA and Child Development
How do you determine if something helps a child be smarter than they would have been without it? It is a tough question that Makrides and colleagues attempted to answer.
Neurodevelopmental outcomes were assessed in 646 children born from mothers randomized to receive 800 mg DHA (n= 313) or placebo (n = 333)daily during pregnancy at 18 months after birth and again 4 years later. Treatment by sex differences measured at 18 months in mean cognitive and language composite scores could not be seen at 4 years. What does this mean?
The DHA intervention significantly increased cord blood phospholipid concentrations from 6.1% to 7.2%. Basically, these Australian women had pretty good omega-3 status. In a study of Swedish women (1985 to 2005), cord blood phospholipid DHA levels ranged between 4.6% to 5.9%. In a longitudinal study of 416 children born in Munich, Kohlboeck and colleagues reported cord blood phospholipid DHA fatty acid percentages from as low as 3.8% up to 11.4% (by weight).
According to a previous publication by the same authors, the DHA intervention was discontinued when the children were born. DHA supplementation during lactation increases breast milk DHA content and is related to infant plasma DHA concentrations at 6 mo. In fact, Meldrum and colleagues reported that breast milk DHA content is the strongest predictor of infant red blood cell DHA levels at 6 mo of age, even after adjusting for cord blood DHA concentrations. In other words, breast milk DHA concentrations reflect maternal DHA intake and infant DHA status when nursing. Once the child weans, his/her dietary intake will influence DHA status. The older the child becomes, the impact of maternal nutrition (in utero and breast feeding) recedes and environmental factors on neurodevelopment become more relevant. It is not surprising that a 4 year old child’s neurodevelopment may be affected by influencers other than maternal DHA status during pregnancy.
Young parents should not be discouraged by headlines. What parent, or scientist, can demonstrate that an action or a single nutrient changed their child’s brain development? It isn’t possible. Each child is unique. Every parent-child-home environment is exceptional.
However, it is a fact that DHA is an essential structural component of a healthy brain. It is a fact that experts recommend a higher daily DHA intake than the national average of 80 mg DHA consumed by children (2-5y) living in the US.
Makrides M, Gould JF, Gawlik NR, Yelland LN, Smithers LG, Anderson PJ, Gibson RA. Four-year follow-up of children born to women in a randomized trial of prenatal DHA supplementation. 2014 JAMA doi: 10.1001/jama.2014.2194
Makrides M, Gibson RA, McPhee AJ, Yelland L, Quinlivan J, Ryan P and the DOMInO Investigative Team. Effect of DHA supplementation during pregnancy on maternal depression and neurodevelopment of young children: A randomized controlled trial. 2010 JAMA doi: 10.1001/jama.2010.1507
Meldrum SJ, D’Vaz N, Casadio Y, Dunstan JA, Krogsgaard-Larsen N, Simmer K, Prescott SL. Determinants of DHA levels in early infancy: Differential effects of breast milk and direct fish oil supplementation. 2012 Prostaglandins, Leukotrienes and Essential Fatty Acids doi: 10.1016/j.plefa.2012.05.006
Warstedt K, Duchen K. Increased linoleic acid/α-linolenic acid ratio in Swedish cord blood samples collected between 1985 to 2005. 2012 Eur J Nutr doi:10.1007/s00394-012-0369-6
Kohlboeck G, Glaser C, Tiesler C, Demmelmair H, Standl M, Romanos M, Koletzko B, Lehmann I, Heinrich J for the LISAplus Study Group. Effect of fatty acid status in cord blood serum on children’s behavioral difficulties at 10 y of age: results from the LISAplus Study. 2011 Am J Clin Nutr doi: 10.3945/ajcn.111.015800