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Kedir S, Hassen K, Mohammed B, Ademe BW. Weekly iron-folic acid supplementation and its impact on children and adolescents iron status, mental health and school performance: a systematic review and meta-analysis in sub-Saharan Africa. BMJ Open 2024; 14:e084033. [PMID: 38862227 PMCID: PMC11168171 DOI: 10.1136/bmjopen-2024-084033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 05/30/2024] [Indexed: 06/13/2024] Open
Abstract
OBJECTIVE This systematic review and meta-analysis aimed to comprehensively assess the impact of weekly iron-folic acid supplementation (WIFAS) on the nutrition, health and educational outcomes of children and adolescents in sub-Saharan Africa. DESIGN A systematic review and meta-analysis was used. DATA SOURCES Five databases, namely, MEDLINE, Scopus, Web of Science, Cochrane Library and Google Scholar, were systematically searched for relevant articles up to 23 August 2023. ELIGIBILITY CRITERIA It was focused on randomised controlled trials involving children and adolescents in sub-Saharan Africa, exploring the effects of iron supplementation on various outcomes, such as serum ferritin and haemoglobin levels, anaemia, mental health and school performance. DATA EXTRACTION AND SYNTHESIS The Joanna Briggs Institute Critical Appraisal tools were used for quality assessment, with two independent reviewers thoroughly evaluating each paper. Using the Cochrane risk of bias tool, we evaluated the certainty of evidence such as the risk of bias, inconsistency, indirectness, imprecision and publication bias. RESULTS A systematic review of 10 articles revealed that WIFAS significantly increased serum ferritin levels in adolescent girls (Hedge's g=0.53, 95% CI 0.28 to 0.78; heterogeneity I2=41.21%, p<0.001) and haemoglobin levels in school-aged children (Hedge's g=0.37, 95% CI 0.01 to 0.73; heterogeneity I2=91.62%, p<0.001). The analysis further demonstrated a substantial reduction in the risk of anaemia by 20% (risk ratio=0.8, 95% CI 0.69 to 0.93; heterogeneity I2=28.12%, p<0.001). CONCLUSION WIFAS proved effective in enhancing serum ferritin and haemoglobin concentrations and lowering the risk of anaemia in school-aged children and adolescents compared with a placebo. Similarly, there are not enough studies to examine the effects of WIFAS on school performance. However, information regarding mental health problems, mortality and potential side effects remains insufficient. PROSPERO REGISTRATION NUMBER CRD42023397898.
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Affiliation(s)
- Shemsu Kedir
- Department of Nutrition and Dietetics, Institute of Health, Jimma University, Jimma, Ethiopia
- Department of Public Health, College of Medicine and Health Science, Werabe University, Werabe Ethiopia
| | - Kalkidan Hassen
- Department of Nutrition and Dietetics, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Bekri Mohammed
- Department of Nutrition and Dietetics, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Beyene Wondafrash Ademe
- Department of Nutrition and Dietetics, Institute of Health, Jimma University, Jimma, Ethiopia
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Sherzai D, Moness R, Sherzai S, Sherzai A. A Systematic Review of Omega-3 Fatty Acid Consumption and Cognitive Outcomes in Neurodevelopment. Am J Lifestyle Med 2023; 17:649-685. [PMID: 37711355 PMCID: PMC10498982 DOI: 10.1177/15598276221116052] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023] Open
Abstract
INTRODUCTION This systematic review addresses the effects of n-3 long-chain polyunsaturated fatty acids consumption on human neurodevelopment. It evaluates articles published between 2000 and 2022 investigating the cognitive outcomes during the period of neurodevelopment: from fetal development to adolescence. For the purpose of this review the terms LC PUFA and omega-3 fatty acid will be used interchangeably. METHOD Data were sourced from several major databases including PubMed (MEDLINE), Web of Science, and ProQuest Central. Randomized controlled trials (RCTs), nonrandomized controlled trials, prospective or retrospective cohort studies, and observational studies investigating the effects of omega-3 fatty acid consumption from dietary supplements, multiple-nutrient supplement, or food questionnaire on neurodevelopment were considered. Study population was separated in three developmental phases: (1) in-utero, (2) lactation/infancy, and (3) childhood/adolescence. Each article was evaluated for several key factors such as study type, type/dosage of PUFAs, number of subjects, length of intervention, participant age range, population characteristics, outcome measure (both primary/cognitive and secondary/other), results, conclusion, and confounding variables/limitations. RESULTS A total of 88 articles were included in the review, 69 RCTs and 19 longitudinal or observational studies. The results indicate equivocal effect of intervention, with some short-term benefits observed in the areas of visual attention, working memory, executive function, and communication. Omega-3 supplement might have a short-term positive impact on neurodevelopment in all three phases. Supplementation is recommended throughout life, rather than only during the earliest developmental stage.
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Affiliation(s)
- Dean Sherzai
- Dept of Neurology, Brain Health and Alzheimer's Prevention Program, Loma Linda University, Loma Linda, CA, USA (AS, DS); Oak Ridge High School, El Dorado Hills, CA, USA (RM); California State University, Los Angeles, CA, USA (SS)
| | - Roman Moness
- Dept of Neurology, Brain Health and Alzheimer's Prevention Program, Loma Linda University, Loma Linda, CA, USA (AS, DS); Oak Ridge High School, El Dorado Hills, CA, USA (RM); California State University, Los Angeles, CA, USA (SS)
| | - Sophia Sherzai
- Dept of Neurology, Brain Health and Alzheimer's Prevention Program, Loma Linda University, Loma Linda, CA, USA (AS, DS); Oak Ridge High School, El Dorado Hills, CA, USA (RM); California State University, Los Angeles, CA, USA (SS)
| | - Ayesha Sherzai
- Dept of Neurology, Brain Health and Alzheimer's Prevention Program, Loma Linda University, Loma Linda, CA, USA (AS, DS); Oak Ridge High School, El Dorado Hills, CA, USA (RM); California State University, Los Angeles, CA, USA (SS)
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Cardino VN, Goeden T, Yakah W, Ezeamama AE, Fenton JI. New Perspectives on the Associations between Blood Fatty Acids, Growth Parameters, and Cognitive Development in Global Child Populations. Nutrients 2023; 15:nu15081933. [PMID: 37111152 PMCID: PMC10143140 DOI: 10.3390/nu15081933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/11/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023] Open
Abstract
Malnutrition is prevalent in low-middle-income countries (LMICs), but it is usually clinically diagnosed through abnormal anthropometric parameters characteristic of protein energy malnutrition (PEM). In doing so, other contributors or byproducts of malnutrition, notably essential fatty acid deficiency (EFAD), are overlooked. Previous research performed mainly in high-income countries (HICs) shows that deficiencies in essential fatty acids (EFAs) and their n-3 and n-6 polyunsaturated fatty acid (PUFA) byproducts (also known as highly unsaturated fatty acids or HUFAs) lead to both abnormal linear growth and impaired cognitive development. These adverse developmental outcomes remain an important public health issue in LMICs. To identify EFAD before severe malnutrition develops, clinicians should perform blood fatty acid panels to measure levels of fatty acids associated with EFAD, notably Mead acid and HUFAs. This review demonstrates the importance of measuring endogenous fatty acid levels for measuring fatty acid intake in various child populations in LMICs. Featured topics include a comparison of fatty acid levels between global child populations, the relationships between growth and cognition and PUFAs and the possible mechanisms driving these relationships, and the potential importance of EFAD and HUFA scores as biomarkers of overall health and normal development.
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Affiliation(s)
- Vanessa N Cardino
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA
| | - Travis Goeden
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA
| | - William Yakah
- Department of Pediatrics, Columbia University Medical Center, New York, NY 10032, USA
| | - Amara E Ezeamama
- Department of Psychiatry, Michigan State University, East Lansing, MI 48824, USA
| | - Jenifer I Fenton
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA
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van der Wurff ISM, von Schacky C, Bergeland T, Zeegers MP, Kirschner PA, de Groot RHM. Krill oil supplementation's effect on school grades in typically developing adolescents. Prostaglandins Leukot Essent Fatty Acids 2023; 191:102553. [PMID: 36878083 DOI: 10.1016/j.plefa.2023.102553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 02/03/2023] [Accepted: 02/23/2023] [Indexed: 03/02/2023]
Abstract
Long-chain polyunsaturated fatty acids (LCPUFA) are important for brain development and functioning and with that, possibly school performance. Several cross-sectional studies have shown significant positive associations between fish consumption, an important source of LCPUFA and school grades in adolescents. The effect of LCPUFA supplementation on school grades in adolescents has not been investigated yet. The goal of the current study was to investigate (I) the associations between the Omega-3 Index (O3I) at baseline and after 12 months respectively and school grades and (II) the effect of one year krill oil supplementation (source of LCPUFA) on school grades in adolescents with a low O3I at baseline. A double-blind randomised placebo-controlled trial with repeated measurements was executed. Participants received either 400 mg eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) per day for the first three months in Cohort 1 and the nine months thereafter 800 mg EPA + DHA per day, Cohort 2 started immediately with 800 mg EPA + DHA per day,or a placebo. The O3I was monitored with a finger prick at baseline, three, six and twelve months. Subject grades for English, Dutch and math were collected, a standardised mathematics test was executed at baseline and at 12 months. Data was analysed with (I) explorative linear regressions to investigate associations at baseline and follow-up and (II) mixed model analyses separately for each of the subject grades and the standardised mathematics test to investigate the effect of supplementation after 12 months. The krill oil group had a small significant increase in the mean O3I at all time points. However, very few participants achieved the intended target O3I range of 8-11%. At baseline a significant association between baseline O3I and English grade was show, additionally a trend for an association with Dutch grade was shown. After 12 months no significant associations were found. Additionally, there was no significant effect of krill oil supplementation on subject grades or standardised mathematics test score. In this study, no significant effect of krill oil supplementation on subject grades or standardised mathematics test performance was found. However, as many participants dropped out and/or were non-adherent, results should be interpreted with caution.
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Affiliation(s)
- Inge S M van der Wurff
- Health Psychology, Faculty of Psychology, Open Univerity of the Netherlands, 6419 AT Heerlen, the Netherlands.
| | - Clemens von Schacky
- Omegametrix, 82 152 Martinsried, Germany; Preventive Cardiology, Medical Clinic and Poli-Clinic I, Ludwig Maximilians-University Munich, 80336 Munich, Germany
| | - Trygve Bergeland
- former employee of Aker BioMarine Antarctic AS, NO-1327 Lysaker, Norway
| | - Maurice P Zeegers
- Nutrition and Translational Research in Metabolism (School NUTRIM), Maastricht University,6200 MD Maastricht, the Netherlands; Care and Public Health Research Institute (School CAPHRI), Maastricht University, 6200 MD Maastricht, the Netherlands
| | - Paul A Kirschner
- Health Psychology, Faculty of Psychology, Open Univerity of the Netherlands, 6419 AT Heerlen, the Netherlands; Expertise Centre Effective Learning (ExCEL), Thomas More University of Applied Sciences, 2000 Antwerp, Belgium
| | - Renate H M de Groot
- Conditions for Lifelong Learning, Faculty of Educational Sciences, Open University of the Netherlands, 6419 AT Heerlen, the Netherlands
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Pokharel A, Webb P, Miller LC, Zaharia S, Shrestha R, Davis D, Trevino JA, Baral KP, Paudel K, Ghosh S. Relationship between Animal Sourced Food Consumption and Early Childhood Development Outcomes. Nutrients 2023; 15:nu15020315. [PMID: 36678186 PMCID: PMC9861056 DOI: 10.3390/nu15020315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/18/2022] [Accepted: 01/05/2023] [Indexed: 01/11/2023] Open
Abstract
Early-childhood development (ECD) is an important determinant of a child’s cognitive ability, learning, productivity, and lifetime earnings. Animal-sourced food (ASF), which is a rich source of high-quality protein and micronutrients, has been linked with ECD outcomes. This study investigates the relationship between the number, frequency, and cumulative consumption of ASF at 6, 9, 12, and 18 months of age and ECD outcomes at 24 months of age, controlling for physical growth. The study uses data collected from 701 mother−child pairs from an observational birth cohort study carried out in Banke, Nepal. ECD outcomes were assessed through a standardized ages and stages questionnaire (ASQ-3) tool. Separate multivariable ordinary least squares regression models were used to test for associations. Significant positive association was seen between total ASQ-3 score at 24 months of age and any ASF consumption at 18 months (β = 8.98, p-value < 0.01), controlling for growth outcomes. The study findings highlight the positive contribution and the accumulating benefit of consistent ASF consumption on ECD outcomes. This study recommends support and promotion of ASF intake among young children in Nepal through policy and programming actions relevant to female education; nutrition knowledge; quality ASF production; improved market access; cold storage; and poverty reduction.
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Affiliation(s)
- Ashish Pokharel
- Helen Keller International, Lalitpur 44600, Nepal
- Feed the Future Innovation Lab for Nutrition, Lalitpur 44600, Nepal
- Correspondence:
| | - Patrick Webb
- Feed the Future Innovation Lab for Nutrition, Lalitpur 44600, Nepal
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
| | - Laurie C. Miller
- Feed the Future Innovation Lab for Nutrition, Lalitpur 44600, Nepal
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
| | - Sonia Zaharia
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
| | - Robin Shrestha
- Feed the Future Innovation Lab for Nutrition, Lalitpur 44600, Nepal
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
| | - Dale Davis
- Helen Keller International, Lalitpur 44600, Nepal
- Feed the Future Innovation Lab for Nutrition, Lalitpur 44600, Nepal
| | - Johanna Andrews Trevino
- Feed the Future Innovation Lab for Nutrition, Lalitpur 44600, Nepal
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
| | - Kedar Prasad Baral
- Feed the Future Innovation Lab for Nutrition, Lalitpur 44600, Nepal
- School of Public Health, Patan Academy of Health Sciences, Lalitpur 44600, Nepal
| | | | - Shibani Ghosh
- Feed the Future Innovation Lab for Nutrition, Lalitpur 44600, Nepal
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
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McKune SL, Mechlowitz K, Miller LC. Dietary animal source food across the lifespan in LMIC. GLOBAL FOOD SECURITY 2022. [DOI: 10.1016/j.gfs.2022.100656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Dalile B, Kim C, Challinor A, Geurts L, Gibney ER, Galdos MV, La Fata G, Layé S, Mathers JC, Vauzour D, Verkuyl JM, Thuret S. The EAT-Lancet reference diet and cognitive function across the life course. Lancet Planet Health 2022; 6:e749-e759. [PMID: 36087605 DOI: 10.1016/s2542-5196(22)00123-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 05/02/2022] [Accepted: 05/13/2022] [Indexed: 06/15/2023]
Abstract
The EAT-Lancet Commission devised a sustainable reference diet with the aim of reducing the incidence of non-communicable diseases and mortality globally while improving food system sustainability. The extent to which the reference diet supports cognitive function across the life course, however, has not yet been evaluated. This Review assesses the evidence for diet supporting cognitive function from childhood into old age. A comprehensive but non-exhaustive literature search was done, synthesising studies that investigated the effect of whole foods on cognition in healthy, community-dwelling human participants. We found that the current evidence base is weak with mixed conclusions and multiple methodological caveats, which precludes strong conclusions pertaining to the suitability of dietary recommendations for each food group per age group. Long-term intervention and prospective cohort studies are needed to reduce this knowledge deficit. Revising dietary recommendations with the aim of maintaining an adequate nutrient intake to sustain healthy cognitive function across the life course could be worthwhile. This Review outlines recommendations for future work to help improve the current knowledge deficit regarding dietary intake and cognitive function across the life course and its implications for dietary guidelines such as the EAT-Lancet Commission.
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Affiliation(s)
- Boushra Dalile
- Translational Research Center for Gastrointestinal Disorders, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Curie Kim
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Andy Challinor
- Institute for Climate and Atmospheric Science, School of Earth and Environment, University of Leeds, Leeds, UK
| | - Lucie Geurts
- International Life Sciences Institute European Branch, Brussels, Belgium
| | - Eileen R Gibney
- Institute of Food Health, School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
| | - Marcelo V Galdos
- Institute for Climate and Atmospheric Science, School of Earth and Environment, University of Leeds, Leeds, UK
| | - Giorgio La Fata
- Health Nutrition and Care Innovation, Global Research and Development Center, DSM Nutritional Products, Kaiseraugst, Switzerland
| | - Sophie Layé
- Nutrition et Neurobiologie Intégrée, INRA Bordeaux University, Bordeaux, France
| | - John C Mathers
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - David Vauzour
- Norwich Medical School, Biomedical Research Centre, University of East Anglia, Norwich, UK
| | - J Martin Verkuyl
- Danone Nutricia Research, Nutricia Advanced Medical Nutrition, Utrecht, Netherlands
| | - Sandrine Thuret
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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Short-Term Fish Oil Supplementation during Adolescence Supports Sex-Specific Impact on Adulthood Visuospatial Memory and Cognitive Flexibility. Nutrients 2022; 14:nu14173513. [PMID: 36079771 PMCID: PMC9459882 DOI: 10.3390/nu14173513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
Numerous studies have supported benefits of omega-3 supplementation using Menhaden fish oil (FO) to promote brain maturation and plasticity during critical developmental periods. The goal of this study was to determine sex-specific immediate and delayed impact of adolescent omega-3 supplementation on visuospatial memory and cognitive flexibility. Sixty-four Wistar rats (n = 32 males and females) received daily FO or soybean oil (CSO) supplementation via oral gavage (0.3 mL/100 g body weight) from postnatal day 28–47. The Barnes Maze Test (BMT) was used to measure visuospatial memory and reversal learning trials (RL) determined cognitive flexibility. Juveniles underwent testing immediately after the gavage period, while adults began testing on postnatal day 90. Adult rats showed reduced working memory errors (WME) and gradual decrease in escape latencies compared to juveniles. Importantly, adult FO-supplemented females displayed fewer WME than males, while males’ performance benefited from CSO supplementation. Overall, sex- and supplementation-dependent effects supported a positive impact of FO in female rats only. Our findings support the potential for supplementation limited to the early adolescence period to influence adulthood spatial learning and cognitive flexibility in a sex-specific manner.
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Mulder KA, Dyer RA, Elango R, Innis SM. Complexity of understanding the role of dietary and erythrocyte docosahexaenoic acid (DHA) on the cognitive performance of school-age children. Curr Dev Nutr 2022; 6:nzac099. [PMID: 35854937 PMCID: PMC9283108 DOI: 10.1093/cdn/nzac099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Early childhood is a period of rapid brain development, with increases in synapses rich in the omega-3 (ω-3) fatty acid, DHA (22:6ω-3) continuing well beyond infancy. Despite the importance of DHA to neural phospholipids, the requirement of dietary DHA for neurodevelopment remains unclear. Objectives The aim was to assess the dietary DHA and DHA status of young children, and determine the association with cognitive performance. Methods This was a cross-sectional study of healthy children (5-6 y), some of whom were enrolled in a follow-up of a clinical trial (NCT00620672). Dietary intake data (n = 285) were assessed with a food-frequency questionnaire (FFQ) and three 24-h recalls. Family characteristics were collected by questionnaire, and anthropometric data measured. Venous blood was collected, cognitive performance assessed using several age-appropriate tools including the Kaufman Assessment Battery for Children. The relation between dietary DHA, RBC DHA, and child neurodevelopment test scores was determined using Pearson's correlation or Spearman's rho, and quintiles of test scores compared by Mann-Whitney U test. Results Child DHA intakes were highly variable, with a stronger association between RBC DHA and DHA intake assessed by FFQ (rho = 0.383, P < 0.001) compared with one or three 24-h recalls. Observed ethnic differences in DHA intake status as well as neurodevelopmental test scores led to analysis of the association between DHA intake and status with neurodevelopment test scores for White children only (n = 190). Child RBC DHA status was associated with neurodevelopment test scores, including language (rho = 0.211, P = 0.009) and short-term memory (rho = 0.187, P = 0.019), but only short-term memory was associated with dietary DHA (rho = 0.221, P = 0.003). Conclusions Child RBC DHA but not dietary DHA was associated with multiple tests of cognitive performance. In addition, DHA intake was only moderately associated with RBC DHA, raising complex questions on the relation between diet, DHA transfer to membrane lipids, and neural function.
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Affiliation(s)
- Kelly A Mulder
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Roger A Dyer
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Analytical Core for Metabolics and Nutrition (ACMaN), BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Rajavel Elango
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Sheila M Innis
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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Susai SR, Sabherwal S, Mongan D, Föcking M, Cotter DR. Omega-3 fatty acid in ultra-high-risk psychosis: A systematic review based on functional outcome. Early Interv Psychiatry 2022; 16:3-16. [PMID: 33652502 DOI: 10.1111/eip.13133] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 01/12/2021] [Accepted: 01/31/2021] [Indexed: 12/27/2022]
Abstract
AIM Among different types of poly unsaturated fatty acids, omega-3 fatty acids (FA) play a substantial role in brain development and functioning. This review was designed to evaluate and synthesize available evidence regarding omega-3 FAs and functional outcome in the ultra-high-risk (UHR) population. METHODS An electronic search in PubMed, EMBASE, PSYCINFO and COCHRANE search engines has been performed for all articles published until January 2019. The studies that have data regarding omega-3 FAs and functional outcome in UHR population were included. RESULTS Out of 397 nonduplicate citations, 19 articles met selection criteria. These articles were from four different primary studies, namely the Program of Rehabilitation and Therapy (PORT), the North American Prodromal Longitudinal Studies (NAPLS), Vienna High Risk study (VHR) and the NEURAPRO. The data from the NAPLS study found a positive correlation between functional improvement and frequency of dietary intake omega-3 FA. Moreover, among the erythrocyte omega-3 FA only eicosapentaenoic acid (EPA) showed a positive correlation with functional score. The VHR study found long-term improvement in functional outcome in omega-3 group compared to control, whereas such difference was noticed in the NEURAPRO. In the VHR study both omega-3 and omega-6 together predicted the functional improvement at 12 weeks. CONCLUSIONS The number of studies available remains insufficient and more studies with standardized outcome measures in a clinically comparable UHR population would be of more value to understand the clinical benefits of omega-3 FA in the UHR population.
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Affiliation(s)
- Subash Raj Susai
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Sophie Sabherwal
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - David Mongan
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Melanie Föcking
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - David R Cotter
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
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Rahmawaty S, Ramadhani FE, Anwar IK, Puspitasari O, Dewi TSK, Meyer BJ. A mothers' perspective on fish and her child's fish consumption in Surakarta, Indonesia. Nutr Res Pract 2021; 15:761-772. [PMID: 34858553 PMCID: PMC8601949 DOI: 10.4162/nrp.2021.15.6.761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 09/12/2019] [Accepted: 05/31/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUD/OBJECTIVES Understanding the factors associated with fish consumption is necessary to determine strategies to improve the fish consumption particularly those high in omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA). The aim of this study was to analyse the correlation between a mother's perspective on fish and actual fish consumption in their children. SUBJECTS/METHODS Two hundred thirty-one elementary school children grade 3-6 and their mothers in Surakarta were recruited using multi stage random sampling for this study. Data was collected in July and August 2017. A validated questionnaire consisted of 3 topics including knowledge related to the health benefits and organoleptic properties of fish and cooking technique-related attitudes on fish were used to measure the mother's response to the fish properties. A validated food frequency questionnaire and a food picture book of fish specifically designed for the survey were developed and used to assess fish consumption of the children. A χ2 test was used to analyse the correlation between the mothers' perspective on fish and their children's fish consumption. RESULTS The median fish consumption in children was 65 g/d with fried non-oily or lean fish, e.g., milkfish (locally called Bandeng) and catfish (locally called Lele) were consumed more than oily fish as well as processed fish products. Of all children, 31% met the fish consumption recommended by the Environmental Protection Agency-Food and Drug Administration 2017. There was no relationship between a mother's knowledge related to health benefits, organoleptic properties and cooking technique-related attitude toward fish and her child's fish consumption. CONCLUSIONS The fish consumption of children is not influenced by their mother's perspective on fish. Nutrition education strategies are warranted to improve fish consumption and maintain the optimal benefits by consuming fish, including fish high in n-3 LCPUFA.
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Affiliation(s)
- Setyaningrum Rahmawaty
- Department of Nutrition Science, Faculty of Health Science, Universitas Muhammadiyah Surakarta, Surakarta, Central Java 57102, Indonesia
| | - Farhanah Erwida Ramadhani
- Department of Nutrition Science, Faculty of Health Science, Universitas Muhammadiyah Surakarta, Surakarta, Central Java 57102, Indonesia
| | - Innani Kharisma Anwar
- Department of Nutrition Science, Faculty of Health Science, Universitas Muhammadiyah Surakarta, Surakarta, Central Java 57102, Indonesia
| | - Ola Puspitasari
- Department of Nutrition Science, Faculty of Health Science, Universitas Muhammadiyah Surakarta, Surakarta, Central Java 57102, Indonesia
| | - Tri Suci Kusuma Dewi
- Department of Nutrition Science, Faculty of Health Science, Universitas Muhammadiyah Surakarta, Surakarta, Central Java 57102, Indonesia
| | - Barbara J Meyer
- Lipid Research Centre, School of Medicine, Faculty of Science, Medicine and Health, and Illawarra Medical Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia
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Ahern MB, Thilsted SH, Kjellevold M, Overå R, Toppe J, Doura M, Kalaluka E, Wismen B, Vargas M, Franz N. Locally-Procured Fish Is Essential in School Feeding Programmes in Sub-Saharan Africa. Foods 2021; 10:foods10092080. [PMID: 34574190 PMCID: PMC8466277 DOI: 10.3390/foods10092080] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/20/2021] [Accepted: 08/20/2021] [Indexed: 11/16/2022] Open
Abstract
Fish make an important contribution to micronutrient intake, long-chained polyunsaturated omega-3 fatty acids (n-3 LC-PUFAS), and animal protein, as well as ensuring food and nutrition security and livelihoods for fishing communities. Micronutrient deficiencies are persistent in sub-Saharan Africa (SSA), contributing to public health issues not only in the first 1000 days but throughout adolescence and into adulthood. School feeding programs (SFPs) and home-grown school feeding programs (HGSF), which source foods from local producers, particularly fisherfolk, offer an entry point for encouraging healthy diets and delivering essential macro- and micronutrients to schoolchildren, which are important for the continued cognitive development of children and adolescents and can contribute to the realization of sustainable development goals (SDGs) 1, 2, 3, 5, and 14. The importance of HGSF for poverty alleviation (SDG1) and zero hunger (SDG 2) have been recognized by the United Nations Hunger Task Force and the African Union Development Agency-New Partnership for African Development (AUDA-NEPAD), which formulated a strategy for HGSF to improve nutrition for the growing youth population across Africa. A scoping review was conducted to understand the lessons learned from SFPs, which included fish and fish products from small-scale producers, identifying the challenges and best practices for the inclusion of fish, opportunities for improvements across the supply chain, and gaps in nutritional requirements for schoolchildren which could be improved through the inclusion of fish. Challenges to the inclusion fish in SFPs include food safety, supply and access to raw materials, organizational capacity, and cost, while good practices include the engagement of various stakeholders in creating and testing fish products, and repurposing fisheries by-products or using underutilized species to ensure cost-effective solutions. This study builds evidence of the inclusion of nutritious fish and fish products in SFPs, highlighting the need to replicate and scale good practices to ensure sustainable, community-centred, and demand-driven solutions for alleviating poverty, malnutrition, and contributing to greater health and wellbeing in adolescence.
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Affiliation(s)
- Molly B. Ahern
- Fisheries and Aquaculture Division, Food and Agriculture Organization of the United Nations (FAO), 00153 Rome, Italy;
- Correspondence:
| | | | | | - Ragnhild Overå
- Department of Geography, University of Bergen, 5007 Bergen, Norway;
| | - Jogeir Toppe
- Sub-Regional Office for Mesoamerica, Food and Agriculture Organization of the United Nations (FAO), Panama City 32408, Panama;
| | - Michele Doura
- School-Based Programmes Unit, World Food Programme, 00148 Rome, Italy; (M.D.); (E.K.)
| | - Edna Kalaluka
- School-Based Programmes Unit, World Food Programme, 00148 Rome, Italy; (M.D.); (E.K.)
| | | | - Melisa Vargas
- Nutrition Division, Food and Agriculture Organization of the United Nations (FAO), 00153 Rome, Italy;
| | - Nicole Franz
- Fisheries and Aquaculture Division, Food and Agriculture Organization of the United Nations (FAO), 00153 Rome, Italy;
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13
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Patan MJ, Kennedy DO, Husberg C, Hustvedt SO, Calder PC, Khan J, Forster J, Jackson PA. Supplementation with oil rich in eicosapentaenoic acid, but not in docosahexaenoic acid, improves global cognitive function in healthy, young adults: results from randomized controlled trials. Am J Clin Nutr 2021; 114:914-924. [PMID: 34113957 PMCID: PMC8408864 DOI: 10.1093/ajcn/nqab174] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 04/28/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Evidence regarding the effects of the omega-3 (ɷ-3) PUFAs (n-3 PUFAs) DHA and EPA on cognition is lacking. OBJECTIVES We investigated whether supplementation with oils rich in EPA or DHA improves cognition, prefrontal cortex (PFC) hemoglobin (Hb) oxygenation, and memory consolidation. METHODS Healthy adults (n = 310; age range: 25-49 y) completed a 26-wk randomized controlled trial in which they consumed either 900 mg DHA/d and 270 mg EPA/d (DHA-rich oil), 360 mg DHA/d and 900 mg EPA/d (EPA-rich oil), or 3000 mg/d refined olive oil (placebo). Cognitive performance and memory consolidation were assessed via computerized cognitive test battery. PFC Hb oxygenation was measured using near infrared spectroscopy (NIRS). RESULTS Both global accuracy and speed improved with EPA-rich oil compared with placebo and DHA-rich oil [EPA vs. placebo accuracy: estimated marginal mean (EMM) = 0.17 (95% CI: 0.09, 0.24) vs. EMM = 0.03 (95% CI = -0.04, 0.11); P = 0.044; EPA vs. placebo speed: EMM = -0.15 (95% CI: -0.22, -0.07) vs. EMM = 0.03 (95% CI: -0.05, 0.10); P = 0.003]. Accuracy of memory was improved with EPA compared with DHA [EMM = 0.66 (95% CI: 0.26, 1.06) vs. EMM = -0.08 (95% CI: -0.49, 0.33); P = 0.034]. Both EPA- and DHA-rich oils showed trends towards reduced PFC oxygenated Hb (oxy-Hb) compared with placebo [placebo: EMM = 27.36 µM (95% CI: 25.73, 28.98); DHA: EMM = 24.62 µM (95% CI: 22.75, 26.48); P = 0.060; EPA: EMM = 24.97 µM (95% CI: 23.35, 26.59); P = 0.082]. CONCLUSIONS EPA supplementation improved global cognitive function and was superior to the oil enriched with DHA. Interpreted within a neural efficiency framework, reduced PFC oxygenated Hb suggests that n-3 PUFAs may be associated with increased efficiency.These trials were registered in the clinical trials registry (https://clinicaltrials.gov/) as NCT03158545, NCT03592251, NCT02763514.
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Affiliation(s)
- Michael J Patan
- Brain Performance and Nutrition Research Centre, Northumbria University, Newcastle Upon Tyne, United Kingdom
| | - David O Kennedy
- Brain Performance and Nutrition Research Centre, Northumbria University, Newcastle Upon Tyne, United Kingdom
| | | | | | - Philip C Calder
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- National Institute of Health Research Southampton Biomedical Research Centre, University Hospital Southampton National Health Service Foundation Trust and University of Southampton, Southampton, United Kingdom
| | - Julie Khan
- Brain Performance and Nutrition Research Centre, Northumbria University, Newcastle Upon Tyne, United Kingdom
| | - Joanne Forster
- Brain Performance and Nutrition Research Centre, Northumbria University, Newcastle Upon Tyne, United Kingdom
| | - Philippa A Jackson
- Brain Performance and Nutrition Research Centre, Northumbria University, Newcastle Upon Tyne, United Kingdom
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14
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Parasannanavar D, Gaddam I, Bukya T, Ibrahim S A, Reddy K S, Banjara SK, Salvadi BPP, Kumar B N, Rao SF, Geddam JJB, Rajkumar H. Omega-3 polyunsaturated fatty acid intake and plasma fatty acids of school going Indian children - a cross-sectional study. Prostaglandins Leukot Essent Fatty Acids 2021; 170:102294. [PMID: 34052598 DOI: 10.1016/j.plefa.2021.102294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 03/25/2021] [Accepted: 05/06/2021] [Indexed: 12/18/2022]
Abstract
Long-chain omega-3 polyunsaturated fatty acids (PUFA) such as docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) play an essential role in cognitive and behavioural changes among school going children. This study delineates the dietary omega-3 PUFA [alpha-Linolenic acid (ALA), DHA, and EPA] intake and plasma fatty acids levels among school-going children. This is a cross-sectional study purely observational in nature, wherein 625 apparently healthy boys and girls aged between 7 and 13 years were selected from five different schools of Hyderabad. Dietary information on omega-3 PUFA (ALA, DHA, and EPA) intake was collected using a food frequency questionnaire. Plasma fatty acid concentrations were measured in 34% of sub-sample using standard gas chromatography. The study revealed that the average dietary intakes of omega-3 PUFA, ALA, DHA, and EPA were 55.46, 15.82, 35.59, 4.06 mg/day, respectively. There was a significant difference in mean DHA intake among gender and age group [girls (38.64±1.45 mg/day), boys (31.80±1.38 mg/day) p < 0.001] and [7-10 years (31.75±1.38 mg/day), 11-13 years (38.07±1.40 mg/day) p < 0.01]. The mean plasma DHA and DPA levels of overall subjects were 0.98 nmol% and 0.18nmol% respectively which was comparable among different gender, age and BMI-for age groups. There was a positive correlation between dietary DHA intake and plasma DHA level [ρ=0.376 (p < 0.001)]. The current study demonstrated that the omega-3 PUFA intake in school going children was less and reinforces the importance of increasing the omega-3 PUFA intake through diet and supplements.
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Affiliation(s)
- Devaraj Parasannanavar
- Division of Clinical Epidemiology, ICMR-National Institute of Nutrition, Hyderabad, Telangana, India-500 007. 8074928620.
| | - Indraja Gaddam
- ICMR-National Institute of Nutrition, Hyderabad, Telangana, India-500 007.
| | - Tulja Bukya
- Division of Clinical Epidemiology, ICMR-National Institute of Nutrition, Hyderabad, Telangana, India-500 007. 8074928620.
| | - Ahamed Ibrahim S
- Lipid Chemistry Department, ICMR-National Institute of Nutrition, Hyderabad, Telangana, India-500 007.
| | - Suryam Reddy K
- Lipid Chemistry Department, ICMR-National Institute of Nutrition, Hyderabad, Telangana, India-500 007.
| | - Santosh Kumar Banjara
- Clinical Division, ICMR-National Institute of Nutrition, Hyderabad, Telangana, India-500 007.
| | - Blessy P Priyanka Salvadi
- Division of Clinical Epidemiology, ICMR-National Institute of Nutrition, Hyderabad, Telangana, India-500 007. 8074928620.
| | - Naveen Kumar B
- Division of Clinical Epidemiology, ICMR-National Institute of Nutrition, Hyderabad, Telangana, India-500 007. 8074928620.
| | - Sylvia Fernandez Rao
- Behavioral Science Unit, Extension & Training Division, (ICMR)-National Institute of Nutrition, Hyderabad, Telangana, India-500 007.
| | - J J Babu Geddam
- Division of Clinical Epidemiology, ICMR-National Institute of Nutrition, Hyderabad, Telangana, India-500 007. 8074928620.
| | - Hemalatha Rajkumar
- Scientist 'G' and The Director, ICMR-National Institute of Nutrition, Jamai-Osmania, Tarnaka, Hyderabad, Telangana-500007.
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15
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Basak S, Mallick R, Banerjee A, Pathak S, Duttaroy AK. Maternal Supply of Both Arachidonic and Docosahexaenoic Acids Is Required for Optimal Neurodevelopment. Nutrients 2021; 13:2061. [PMID: 34208549 PMCID: PMC8234848 DOI: 10.3390/nu13062061] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 06/10/2021] [Accepted: 06/14/2021] [Indexed: 12/22/2022] Open
Abstract
During the last trimester of gestation and for the first 18 months after birth, both docosahexaenoic acid,22:6n-3 (DHA) and arachidonic acid,20:4n-6 (ARA) are preferentially deposited within the cerebral cortex at a rapid rate. Although the structural and functional roles of DHA in brain development are well investigated, similar roles of ARA are not well documented. The mode of action of these two fatty acids and their derivatives at different structural-functional roles and their levels in the gene expression and signaling pathways of the brain have been continuously emanating. In addition to DHA, the importance of ARA has been much discussed in recent years for fetal and postnatal brain development and the maternal supply of ARA and DHA. These fatty acids are also involved in various brain developmental processes; however, their mechanistic cross talks are not clearly known yet. This review describes the importance of ARA, in addition to DHA, in supporting the optimal brain development and growth and functional roles in the brain.
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Affiliation(s)
- Sanjay Basak
- Molecular Biology Division, ICMR-National Institute of Nutrition, Indian Council of Medical Research, Hyderabad 500 007, India;
| | - Rahul Mallick
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, 70210 Kuopio, Finland;
| | - Antara Banerjee
- Department of Medical Biotechnology, Faculty of Allied Health Sciences, Chettinad Academy of Research and Education (CARE), Chettinad Hospital and Research Institute (CHRI), Kelambakkam, Chennai 603 103, India; (A.B.); (S.P.)
| | - Surajit Pathak
- Department of Medical Biotechnology, Faculty of Allied Health Sciences, Chettinad Academy of Research and Education (CARE), Chettinad Hospital and Research Institute (CHRI), Kelambakkam, Chennai 603 103, India; (A.B.); (S.P.)
| | - Asim K. Duttaroy
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, 0317 Oslo, Norway
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16
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Mahomoodally MF, Sanaa DA, Zengin G, Gallo M, Montesano D. Traditional Therapeutic Uses of Marine Animal Parts and Derived Products as Functional Foods – A Systematic Review. FOOD REVIEWS INTERNATIONAL 2021. [DOI: 10.1080/87559129.2021.1926486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Mohamad Fawzi Mahomoodally
- Department of Health Sciences, Faculty of Medicine and Health Sciences, University of Mauritius, Mauritius
| | - Dilmar Aniisah Sanaa
- Department of Health Sciences, Faculty of Medicine and Health Sciences, University of Mauritius, Mauritius
| | - Gokhan Zengin
- Department of Biology, Faculty of Science, Selcuk Universtiy, Konya, Turkey
| | - Monica Gallo
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples, Italy
| | - Domenico Montesano
- Department of Pharmaceutical Sciences, Section of Food Science and Nutrition, University of Perugia, Perugia, Italy
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17
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How the inclusion of cod (Pseudophycis bachus) protein enriched powder to bread affects the in vitro protein and starch digestibility, amino acid profiling and antioxidant properties of breads. Eur Food Res Technol 2021. [DOI: 10.1007/s00217-021-03699-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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18
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Van Pelt AE, Lipow MI, Scott JC, Lowenthal ED. Interventions for Children with Neurocognitive Impairments in Resource-Limited Settings: A Systematic Review. CHILDREN AND YOUTH SERVICES REVIEW 2020; 118:105393. [PMID: 32968334 PMCID: PMC7505233 DOI: 10.1016/j.childyouth.2020.105393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Many children and adolescents around the world suffer from neurocognitive deficits due to chronic disorders, such as Human Immunodeficiency Virus (HIV) and malaria. Resource-limited settings exacerbate the risk of negative cognitive outcomes due to high prevalence of associated disorders, poverty, and limited access to interventions. Current literature does not provide consensus regarding the efficacy of interventions to support children with cognitive impairments in low-resource settings. This research aimed to identify and evaluate interventions for youth with neurocognitive deficits in resource-limited settings. A systematic review of peer-reviewed literature was conducted within five databases (PubMed, Web of Science, CINAHL, PsycInfo, and WHO Index Medicus). Cognitive impairment was broadly defined to be inclusive of aspects of intellectual and cognitive functioning (e.g., working memory, attention, executive function). The income status of the country or countries in which each study was located was determined according to World Bank Income Status. Studies conducted in countries classified as low- or middle-income were included. Since low-resource areas exist within high-income countries, the resource availability within study settings in high-income countries was systematically evaluated for inclusion. The search yielded 19 articles that met all inclusion criteria. Interventions included strategies involving caregiver training, computerized and non-computerized cognitive training, physical activity, and nutritional supplementation. Interventions were administered in medical facilities, educational facilities, or the home. The majority of the interventions targeted the domains of memory and attention. Overall, the efficacy of interventions was inconsistent. Further, results indicated that the relationship between cognitive improvement and intervention types was not consistent across cognitive domains. However, when evaluating studies on an individual basis, some strategies demonstrated clinically- and statistically-significant improvement in cognitive function among specific groups of children. The low article yield highlights that few researchers have evaluated pediatric cognitive support interventions in low-resource contexts. This review suggests support strategies that should be considered for future studies as neurocognitive screening capacity improves in resource-limited settings.
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Affiliation(s)
- Amelia E. Van Pelt
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at the University of Pennsylvania, 423 Guardian Drive, Philadelphia, Pennsylvania, United States 19104-6021
- Department of Pediatrics (Global Health Center), Children’s Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, 3501 Civic Center Blvd, Philadelphia, Pennsylvania, United States 19104
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Colonial Penn Center, 3461 Locust Walk, Philadelphia, Pennsylvania, United States 19104-6218
| | - Matthew I. Lipow
- Department of Pediatrics (Global Health Center), Children’s Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, 3501 Civic Center Blvd, Philadelphia, Pennsylvania, United States 19104
- Drexel University College of Medicine, 2900 Queen Lane, Philadelphia, Pennsylvania, United States 19129
| | - J. Cobb Scott
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Richards Building, 5th Floor, 3700 Hamilton Walk, Philadelphia, Pennsylvania, 19104-6085 United States
- VISN4 Mental Illness Research, Education, and Clinical Center at the Philadelphia VA Medical Center, 3900 Woodland Ave, MC116, Philadelphia, PA, 19104, United States
| | - Elizabeth D. Lowenthal
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at the University of Pennsylvania, 423 Guardian Drive, Philadelphia, Pennsylvania, United States 19104-6021
- Department of Pediatrics (Global Health Center), Children’s Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, 3501 Civic Center Blvd, Philadelphia, Pennsylvania, United States 19104
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van der Wurff IS, Meyer BJ, de Groot RH. Effect of Omega-3 Long Chain Polyunsaturated Fatty Acids (n-3 LCPUFA) Supplementation on Cognition in Children and Adolescents: A Systematic Literature Review with a Focus on n-3 LCPUFA Blood Values and Dose of DHA and EPA. Nutrients 2020; 12:E3115. [PMID: 33053843 PMCID: PMC7599612 DOI: 10.3390/nu12103115] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/05/2020] [Accepted: 10/06/2020] [Indexed: 02/06/2023] Open
Abstract
Omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA) supplementation in the cardiovascular field is effective if a certain Omega-3 index (O3I) is achieved or the daily n-3 LCPUFA dose is high enough. Whether this applies to studies on cognition in children and adolescents is unclear. The aims of the current review were to investigate whether: (1) a certain O3I level and (2) a minimum daily n-3 LCPUFA dose are required to improve cognition in 4-25 year olds. Web of Science and PubMed were searched. Inclusion criteria: placebo controlled randomized controlled trial; participants 4-25 years; supplementation with docosahexaenoic acid (DHA) and/or eicosapentaenoic acid (EPA); assessing cognition; in English and ≥10 participants per treatment arm. Thirty-three studies were included, 21 in typically developing participants, 12 in those with a disorder. A positive effect on cognitive measures was more likely in studies with an increase in O3I to >6%. Half of the studies in typically developing children with daily supplementation dose ≥450 mg DHA + EPA showed improved cognition. For children with a disorder no cut-off value was found. In conclusion, daily supplementation of ≥450 mg DHA + EPA per day and an increase in the O3I to >6% makes it more likely to show efficacy on cognition in children and adolescents.
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Affiliation(s)
- Inge S.M. van der Wurff
- Conditions for Lifelong Learning, Faculty of Educational Sciences, Open University of the Netherlands, 6419 Heerlen, The Netherlands;
| | - Barbara J. Meyer
- School of Medicine, Lipid Research Centre, Molecular Horizons, Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia;
| | - Renate H.M. de Groot
- Conditions for Lifelong Learning, Faculty of Educational Sciences, Open University of the Netherlands, 6419 Heerlen, The Netherlands;
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6200 Maastricht, The Netherlands
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20
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Teisen MN, Vuholm S, Niclasen J, Aristizabal-Henao JJ, Stark KD, Geertsen SS, Damsgaard CT, Lauritzen L. Effects of oily fish intake on cognitive and socioemotional function in healthy 8-9-year-old children: the FiSK Junior randomized trial. Am J Clin Nutr 2020; 112:74-83. [PMID: 32529206 DOI: 10.1093/ajcn/nqaa050] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 02/24/2020] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Long-chain n-3 PUFAs (n-3 LCPUFAs) accrete in the brain during childhood and affect brain development. Randomized trials in children show inconsistent effects of n-3 LCPUFAs on cognitive and socioemotional function, and few have investigated effects of fish per se. OBJECTIVES We aimed to investigate the effects of oily fish consumption on overall and domain-specific cognitive and socioemotional scores and explore sex differences. METHODS Healthy 8-9-y-old children (n = 199) were randomly allocated to receive ∼300 g/wk oily fish or poultry (control) for 12 ± 2 wk. At baseline and endpoint, we assessed attention, processing speed, executive functions, memory, emotions, and behavior with a large battery of tests and questionnaires and analyzed erythrocyte fatty acid composition. RESULTS One hundred and ninety-seven (99%) children completed the trial. Children in the fish group consumed 375 (25th-75th percentile: 325-426) g/wk oily fish resulting in 2.3 (95% CI: 1.9, 2.6) fatty acid percentage points higher erythrocyte n-3 LCPUFA than in the poultry group. The overall cognitive performance score tended to improve by 0.17 (95% CI: -0.01, 0.35) points in children who received fish compared with poultry, supported by n-3 LCPUFA dose dependency. This was driven mainly by fewer errors [-1.9 (95% CI: -3.4, -0.3)] in an attention task and improved cognitive flexibility measured as faster reaction time [-51 ms (95% CI: -94, -7 ms)] in a complex relative to a simple task ("mixing cost"). The fish intervention furthermore reduced parent-rated Strength and Difficulties Questionnaire total difficulties by -0.89 (95% CI: -1.60, -0.18) points mainly due to a -0.63 (95% CI: -1.11, -0.16) points reduction in internalizing problems that was reflected in tendency to a decrease in the overall socioemotional problems score of -0.13 (95% CI: -0.26, 0.01) points. The overall effects were similar in boys and girls. CONCLUSIONS Oily fish dose-dependently improved cognitive function, especially attention and cognitive flexibility, and reduced socioemotional problems. The results support the importance of n-3 LCPUFAs for optimal brain function and fish intake recommendations in children.The trial was registered at www.clinicaltrials.gov as NCT02809508.
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Affiliation(s)
- Marie N Teisen
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Stine Vuholm
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Janni Niclasen
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | | | - Ken D Stark
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Svend S Geertsen
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Camilla T Damsgaard
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Lotte Lauritzen
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
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21
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Rahmawaty S, Meyer BJ. Stunting is a recognized problem: Evidence for the potential benefits of ω-3 long-chain polyunsaturated fatty acids. Nutrition 2020; 73:110564. [DOI: 10.1016/j.nut.2019.110564] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 07/11/2019] [Indexed: 02/06/2023]
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22
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Barón-Mendoza I, González-Arenas A. Relationship between the effect of polyunsaturated fatty acids (PUFAs) on brain plasticity and the improvement on cognition and behavior in individuals with autism spectrum disorder. Nutr Neurosci 2020; 25:387-410. [PMID: 32338174 DOI: 10.1080/1028415x.2020.1755793] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objective: This work aimed to compile information about the neuronal processes in which polyunsaturated fatty acids (PUFAs) could modulate brain plasticity, in order to analyze the role of nutritional intervention with the ω-3 and ω-6 fatty acids as a therapeutic strategy for the Autism Spectrum Disorder (ASD)-related signs and symptoms.Methods: We reviewed different articles reporting the effect of PUFAS on neurite elongation, membrane expansion, cytoskeleton rearrangement and neurotransmission, considering the ASD-related abnormalities in these processes.Results: In accordance to the reviewed studies, it is clear that ASD is one of the neurological conditions associated with an impairment in neuronal plasticity; therefore, PUFAs-rich diet improvements on cognition and behavioral deficits in individuals with autism, could be involved with the regulation of neuronal processes implicated in the atypical brain plasticity related with this neurodevelopmental disorder.Discussion: The behavioral and cognitive improvement observed in individuals with ASD after PUFAs treatment might underlie, at least in part, in the ability of ω-3 and ω-6 fatty acids to induce neurite outgrowth, probably, through the dynamic regulation of the neuronal cytoskeleton along with the expansion of neuronal membranes. Furthermore, it might also be associated with an enhancement of the efficacy of synaptic transmission and the modulation of neurotransmitters release.
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Affiliation(s)
- Isabel Barón-Mendoza
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, CDMX, México
| | - Aliesha González-Arenas
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, CDMX, México
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Soe LT, Fahmida U, Seniati ANL, Firmansyah A. Nutrients Essential for Cognitive Function Are Typical Problem Nutrients in the Diets of Myanmar Primary School Children: Findings of a Linear Programming Analysis. Food Nutr Bull 2020; 41:211-223. [PMID: 32013580 DOI: 10.1177/0379572119878070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Good cognitive function is important for school-age children. Although essential fatty acids play a main role in cognitive functions, their intakes are assumed as inadequate among developing countries including Myanmar. However, there is still lack of evidence to show whether they are problem nutrients. OBJECTIVE This study aimed to determine the problem nutrients in the diets of Myanmar primary schoolchildren and to formulate food-based recommendations (FBR) to optimize the intake of these micronutrients. METHODS A cross-sectional study was conducted at 3 primary schools in Nyaungdon Township of Myanmar. A 1-week dietary intake assessment was done on 7- to 9-year-old (n = 100) primary schoolchildren. A linear programming approach using the World Health Organization Optifood software was used to assess the nutrient intake and develop FBRs. RESULTS The prevalence of stunted growth, wasting, and being underweight in the students were 28%, 18%, and 28%, respectively. The intake of calcium, vitamin B1, folate, iron, omega-3 fatty acids, eicosapentaenoic acid, and docosahexaenoic acid was insufficient. Locally available nutrient-dense foods that include water spinach, carp fish, duck egg, garden pea, and shrimp were selected to develop FBR to increase the intake of problem nutrients. CONCLUSION The linear programming analysis showed that the primary schoolchildren have difficulty meeting nutrient recommendations given locally available foods, especially iron and essential fatty acids which are important for cognitive performance of schoolchildren.
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Affiliation(s)
- Le Thandar Soe
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia-Dr. CiptoMangunkusumo General Hospital, Jakarta, Indonesia.,South East Asian Ministers of Education Organization Regional Centre for Food and Nutrition (SEAMEO-RECFON) - Pusat Kajian Gizi Regional (PKGR), Universitas Indonesia, Jakarta, Indonesia.,Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Umi Fahmida
- South East Asian Ministers of Education Organization Regional Centre for Food and Nutrition (SEAMEO-RECFON) - Pusat Kajian Gizi Regional (PKGR), Universitas Indonesia, Jakarta, Indonesia
| | | | - Agus Firmansyah
- Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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24
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Hibbeln JR, Spiller P, Brenna JT, Golding J, Holub BJ, Harris WS, Kris-Etherton P, Lands B, Connor SL, Myers G, Strain JJ, Crawford MA, Carlson SE. Relationships between seafood consumption during pregnancy and childhood and neurocognitive development: Two systematic reviews. Prostaglandins Leukot Essent Fatty Acids 2019; 151:14-36. [PMID: 31739098 PMCID: PMC6924512 DOI: 10.1016/j.plefa.2019.10.002] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 10/10/2019] [Indexed: 12/28/2022]
Abstract
Abundant data are now available to evaluate relationships between seafood consumption in pregnancy and childhood and neurocognitive development. We conducted two systematic reviews utilizing methodologies detailed by the Dietary Guidelines for Americans Scientific Advisory Committee 2020-2025. After reviewing 44 publications on 106,237 mother-offspring pairs and 25,960 children, our technical expert committee developed two conclusion statements that included the following: "Moderate and consistent evidence indicates that consumption of a wide range of amounts and types of commercially available seafood during pregnancy is associated with improved neurocognitive development of offspring as compared to eating no seafood. Overall, benefits to neurocognitive development began at the lowest amounts of seafood consumed (∼4 oz/wk) and continued through the highest amounts, above 12 oz/wk, some range up to >100 oz/wk.", "This evidence does not meet the criteria for "strong evidence" only due to a paucity of randomized controlled trials that may not be ethical or feasible to conduct for pregnancy" and "Moderate and consistent evidence indicates that consumption of >4 oz/wk and likely >12 oz/wk of seafood during childhood has beneficial associations with neurocognitive outcomes." No net adverse neurocognitive outcomes were reported among offspring at the highest ranges of seafood intakes despite associated increases in mercury exposures. Data are insufficient for conclusive statements regarding lactation, optimal amounts, categories or specific species characterized by mercury content and neurocognitive development; although there is some evidence that dark/oily seafood may be more beneficial. Research was conducted in healthy women and children and is generalizable to US populations. Assessment of seafood as a whole food integrates inherently integrates any adverse effects from neurotoxicants, if any, and benefits to neurocognition from omega-3 fats, as well as other nutrients critical to optimal neurological development. Understanding of the effects of seafood consumption on neurocognition can have significant public health implications.
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Affiliation(s)
| | | | - J Thomas Brenna
- Dell Pediatric Research Institute, Depts of Pediatrics, of Chemistry, and of Nutrition, University of Texas at Austin, TX, USA
| | - Jean Golding
- Pediatric and Perinatal Epidemiology, Population Health Sciences, University of Bristol, Bristol, UK
| | - Bruce J Holub
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - William S Harris
- Department of Internal Medicine, University of South Dakota School of Medicine and OmegaQuant Analytics, LLC, Sioux Falls, SD, USA
| | - Penny Kris-Etherton
- Department of Nutritional Sciences, Penn State University, University Park, PA, USA
| | - Bill Lands
- American Society for Nutrition, College Park, MD, USA
| | - Sonja L Connor
- Endocrinology, Diabetes and Clinical Nutrition, Oregon Health and Science University, Portland, OR, USA
| | - Gary Myers
- Neurology, Pediatrics, and Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - J J Strain
- Nutrition Innovation Centre for Food & Health, (NICHE), Ulster University, Coleraine, Northern Ireland, UK
| | - Michael A Crawford
- Division of Obstetrics and Gynaecology, Department of Surgery and Cancer, Imperial College London, UK
| | - Susan E Carlson
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS, USA
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25
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Cook RL, Parker HM, Donges CE, O'Dwyer NJ, Cheng HL, Steinbeck KS, Cox EP, Franklin JL, Garg ML, O'Connor HT. Omega-3 polyunsaturated fatty acids status and cognitive function in young women. Lipids Health Dis 2019; 18:194. [PMID: 31694658 PMCID: PMC6836340 DOI: 10.1186/s12944-019-1143-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 10/27/2019] [Indexed: 12/11/2022] Open
Abstract
Background Research indicates that low omega-3 polyunsaturated fatty acid (n-3 PUFA) may be associated with decreased cognitive function. This study examined the association between n-3 PUFA status and cognitive function in young Australian women. Methods This was a secondary outcome analysis of a cross-sectional study that recruited 300 healthy women (18–35 y) of normal weight (NW: BMI 18.5–24.9 kg/m2) or obese weight (OB: BMI ≥30.0 kg/m2). Participants completed a computer-based cognition testing battery (IntegNeuro™) evaluating the domains of impulsivity, attention, information processing, memory and executive function. The Omega-3 Index (O3I) was used to determine n-3 PUFA status (percentage of EPA (20:5n-3) plus DHA (22:6n3) in the red cell membrane) and the participants were divided into O3I tertile groups: T1 < 5.47%, T2 = 5.47–6.75%, T3 > 6.75%. Potential confounding factors of BMI, inflammatory status (C-reactive Protein), physical activity (total MET-min/wk), alpha1-acid glycoprotein, serum ferritin and hemoglobin, were assessed. Data reported as z-scores (mean ± SD), analyses via ANOVA and ANCOVA. Results Two hundred ninety-nine women (26.9 ± 5.4 y) completed the study (O3I data, n = 288). The ANOVA showed no overall group differences but a significant group × cognition domain interaction (p < 0.01). Post hoc tests showed that participants in the low O3I tertile group scored significantly lower on attention than the middle group (p = 0.01; ES = 0.45 [0.15–0.74]), while the difference with the high group was borderline significant (p = 0.052; ES = 0.38 [0.09–0.68]). After confounder adjustments, the low group had lower attention scores than both the middle (p = 0.01) and high (p = 0.048) groups. These findings were supported by univariate analyses which found significant group differences for the attention domain only (p = 0.004). Conclusions Cognitive function in the attention domain was lower in women with lower O3I, but still within normal range. This reduced but normal level of cognition potentially provides a lower baseline from which cognition would decline with age. Further investigation of individuals with low n-3 PUFA status is warranted.
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Affiliation(s)
- Rebecca L Cook
- Faculty of Health Sciences, Discipline of Exercise and Sport Science, The University of Sydney, PO Box 170, Lidcombe, NSW, 1825, Australia
| | - Helen M Parker
- Faculty of Health Sciences, Discipline of Exercise and Sport Science, The University of Sydney, PO Box 170, Lidcombe, NSW, 1825, Australia.,Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Cheyne E Donges
- School of Exercise Science, Sport and Health, Charles Sturt University, Bathurst, NSW, Australia
| | - Nicholas J O'Dwyer
- Faculty of Health Sciences, Discipline of Exercise and Sport Science, The University of Sydney, PO Box 170, Lidcombe, NSW, 1825, Australia.,School of Exercise Science, Sport and Health, Charles Sturt University, Bathurst, NSW, Australia
| | - Hoi Lun Cheng
- Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Westmead, NSW, Australia.,Faculty of Medicine and Health, Sydney Medical School, Discipline of Child and Adolescent Health, The University of Sydney, Westmead, NSW, Australia
| | - Katharine S Steinbeck
- Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Westmead, NSW, Australia.,Faculty of Medicine and Health, Sydney Medical School, Discipline of Child and Adolescent Health, The University of Sydney, Westmead, NSW, Australia
| | - Eka P Cox
- Faculty of Health Sciences, Discipline of Exercise and Sport Science, The University of Sydney, PO Box 170, Lidcombe, NSW, 1825, Australia
| | - Janet L Franklin
- Metabolism and Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Manohar L Garg
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia
| | - Helen T O'Connor
- Faculty of Health Sciences, Discipline of Exercise and Sport Science, The University of Sydney, PO Box 170, Lidcombe, NSW, 1825, Australia. .,Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia.
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26
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Bahgat KA, Elhady M, Abdel Aziz A, Youness ER, Zakzok E. Omega-6/omega-3 ratio and cognition in children with epilepsy. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2019. [DOI: 10.1016/j.anpede.2018.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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27
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Jain R, Ezeamama AE, Sikorskii A, Yakah W, Zalwango S, Musoke P, Boivin MJ, Fenton JI. Serum n-6 Fatty Acids are Positively Associated with Growth in 6-to-10-Year Old Ugandan Children Regardless of HIV Status-A Cross-Sectional Study. Nutrients 2019; 11:nu11061268. [PMID: 31167445 PMCID: PMC6628545 DOI: 10.3390/nu11061268] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 05/24/2019] [Accepted: 05/30/2019] [Indexed: 12/21/2022] Open
Abstract
Fatty acids (FAs) are crucial in child growth and development. In Uganda, antiretroviral therapy (ART) has drastically reduced perinatal human immunodeficiency virus (HIV) infection of infants, however, the interplay of FAs, ART, and HIV in relation to child growth is not well understood. To investigate this, serum was collected from 240 children between 6–10 years old in Uganda and analyzed for FAs using gas-chromatography mass-spectrometry. HIV status and anthropometric measurements were taken, and relationships with FAs were assessed. No significant differences in growth parameters or serum FAs were found between HIV uninfected children with and without exposure to ART. HIV positive children had significantly lower height-for-age-z-scores (HAZ) than uninfected children (p < 0.001). HIV-positive children had higher arachidonic acid than uninfected children (p = 0.003). Total omega-6 FAs were significantly associated with HAZ regardless of HIV status (p = 0.035). Mean total omega-3 FAs (2.90%) were low in this population compared to other cohorts in Africa. These results provide reference serum FA values for 6–10-year-old children in Uganda and may be used to inform lipid supplementation programs to promote child growth. Future studies should investigate the relationships between child growth trajectories in relation to HIV status and serum FAs.
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Affiliation(s)
- Raghav Jain
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA.
| | - Amara E Ezeamama
- Department of Psychiatry, Michigan State University, East Lansing, MI 48824, USA.
| | - Alla Sikorskii
- Department of Psychiatry, Michigan State University, East Lansing, MI 48824, USA.
| | - William Yakah
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA.
| | - Sarah Zalwango
- Directorate of Public Health and Environment, Kampala Capital City Authority, Kampala 00256, Uganda.
| | - Philippa Musoke
- Makerere University-Johns Hopkins University Research Collaboration, Kampala 00256, Uganda.
| | - Michael J Boivin
- Departments of Psychiatry, Neurology & Ophthalmology, Michigan State University, East Lansing, MI 48824, USA.
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Jenifer I Fenton
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA.
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28
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Effect of 1 Year Krill Oil Supplementation on Cognitive Achievement of Dutch Adolescents: A Double-Blind Randomized Controlled Trial. Nutrients 2019; 11:nu11061230. [PMID: 31151199 PMCID: PMC6628105 DOI: 10.3390/nu11061230] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 05/24/2019] [Accepted: 05/26/2019] [Indexed: 11/17/2022] Open
Abstract
Long-chain polyunsaturated fatty acids (LCPUFA) are important for brain development and function, maybe especially during adolescence. Observational studies have demonstrated an association between fish consumption (a source of LCPUFA) and cognition in adolescents, but intervention trials are lacking. The goal of the current study was to investigate the effect of one year of krill oil (a source of LCPUFA) supplementation on the cognitive performance of adolescents with a low Omega-3 Index (O3I ≤ 5%). A double-blind, randomized, and placebo-controlled supplementation trial with repeated measurements (baseline (T0), three months (T1), six months (T2), and 12 months (T3)) in adolescents (267 randomized) was executed. Participants were randomized to 400 mg eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) per day in Cohort I or placebo and 800 mg EPA + DHA per day in Cohort II or placebo. O3I was monitored by a finger prick at all time points. At T0, T2, and T3, participants executed a neurocognitive test battery. Covariate corrected mixed models were run with either condition (krill or placebo) or O3I as predictors. Krill oil supplementation led to a small but significant increase in mean O3I, but few participants increased to the intended O3I range (8–11%). There was no significant effect of supplementation on the neurocognitive tests, nor a relationship between O3I and neurocognitive test scores. The increase in O3I was small in most participants, probably due to non-compliance. Possibly the increase in O3I was too small to demonstrate an effect. More research on the influence of LCPUFAs on cognition in adolescents is needed.
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29
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Teisen MN, Niclasen J, Vuholm S, Lundbye-Jensen J, Stark KD, Damsgaard CT, Geertsen SS, Lauritzen L. Exploring correlations between neuropsychological measures and domain-specific consistency in associations with n-3 LCPUFA status in 8-9 year-old boys and girls. PLoS One 2019; 14:e0216696. [PMID: 31116782 PMCID: PMC6530844 DOI: 10.1371/journal.pone.0216696] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 04/25/2019] [Indexed: 01/18/2023] Open
Abstract
Long-chain n-3 polyunsaturated fatty acids (n-3 LCPUFA) have in some studies been associated with cognitive and socioemotional outcomes in children, but results are inconsistent possibly due to the use of different tests and potential gender-specific effects. The objective of this cross-sectional study was to explore overall patterns in neuropsychological scores as well as correlations between scores within specific domains, and to examine potential gender differences and consistency in associations with n-3 LCPUFA status. In 199 Danish 8–9 year-old children, we performed a large battery of tests and questionnaires on attention, processing speed, executive functions, memory, and socioemotional traits, and measured erythrocyte fatty acid composition. Principal component analyses (PCA) showed that most of the variation in both cognitive performance and socioemotional traits was explained by overall performance, followed by speed-accuracy trade off and externalizing vs. internalizing problems, respectively. Boys had higher speed, lower attention and higher externalizing problem scores than girls. Measures of performance within both processing speed and attention domains correlated moderately, whereas no correlations were found for measures of executive functions apart from some weak correlations for impulsivity. Parent-rated scores for both externalizing and internalizing problems correlated strongly, whereas correlations with child-rated scores were weak. Scores within specific domains did not consistently associate with n-3 LCPUFA, except for processing speed measures which all pointed to faster processing with increased n-3 LCPUFA status. Gender differences in the associations were observed for attention and impulsivity. Child- but not parent-rated internalizing and social problems tended to associate directly with n-3 LCPUFA, supported by increased internalizing problems measured by the PCA component. In conclusion, measures of speed and attention seem to represent these domains in general, whereas single measures of more complex cognitive functions should be interpreted with caution. One approach could be to use multiple tests and create multivariate scores to guide interpretations. Furthermore, the results indicate a need to consider both parent- and child-rated socioemotional scores and gender differences in neuropsychological functions e.g. in investigations of n-3 LCPUFA effects.
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Affiliation(s)
- Marie N. Teisen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
- * E-mail:
| | - Janni Niclasen
- Steno Diabetes Center Copenhagen, Health Promotion, Diabetes Prevention Research, Copenhagen, Denmark
- Frederikshøj Dagbehandlingsskole, Copenhagen, Denmark
| | - Stine Vuholm
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Jesper Lundbye-Jensen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Ken D. Stark
- Department of Kinesiology, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Camilla T. Damsgaard
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Svend S. Geertsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Lotte Lauritzen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
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30
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Bernstein AS, Oken E, de Ferranti S. Fish, Shellfish, and Children's Health: An Assessment of Benefits, Risks, and Sustainability. Pediatrics 2019; 143:e20190999. [PMID: 31110165 PMCID: PMC6864235 DOI: 10.1542/peds.2019-0999] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
American children eat relatively little fish and shellfish in comparison with other sources of animal protein, despite the health benefits that eating fish and shellfish may confer. At the same time, fish and shellfish may be sources of toxicants. This report serves to inform pediatricians about available research that elucidates health risks and benefits associated with fish and shellfish consumption in childhood as well as the sustainability of fish and shellfish harvests.
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31
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Bahagat KA, Elhady M, Aziz AA, Youness ER, Zakzok E. [Omega-6/omega-3 ratio and cognition in children with epilepsy]. An Pediatr (Barc) 2019; 91:88-95. [PMID: 30660389 DOI: 10.1016/j.anpedi.2018.07.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 07/20/2018] [Accepted: 07/24/2018] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Cognitive impairment is a common consequence of epilepsy in children. This study aimed to assess the ratio of omega-6 to omega-3 fatty acid levels and its impact on cognitive function in children with idiopathic epilepsy. PATIENTS AND METHODS We performed a case-control study in 30 children with idiopathic epilepsy and 20 healthy children. We measured levels of alpha-linolenic acid (omega-3) and linoleic acid (omega-6) by means of gas-liquid chromatography. We assessed cognitive function with the Arabic version of the fourth edition of the Stanford-Binet test and the P300 component of event-related potentials. All children had an intelligent quotient greater than 70. RESULTS Children with epilepsy had lower levels of omega-3 and higher levels of omega-6 fatty acids and an abnormal omega-6/omega-3 ratio compared to non-epileptic children. We found a significant positive correlation of serum omega-3 levels and a significant negative correlation of serum omega-6 levels with cognitive function scores and P300 latency in children with epilepsy. CONCLUSION Children with epilepsy have abnormal ratios of omega-6 to omega-3 fatty acid serum levels, which is associated with impaired cognitive function in these children.
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Affiliation(s)
| | - Marwa Elhady
- Departamento de Pediatría, Facultad de Medicina, Universidad de Al-Azhar, El Cairo, Egipto.
| | - Ali Abdel Aziz
- Departamento de Salud Infantil, Centro de Investigación Nacional, Guiza, Egipto
| | - Eman R Youness
- Bioquímica Médica, Centro de Investigación Nacional, Guiza, Egipto
| | - Elzarif Zakzok
- Departamento de Pediatría, Facultad de Medicina, Universidad de Al-Azhar, El Cairo, Egipto
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Randomized open-label trial of docosahexaenoic acid–enriched fish oil and fish meal on cognitive and behavioral functioning in Omani children. Nutrition 2019; 57:167-172. [DOI: 10.1016/j.nut.2018.04.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 03/23/2018] [Accepted: 04/21/2018] [Indexed: 11/17/2022]
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Adjepong M, Yakah W, Harris WS, Annan RA, Pontifex MB, Fenton JI. Whole blood n-3 fatty acids are associated with executive function in 2-6-year-old Northern Ghanaian children. J Nutr Biochem 2018; 57:287-293. [PMID: 29852451 DOI: 10.1016/j.jnutbio.2018.03.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 02/06/2018] [Accepted: 03/20/2018] [Indexed: 11/16/2022]
Abstract
Several studies demonstrate the importance of essential fatty acids (EFAs), and the long chain polyunsaturated FA docosahexaenoic acid (DHA), on cognition and brain development. The objective of this study was to investigate the relationship between whole-blood FAs and executive function in children from Northern Ghana. A total of 307, 2-to-6-year-old children attempted the dimensional change card sort (DCCS) task to assess executive function, and dried blood spot samples were collected and analyzed for FA content. Significant differences in mean % total whole-blood fatty acids were observed between children who could not follow directions on the DCCS test (49.8% of the sample) and those who could (50.2% of the sample). Positive associations with DCCS performance were observed for DHA (β=0.25, P=.06), total n-3 (β=0.17, P=.06) and dihomo-gamma-linolenic acid (DGLA; β=0.60, P=.06). Children with the highest levels of total n-3 and DHA were three and four times, respectively, more likely to pass at least one condition of the DCCS test of executive function than those with the lowest DHA levels. The results of this study indicate an association between n-3 FAs and high-level cognitive processes in children two to six years of age, providing impetus for further studies into possible interventions to improve EFA status of children in developing countries.
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Affiliation(s)
- Mary Adjepong
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI
| | - William Yakah
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI
| | - William S Harris
- Sanford School of Medicine, University of South Dakota and Omega Quant Analytics, LLC, Sioux Falls, SD
| | - Reginald A Annan
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Jenifer I Fenton
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI.
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Øyen J, Kvestad I, Midtbø LK, Graff IE, Hysing M, Stormark KM, Markhus MW, Baste V, Frøyland L, Koletzko B, Demmelmair H, Dahl L, Lie Ø, Kjellevold M. Fatty fish intake and cognitive function: FINS-KIDS, a randomized controlled trial in preschool children. BMC Med 2018; 16:41. [PMID: 29530020 PMCID: PMC5848440 DOI: 10.1186/s12916-018-1020-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Marine resources including fatty fish are important sources of n-3 long chain polyunsaturated fatty acids (n-3 LC-PUFAs), which are important for brain development. To our knowledge, this is the first randomized controlled trial (RCT) investigating the impact of fatty fish on cognition in preschool children. The purpose of the trial was to investigate whether an increased intake of fatty fish compared to meat improves cognitive function in children 4-6 years old. METHODS The children (n = 232) in this two-armed RCT, Fish Intervention Studies-KIDS (FINS-KIDS) were recruited from 13 kindergartens in Bergen, Norway. They were randomly assigned to lunch meals with fatty fish (herring/mackerel) or meat (chicken/lamb/beef) three times a week for 16 weeks. The fish and meat were weighed before and after the meals to record the exact consumption (dietary compliance). The primary outcome was cognitive function measured by the Wechsler Preschool and Primary Scale of Intelligence, 3rd edition (WPPSI-III) and fine-motor coordination measured by the 9-Hole Peg Test (9-HPT) at pre- and post-intervention. Biological samples (blood, urine, hair), and questionnaires to the caregivers were included at both time points. Linear mixed effect models with a random intercept for kindergarten were used to analyze changes from pre- to post-intervention in the primary outcome variables. RESULTS There were 218 children included in the trial (105 in the fish, and 113 in the meat group). The children consumed a mean (standard deviation) of 2070 (978) g fish or 2675 (850) g meat from the study meals (p < 0.0001). The fish group had a significant increase of red blood cell n-3 LC-PUFAs. The intervention had no effect on the WPPSI-III scores (mean change total raw score; fish group 17.7, 95% confidence interval (CI) 14.8-20.7 vs meat group 17.8, 95% CI 15.0-20.6, p = 0.97) in the main analyses. In the sub-analyses, adjusting for dietary compliance, the fish group showed a higher improvement on total raw score (20.4, 95% CI 17.5-23.3) compared to the meat group (15.2, 95% CI 12.4-18.0, p = 0.0060); docosahexaenoic acid mediated this effect. CONCLUSIONS There was no beneficial effect of fatty fish compared to meat on cognitive functioning in the preschool children. When considering dietary compliance, we found a beneficial effect of fatty fish on cognitive scores. TRIAL REGISTRATION ClinicalTrials.gov, NCT02331667 December 17, 2014.
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Affiliation(s)
- Jannike Øyen
- Institute of Marine Research (IMR), P.O Box 1870 Nordnes, NO-5817, Bergen, Norway.
| | - Ingrid Kvestad
- Regional Centre for Child and Youth Mental Health, Uni Research Health, Bergen, Norway
| | - Lisa Kolden Midtbø
- Institute of Marine Research (IMR), P.O Box 1870 Nordnes, NO-5817, Bergen, Norway
| | - Ingvild Eide Graff
- Institute of Marine Research (IMR), P.O Box 1870 Nordnes, NO-5817, Bergen, Norway
| | - Mari Hysing
- Regional Centre for Child and Youth Mental Health, Uni Research Health, Bergen, Norway
| | - Kjell Morten Stormark
- Regional Centre for Child and Youth Mental Health, Uni Research Health, Bergen, Norway.,Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | - Maria Wik Markhus
- Institute of Marine Research (IMR), P.O Box 1870 Nordnes, NO-5817, Bergen, Norway
| | | | - Livar Frøyland
- Institute of Marine Research (IMR), P.O Box 1870 Nordnes, NO-5817, Bergen, Norway
| | - Berthold Koletzko
- Ludwig-Maximilians-Universität München, Dr. von Hauner Children's Hospital, Div. Metabolic & Nutritional Medicine, University of Munich Medical Center, Munich, Germany
| | - Hans Demmelmair
- Ludwig-Maximilians-Universität München, Dr. von Hauner Children's Hospital, Div. Metabolic & Nutritional Medicine, University of Munich Medical Center, Munich, Germany
| | - Lisbeth Dahl
- Institute of Marine Research (IMR), P.O Box 1870 Nordnes, NO-5817, Bergen, Norway
| | - Øyvind Lie
- Institute of Marine Research (IMR), P.O Box 1870 Nordnes, NO-5817, Bergen, Norway
| | - Marian Kjellevold
- Institute of Marine Research (IMR), P.O Box 1870 Nordnes, NO-5817, Bergen, Norway
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Wang DD, Wu F, Wen M, Ding L, Du L, Xue CH, Xu J, Wang YM. Replenishment of Docosahexaenoic Acid (DHA) in Dietary n-3-Deficient Mice Fed DHA in Triglycerides or Phosphatidylcholines After Weaning. J Food Sci 2018; 83:481-488. [PMID: 29337366 DOI: 10.1111/1750-3841.14017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 11/19/2017] [Indexed: 01/01/2023]
Abstract
Previous studies have shown that DHA in triglyceride (TG) and phosphatidylcholine (PC) forms are different in their bioavailability. The aim of this study was to investigate the comparative effects of DHA-TG and DHA-PC on tissue DHA accretion in dietary n-3 polyunsaturated fatty acid deficient (n-3 Def) mice. The mice were fed with n-3 Def diet containing DHA-TG or DHA-PC (5 g/kg diet) for 2, 4, 7, or 14 d after weaning, respectively. The DHA levels in the cortex, liver, testis, and erythrocytes were analyzed by gas chromatography. For liver, DHA mainly existed in hepatic phospholipids relative to triglycerides. Both DHA-TG and DHA-PC could recover the hepatic DHA to a normal level. Interestingly, DHA-TG was more effective in increasing the DHA level in hepatic triglycerides, and DHA-PC was more effective in increasing the DHA level in hepatic phospholipids. For erythrocytes, during the first 7 d, no difference was observed after dietary DHA-TG and DHA-PC but a significantly higher DHA percentage was detected in the DHA-PC group after 14 d. For cortex, the DHA-TG group showed a higher cortical DHA level at the 4th day, but the DHA-PC group showed a higher cortical DHA level with a greater slope from Day 7 to Day 14, and the same trend was observed in testis. But unexpectedly, the DHA level in testis showed a downtrend from Day 7 to Day 14. This study suggests that, under dietary n-3-deficient condition, both DHA-TG and DHA-PC could recover the DHA level in tissues after weaning, and DHA-PC showed a better supplemental effect. PRACTICAL APPLICATION Dietary DHA is essential for neurodevelopment which is usually accompanied by large amounts of DHA accretion in the brain. Our present study showed that DHA-PC had a better efficiency for DHA accretion in the brain and other tissues compared with DHA-TG. The findings are supposed to pave the way for the DHA in phospholipids as a novel nutrient added into the infant formula and assisted food for neurodevelopment.
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Affiliation(s)
- Dan-Dan Wang
- College of Food Science and Engineering, Ocean Univ. of China, Qingdao, Shandong 266003, China
| | - Fang Wu
- College of Food Science and Engineering, Ocean Univ. of China, Qingdao, Shandong 266003, China
| | - Min Wen
- College of Food Science and Engineering, Ocean Univ. of China, Qingdao, Shandong 266003, China
| | - Lin Ding
- College of Food Science and Engineering, Ocean Univ. of China, Qingdao, Shandong 266003, China
| | - Lei Du
- Faculty of Fisheries Sciences, Hokkaido Univ., 3-1-1 Minato-cho, Hakodate, Hokkaido 041-8611, Japan
| | - Chang-Hu Xue
- College of Food Science and Engineering, Ocean Univ. of China, Qingdao, Shandong 266003, China
| | - Jie Xu
- College of Food Science and Engineering, Ocean Univ. of China, Qingdao, Shandong 266003, China
| | - Yu-Ming Wang
- College of Food Science and Engineering, Ocean Univ. of China, Qingdao, Shandong 266003, China
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Fetal DHA inadequacy and the impact on child neurodevelopment: a follow-up of a randomised trial of maternal DHA supplementation in pregnancy. Br J Nutr 2018; 119:271-279. [PMID: 29316994 DOI: 10.1017/s0007114517003531] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
DHA is an important component of neural lipids accumulating in neural tissue during development. Inadequate DHA in gestation may compromise infant development, but it is unknown whether there are lasting effects. We sought to determine whether the observed effects of fetal DHA inadequacy on infant development persist into early childhood. This follow-up study assessed children (5-6 years) whose mothers received 400 mg/d DHA or a placebo during pregnancy. Child neurodevelopment was assessed with several age-appropriate tests including the Kaufman Assessment Battery for Children. A risk-reduction model was used whereby the odds that a child from the maternal placebo group would fail to achieve a test score in the top quartile was calculated. The association of maternal DHA intake and status in gestation with child test scores, as well as with child DHA intake and status, was also determined. No differences were detected in children (n 98) from the maternal placebo and DHA groups achieving a high neurodevelopment test score (P>0·05). However, maternal DHA status was positively related to child performance on some tests including language and short-term memory. Furthermore, child DHA intake and status were related to the mother's intake and status in gestation. The neurodevelopment effects of fetal DHA inadequacy may have been lost or masked by other variables in the children. Although we provide evidence that maternal DHA status is related to child cognitive performance, the association of maternal and child DHA intake and status limits the interpretation of whether DHA before or after birth is important.
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A Review of Recruitment, Adherence and Drop-Out Rates in Omega-3 Polyunsaturated Fatty Acid Supplementation Trials in Children and Adolescents. Nutrients 2017; 9:nu9050474. [PMID: 28489030 PMCID: PMC5452204 DOI: 10.3390/nu9050474] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 04/26/2017] [Accepted: 05/02/2017] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION The influence of n-3 long-chain polyunsaturated fatty acids (n-3 LCPUFA) supplementation on health outcomes has been studied extensively with randomized controlled trials (RCT). In many research fields, difficulties with recruitment, adherence and high drop-out rates have been reported. However, what is unknown is how common these problems are in n-3 LCPUFA supplementation studies in children and adolescents. Therefore, this paper will review n-3 LCPUFA supplementation studies in children and adolescents with regard to recruitment, adherence and drop-out rates. METHODS The Web of Science, PubMed and Ovid databases were searched for papers reporting on RCT supplementing children and adolescents (2-18 years) with a form of n-3 LCPUFA (or placebo) for at least four weeks. As a proxy for abiding to CONSORT guidelines, we noted whether manuscripts provided a flow-chart and provided dates defining the period of recruitment and follow-up. RESULTS Ninety manuscripts (reporting on 75 studies) met the inclusion criteria. The majority of the studies did not abide by the CONSORT guidelines: 55% did not provide a flow-chart, while 70% did not provide dates. The majority of studies provided minimal details about the recruitment process. Only 25 of the 75 studies reported an adherence rate which was on average 85%. Sixty-five of the 75 studies included drop-out rates which were on average 17%. CONCLUSION Less than half of the included studies abided by the CONSORT guidelines (45% included a flow chart, while 30% reported dates). Problems with recruitment and drop-out seem to be common in n-3 LCPUFA supplementation trials in children and adolescents. However, reporting about recruitment, adherence and dropout rates was very heterogeneous and minimal in the included studies. Some techniques to improve recruitment, adherence and dropout rates were identified from the literature, however these techniques may need to be tailored to n-3 LCPUFA supplementation studies in children and adolescents.
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Butler LJ, Janulewicz PA, Carwile JL, White RF, Winter MR, Aschengrau A. Childhood and adolescent fish consumption and adult neuropsychological performance: An analysis from the Cape Cod Health Study. Neurotoxicol Teratol 2017; 61:47-57. [PMID: 28263856 DOI: 10.1016/j.ntt.2017.03.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Revised: 02/27/2017] [Accepted: 03/02/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE This exploratory analysis examines the relationship between childhood and adolescent fish consumption and adult neuropsychological performance. DESIGN Data from a retrospective cohort study that assessed fish consumption from age 7 to 18years via questionnaire were analyzed. A subset of the population underwent domain-specific neuropsychological assessment. Functions evaluated included omnibus intelligence, academic achievement, language, visuospatial skills, learning and memory, attention and executive function, fine motor coordination, mood, and motivation to perform. SETTING Eight towns in the Cape Cod region of Massachusetts, USA, an area characterized by high fish consumption and an active seafood industry. SUBJECTS A cohort of 1245 subjects was recruited based on Massachusetts birth records from 1969 to 1983. Sixty-five participants from the original cohort underwent neuropsychological testing in adulthood (average age=30years). RESULTS Participant report of consuming fish at least twice per month was associated with better performance on tests of visual learning, memory, and attentional abilities. However, self-report of consuming fish at rates higher than twice per month was not associated with improved abilities. No statistically significant associations were observed between type of fish consumed (e.g., species known to be high in methylmercury content) and test outcomes. CONCLUSIONS The results suggest that moderate fish consumption during childhood and adolescence may be associated with some cognitive benefits and that consumption of fish during this exposure window may potentially influence adult neuropsychological performance. Future prospective studies should take into account this time period of exposure.
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Affiliation(s)
- Lindsey J Butler
- Department of Environmental Health, Boston University School of Public Health, Medical Campus, 715 Albany Street, T4W, Boston, MA 02118, United States; Department of Epidemiology, Boston University School of Public Health, Medical Campus, 715 Albany Street, T4E, Boston, MA 02118, United States.
| | - Patricia A Janulewicz
- Department of Environmental Health, Boston University School of Public Health, Medical Campus, 715 Albany Street, T4W, Boston, MA 02118, United States
| | - Jenny L Carwile
- Department of Epidemiology, Boston University School of Public Health, Medical Campus, 715 Albany Street, T4E, Boston, MA 02118, United States
| | - Roberta F White
- Department of Environmental Health, Boston University School of Public Health, Medical Campus, 715 Albany Street, T4W, Boston, MA 02118, United States
| | - Michael R Winter
- Data Coordinating Center, Boston University, Medical Campus, 85 East Newton Street, M921, Boston, MA 02118, United States
| | - Ann Aschengrau
- Department of Epidemiology, Boston University School of Public Health, Medical Campus, 715 Albany Street, T4E, Boston, MA 02118, United States
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Johnson M, Fransson G, Östlund S, Areskoug B, Gillberg C. Omega 3/6 fatty acids for reading in children: a randomized, double-blind, placebo-controlled trial in 9-year-old mainstream schoolchildren in Sweden. J Child Psychol Psychiatry 2017; 58:83-93. [PMID: 27545509 DOI: 10.1111/jcpp.12614] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/23/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Previous research has shown positive effects of Omega 3/6 fatty acids in children with inattention and reading difficulties. We aimed to investigate if Omega 3/6 improved reading ability in mainstream schoolchildren. METHODS We performed a 3-month parallel, randomized, double-blind, placebo-controlled trial followed by 3-month active treatment for all subjects. Mainstream schoolchildren aged 9-10 years were randomized 1:1 to receive three Omega 3/6 capsules twice daily or identical placebo. Assessments were made at baseline, 3 months, and 6 months. The primary outcome measure was the Logos test battery for evaluating reading abilities. The trial is registered with ClinicalTrials.gov, number NCT02557477. RESULTS The study enrolled 154 children (active n = 78; placebo n = 76), of whom 122 completed the first 3 months (active n = 64; placebo n = 58) and 105 completed the whole study (active/active n = 55; placebo/active n = 50). Outcomes were assessed by per protocol (PP) and intention-to-treat (ITT) analyses. Active treatment was superior to placebo at 3 months for improvement in phonologic decoding time (PP active/placebo difference -0.16; 95% CI -0.03, -0.29; effect size (ES) .44; p = .005; and ITT ES .37; p = .036), in visual analysis time (PP active/placebo difference -0.19; 95% CI -0.05, -0.33; ES .49; p = .013; and ITT ES .40; p = .01), and for boys in phonologic decoding time (PP -0.22; 95% CI -0.03, -0.41; ES .62; p = .004). Children with ADHD-RS scores above the median showed treatment benefits in visual analysis time (PP ES .8, p = .009), reading speed per word (PP ES .61, p = .008), and phonologic decoding time per word (PP ES .85, p = .006). Adverse events were rare and mild, mainly stomach pain/diarrhea (active n = 9, placebo n = 2). CONCLUSIONS Compared with placebo, 3 months of Omega 3/6 treatment improved reading ability - specifically the clinically relevant 'phonologic decoding time' and 'visual analysis time' - in mainstream schoolchildren. In particular, children with attention problems showed treatment benefits.
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Affiliation(s)
- Mats Johnson
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden
| | - Gunnar Fransson
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden
| | - Sven Östlund
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden
| | - Björn Areskoug
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden
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Gispert-Llaurado M, Perez-Garcia M, Escribano J, Closa-Monasterolo R, Luque V, Grote V, Weber M, Torres-Espínola F, Czech-Kowalska J, Verduci E, Martin F, Piqueras M, Koletzko B, Decsi T, Campoy C, Emmett P, Goyens P, Carlier C, Hoyos J, Poncelet P, Dain E, Martin F, Xhonneux A, Langhendries JP, Van Hees JN, Rousseaux D, Closa-Monasterolo R, Escribano J, Luque V, Mendez G, Ferre N, Zaragoza-Jordana M, Giovannini M, Riva E, Agostoni C, Scaglioni S, Verduci E, Vecchi F, Dionigi AR, Arrizza C, Mariani B, Socha J, Socha P, Stolarczyk A, Szott K, Dobrzańska A, Gruszfeld D, Kowalik A, Janas R, Pietraszek E, Perrin E, von Kries R, Groebe H, Reith A, Hofmann R, Koletzko B, Grote V, Weber M, Rzehak P, Schiess S, Beyer J, Fritsch M, Handel U, Pawellek I, Verwied-Jorky S, Hannibal I, Demmelmair H, Haile G, Kirchberg F, Akopjan L, Campoy (PI) C, Pérez M, Catena A, Torres-Espínola FJ, Cristina Martínez-Zaldívar M, Brandi P, Victoria Escolano-Margarit M, Koletzko B, Demmelmair H, Gudrun H, Krauss-Estchmann S, Décsi T, Csábi G, Györey E. Fish consumption in mid-childhood and its relationship to neuropsychological outcomes measured in 7–9 year old children using a NUTRIMENTHE neuropsychological battery. Clin Nutr 2016; 35:1301-1307. [DOI: 10.1016/j.clnu.2016.02.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 02/06/2016] [Accepted: 02/08/2016] [Indexed: 10/22/2022]
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Pusceddu MM, Kelly P, Stanton C, Cryan JF, Dinan TG. N-3 Polyunsaturated Fatty Acids through the Lifespan: Implication for Psychopathology. Int J Neuropsychopharmacol 2016; 19:pyw078. [PMID: 27608809 PMCID: PMC5203760 DOI: 10.1093/ijnp/pyw078] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE The impact of lifetime dietary habits and their role in physical, mental, and social well-being has been the focus of considerable recent research. Omega-3 polyunsaturated fatty acids as a dietary constituent have been under the spotlight for decades. Omega-3 polyunsaturated fatty acids constitute key regulating factors of neurotransmission, neurogenesis, and neuroinflammation and are thereby fundamental for development, functioning, and aging of the CNS. Of note is the fact that these processes are altered in various psychiatric disorders, including attention deficit hyperactivity disorder, depression, and Alzheimer's disease. DESIGN Relevant literature was identified through a search of MEDLINE via PubMed using the following words, "n-3 PUFAs," "EPA," and "DHA" in combination with "stress," "cognition," "ADHD," "anxiety," "depression," "bipolar disorder," "schizophrenia," and "Alzheimer." The principal focus was on the role of omega-3 polyunsaturated fatty acids throughout the lifespan and their implication for psychopathologies. Recommendations for future investigation on the potential clinical value of omega-3 polyunsaturated fatty acids were examined. RESULTS The inconsistent and inconclusive results from randomized clinical trials limits the usage of omega-3 polyunsaturated fatty acids in clinical practice. However, a body of literature demonstrates an inverse correlation between omega-3 polyunsaturated fatty acid levels and quality of life/ psychiatric diseases. Specifically, older healthy adults showing low habitual intake of omega-3 polyunsaturated fatty acids benefit most from consuming them, showing improved age-related cognitive decline. CONCLUSIONS Although further studies are required, there is an exciting and growing body of research suggesting that omega-3 polyunsaturated fatty acids may have a potential clinical value in the prevention and treatment of psychopathologies.
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Affiliation(s)
- Matteo M Pusceddu
- APC Microbiome Institute, University College Cork, Cork, Ireland (Drs Pusceddu, Cryan, and Dinan); Teagasc, Moorepark, Cork, Ireland (Drs Kelly and Stanton); Department of Anatomy and Neuroscience (Dr Cryan), and Department of Psychiatry and Neurobehavioural Science (Dr Dinan), University College Cork, Cork, Ireland
| | - Philip Kelly
- APC Microbiome Institute, University College Cork, Cork, Ireland (Drs Pusceddu, Cryan, and Dinan); Teagasc, Moorepark, Cork, Ireland (Drs Kelly and Stanton); Department of Anatomy and Neuroscience (Dr Cryan), and Department of Psychiatry and Neurobehavioural Science (Dr Dinan), University College Cork, Cork, Ireland
| | - Catherine Stanton
- APC Microbiome Institute, University College Cork, Cork, Ireland (Drs Pusceddu, Cryan, and Dinan); Teagasc, Moorepark, Cork, Ireland (Drs Kelly and Stanton); Department of Anatomy and Neuroscience (Dr Cryan), and Department of Psychiatry and Neurobehavioural Science (Dr Dinan), University College Cork, Cork, Ireland
| | - John F Cryan
- APC Microbiome Institute, University College Cork, Cork, Ireland (Drs Pusceddu, Cryan, and Dinan); Teagasc, Moorepark, Cork, Ireland (Drs Kelly and Stanton); Department of Anatomy and Neuroscience (Dr Cryan), and Department of Psychiatry and Neurobehavioural Science (Dr Dinan), University College Cork, Cork, Ireland
| | - Timothy G Dinan
- APC Microbiome Institute, University College Cork, Cork, Ireland (Drs Pusceddu, Cryan, and Dinan); Teagasc, Moorepark, Cork, Ireland (Drs Kelly and Stanton); Department of Anatomy and Neuroscience (Dr Cryan), and Department of Psychiatry and Neurobehavioural Science (Dr Dinan), University College Cork, Cork, Ireland.
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Bouhouch RR, El-Fadeli S, Andersson M, Aboussad A, Chabaa L, Zeder C, Kippler M, Baumgartner J, Sedki A, Zimmermann MB. Effects of wheat-flour biscuits fortified with iron and EDTA, alone and in combination, on blood lead concentration, iron status, and cognition in children: a double-blind randomized controlled trial. Am J Clin Nutr 2016; 104:1318-1326. [PMID: 27733396 DOI: 10.3945/ajcn.115.129346] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 09/08/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Lead is a common neurotoxicant and its absorption may be increased in iron deficiency (ID). Thus, iron fortification to prevent ID in populations is a promising lead mitigation strategy. Two common fortificants are ferrous sulfate (FeSO4) and ferric sodium EDTA (NaFeEDTA). EDTA can chelate iron and lead. OBJECTIVES Our study objective was to determine the effects of iron and EDTA, alone and in combination, on blood lead (BPb) concentration, iron status, and cognition. DESIGN In this 2 × 2 factorial, double-blind placebo-controlled trial, 457 lead-exposed Moroccan children were stratified by school and grade and randomly assigned to consume biscuits (6 d/wk at school) containing 1) ∼8 mg Fe as FeSO4, 2) ∼8 mg Fe as NaFeEDTA that contained ∼41 mg EDTA, 3) ∼41 mg EDTA as sodium EDTA (Na2EDTA), or 4) placebo for 28 wk. The primary outcome was BPb concentration; secondary outcomes were iron status and cognitive outcomes from subtests of the Kaufman Assessment Battery for Children and the Hopkins Verbal Learning Test. These outcomes were measured at baseline and endpoint. All data were analyzed by intention-to-treat. RESULTS The adjusted geometric mean BPb concentration at baseline was 4.3 μg/dL (95% CI: 4.2, 4.3 μg/dL), and at endpoint these values were 3.3 μg/dL (95% CI: 3.1, 3.5 μg/dL) for FeSO4, 2.9 μg/dL (95% CI: 2.7, 3.0 μg/dL) for NaFeEDTA, 3.3 μg/dL (95% CI: 3.1, 3.5 μg/dL) for EDTA, and 3.7 μg/dL (95% CI: 3.5, 3.9 μg/dL) for placebo. We found an effect of iron (P = 0.009) and EDTA (P = 0.012) for reduced BPb concentrations at endpoint, but no iron × EDTA interaction. Iron fortification improved iron status, but there were no positive effects of iron or EDTA on cognitive test scores. CONCLUSIONS Food fortification with iron and EDTA additively reduces BPb concentrations. Our findings suggest that NaFeEDTA should be the iron fortificant of choice in lead-exposed populations. This trial was registered at clinicaltrials.gov as NCT01573013.
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Affiliation(s)
| | | | - Maria Andersson
- Laboratory of Human Nutrition, ETH Zurich, Zurich, Switzerland
| | | | - Laila Chabaa
- Medical University Hospital Mohammed VI University Hospital, Marrakesh, Morocco
| | | | - Maria Kippler
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; and
| | - Jeannine Baumgartner
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
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Muldoon MF, Ryan CM, Yao JK, Conklin SM, Manuck SB. Long-chain omega-3 fatty acids and optimization of cognitive performance. Mil Med 2016; 179:95-105. [PMID: 25373092 DOI: 10.7205/milmed-d-14-00168] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Low consumption of the omega-3 fatty acids, eicosapentaenoic and docosahexaenonic acids, is linked to delayed brain development and, in late life, increased risk for Alzheimer's disease. The current review focuses on cognitive functioning during midlife and summarizes available scientific evidence relevant to the hypothesis that adequate dietary consumption of the long-chain omega-3 fatty acids is necessary for optimal cognitive performance. Taken together, the findings suggest that raising the currently low consumption among healthy adults may improve some aspects of cognitive performance. Nonetheless, evidence from randomized clinical trials is comparatively sparse and leaves unclear: (a) whether such effects are clinically significant, (b) whether effects of eicosapentaenoic acid and DHA differ, (c) which dimensions of cognitive function are affected, (d) the dose-response relationships, or (e) the time course of the response. Clarification of these issues through both laboratory and clinical investigations is a priority given the broad implications for public health, as well as for military personnel and other positions of high performance demand and responsibility.
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Affiliation(s)
- Matthew F Muldoon
- Heart and Vascular Institute, University of Pittsburgh School of Medicine, Old Engineering Hall, Room 506, University of Pittsburgh, Pittsburgh, PA 15260
| | - Christopher M Ryan
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3500 Fifth Avenue, Suite 106, Pittsburg, PA 15213
| | - Jeffrey K Yao
- VA Pittsburgh Healthcare System and Department of Psychiatry, University of Pittsburgh School of Medicine, 7180 Highland Drive, Building 13, Room 131, Pittsburg, PA 15206
| | - Sarah M Conklin
- Department of Psychology and Neuroscience, Allegheny College, 520 North Main Street, Meadville, PA 16335
| | - Stephen B Manuck
- Behavioral Physiology Laboratory, Department of Psychology, University of Pittsburgh, Sennott Square, 3rd Floor, 210 South Bouquet Street, Pittsburgh, PA 15260
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Mashavave G, Kuona P, Tinago W, Stray-Pedersen B, Munjoma M, Musarurwa C. Dried blood spot omega-3 and omega-6 long chain polyunsaturated fatty acid levels in 7-9 year old Zimbabwean children: a cross sectional study. BMC Clin Pathol 2016; 16:14. [PMID: 27499701 PMCID: PMC4974798 DOI: 10.1186/s12907-016-0035-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 07/20/2016] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Omega-3 long chain-polyunsaturated fatty acids (LC-PUFAs)-docosahexaenoic acid (DHA), docosapentaenoic acid (DPA) and eicosapentaenoic acid (EPA)- and omega-6 LC-PUFA arachidonic acid (ARA), are essential for optimum physical and mental development in children. Prior to this study, the blood omega-3 LC-PUFA levels were unknown in Zimbabwean children, particularly in those aged 7-9 years, despite the documented benefits of LC-PUFAs. Documentation of the LC-PUFA levels in this age group would help determine whether interventions, such as fortification, are necessary. This study aimed to determine dried whole blood spot omega-3 and omega-6 LC-PUFA levels and LC-PUFA reference intervals among a selected group of Zimbabwean children aged 7-9 years old. METHODS We conducted a cross sectional study from September 2011 to August 2012 on a cohort of peri-urban, Zimbabwean children aged 7-9 years. The children were born to mothers enrolled at late pregnancy into an HIV prevention program between 2002 and 2004. Dried whole blood spots were sampled on butylated hydroxytoluene antioxidant impregnated filter papers and dried. LC-PUFAs were quantified using gas liquid chromatography. Differences in LC-PUFAs between groups were compared using the Kruskal Wallis test and reference intervals determined using non-parametric statistical methods. RESULTS LC-PUFAs levels were determined in 297 Zimbabwean children of whom 170 (57.2 %) were girls. The study determined that LC-PUFAs (wt/wt) ranges were EPA 0.06-0.55 %, DPA 0.38-1.98 %, DHA 1.13-3.52 %, ARA 5.58-14.64 % and ARA: EPA ratio 15.47-1633.33. Sixteen participants had omega-3 LC-PUFAs levels below the determined reference intervals, while 18 had higher omega-6 LC-PUFAs. The study did not show gender differences in omega-3 and omega-6 LC-PUFAs levels (all p > 0.05). EPA was significantly higher in the 8 year age group compared to those aged 7 and 9 years (median; 0.20 vs 0.17 vs 0.18, respectively, p = 0.049). ARA: EPA ratio was significantly higher in the 7 year age group compared to those aged 8 and 9 years (median; 64.38 vs 56.43 vs 55.87 respectively, p = 0.014). CONCLUSIONS In this cohort of children, lower EPA levels and higher ARA: EPA ratios were observed compared to those reported in apparently healthy children elsewhere. The high ARA: EPA ratios might increase the vulnerability of these children to inflammatory pathologies. Identification and incorporation into diet of locally produced foodstuffs rich in omega-3 LC-PUFAs is recommended as well as advocating for dietary supplementation with omega-3 fish oils and algae based oils.
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Affiliation(s)
- Grace Mashavave
- Department of Chemical Pathology, College of Health Sciences, University of Zimbabwe, PO BOX A178, Avondale, Harare, Zimbabwe
| | - Patience Kuona
- Department of Paediatrics and Child Health, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Willard Tinago
- Department of Community Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Babill Stray-Pedersen
- Division of Women and Children, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Marshall Munjoma
- Department of Obstetrics and Gynaecology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Cuthbert Musarurwa
- Department of Chemical Pathology, College of Health Sciences, University of Zimbabwe, PO BOX A178, Avondale, Harare, Zimbabwe
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Zhang Z, Goldsmith PD, Winter-Nelson A. The Importance of Animal Source Foods for Nutrient Sufficiency in the Developing World. Food Nutr Bull 2016; 37:303-316. [DOI: 10.1177/0379572116647823] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There have been successful interventions fortifying staple foods to mobilize micronutrients as well as agricultural efforts to raise yields of staple foods to increase food availability. Zambia serves as an interesting case study because since 1961 there has been a notable decline in the availability of animal source foods (ASFs) and pulses and a significant increase in the supply of cassava and vegetable oils. The shift in food availability was partly attributed to the agricultural success in high-yielding and drought-resistant varieties that made cassava and oil crops more affordable and readily available. In this research, we explore another policy strategy that involves ASF as a mechanism to help remedy micronutrient inadequacies in a population. A scenario modeling analysis compares the changes in the nutrient profile of the Zambian diet through adding either staple plant source foods (PSFs) or ASFs. The scenarios under study involve the addition of (1) 18 fl oz of whole cow’s milk; (2) 60 g of beef, 30 g of chicken, and 5 g of beef liver; (3) milk plus meat; or (4) 83 g of maize flour, 123 g of cassava, and other staple PSF, that is, isocaloric to the “milk + meat” group. The findings alert program planners and policy makers to the value of increasing the availability, accessibility, and utilization of ASF to simultaneously address multiple nutrient deficiencies, as well as the nutrition challenges that remain when expanding the availability of plant-based staples.
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Affiliation(s)
- Zhiying Zhang
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Peter D. Goldsmith
- Department of Agriculture and Consumer Economics, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Alex Winter-Nelson
- Department of Agriculture and Consumer Economics, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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Abstract
Docosahexaenoic acid (DHA) is the predominant omega-3 (n-3) polyunsaturated fatty acid (PUFA) found in the brain and can affect neurological function by modulating signal transduction pathways, neurotransmission, neurogenesis, myelination, membrane receptor function, synaptic plasticity, neuroinflammation, membrane integrity and membrane organization. DHA is rapidly accumulated in the brain during gestation and early infancy, and the availability of DHA via transfer from maternal stores impacts the degree of DHA incorporation into neural tissues. The consumption of DHA leads to many positive physiological and behavioral effects, including those on cognition. Advanced cognitive function is uniquely human, and the optimal development and aging of cognitive abilities has profound impacts on quality of life, productivity, and advancement of society in general. However, the modern diet typically lacks appreciable amounts of DHA. Therefore, in modern populations, maintaining optimal levels of DHA in the brain throughout the lifespan likely requires obtaining preformed DHA via dietary or supplemental sources. In this review, we examine the role of DHA in optimal cognition during development, adulthood, and aging with a focus on human evidence and putative mechanisms of action.
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Weiser MJ, Butt CM, Mohajeri MH. Docosahexaenoic Acid and Cognition throughout the Lifespan. Nutrients 2016; 8:99. [PMID: 26901223 PMCID: PMC4772061 DOI: 10.3390/nu8020099] [Citation(s) in RCA: 229] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 01/26/2016] [Accepted: 01/28/2016] [Indexed: 12/30/2022] Open
Abstract
Docosahexaenoic acid (DHA) is the predominant omega-3 (n-3) polyunsaturated fatty acid (PUFA) found in the brain and can affect neurological function by modulating signal transduction pathways, neurotransmission, neurogenesis, myelination, membrane receptor function, synaptic plasticity, neuroinflammation, membrane integrity and membrane organization. DHA is rapidly accumulated in the brain during gestation and early infancy, and the availability of DHA via transfer from maternal stores impacts the degree of DHA incorporation into neural tissues. The consumption of DHA leads to many positive physiological and behavioral effects, including those on cognition. Advanced cognitive function is uniquely human, and the optimal development and aging of cognitive abilities has profound impacts on quality of life, productivity, and advancement of society in general. However, the modern diet typically lacks appreciable amounts of DHA. Therefore, in modern populations, maintaining optimal levels of DHA in the brain throughout the lifespan likely requires obtaining preformed DHA via dietary or supplemental sources. In this review, we examine the role of DHA in optimal cognition during development, adulthood, and aging with a focus on human evidence and putative mechanisms of action.
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Affiliation(s)
- Michael J Weiser
- DSM Nutritional Products, R&D Human Nutrition and Health, Boulder, CO, USA.
| | - Christopher M Butt
- DSM Nutritional Products, R&D Human Nutrition and Health, Boulder, CO, USA.
| | - M Hasan Mohajeri
- DSM Nutritional Products, R&D Human Nutrition and Health, Basel, Switzerland.
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48
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Essential role of docosahexaenoic acid towards development of a smarter brain. Neurochem Int 2015; 89:51-62. [DOI: 10.1016/j.neuint.2015.08.014] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 08/18/2015] [Accepted: 08/26/2015] [Indexed: 01/25/2023]
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49
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Diet-induced changes in iron and n-3 fatty acid status and associations with cognitive performance in 8-11-year-old Danish children: secondary analyses of the Optimal Well-Being, Development and Health for Danish Children through a Healthy New Nordic Diet School Meal Study. Br J Nutr 2015; 114:1623-37. [PMID: 26359192 DOI: 10.1017/s0007114515003323] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Fe and n-3 long-chain PUFA (n-3 LCPUFA) have both been associated with cognition, but evidence remains inconclusive in well-nourished school-aged children. In the Optimal Well-Being, Development and Health for Danish Children through a Healthy New Nordic Diet (OPUS) School Meal Study, the 3-month intervention increased reading performance, inattention, impulsivity and dietary intake of fish and Fe. This study investigated whether the intervention influenced n-3 LCPUFA and Fe status and, if so, explored how these changes correlated with the changes in cognitive performance. The study was a cluster-randomised cross-over trial comparing school meals with packed lunch (control). At baseline and after each treatment, we measured serum ferritin, whole-blood n-3 LCPUFA and Hb, and performance in reading, mathematics and d2-test of attention. Data were analysed using mixed models (n 726) and principal component analysis of test performances (n 644), which showed two main patterns: 'school performance' and 'reading comprehension'. The latter indicated that children with good reading comprehension were also more inattentive and impulsive (i.e. higher d2-test error%). The intervention improved 'school performance' (P=0·015), 'reading comprehension' (P=0·043) and EPA+DHA status 0·21 (95% CI 0·15, 0·27) w/w % (P<0·001), but it did not affect serum ferritin or Hb. At baseline, having small Fe stores was associated with poorer 'school performance' in girls, but with better 'reading comprehension' in both boys and girls. Both baseline EPA+DHA status and the intervention-induced increase in EPA+DHA status was positively associated with 'school performance', suggesting that n-3 LCPUFA could potentially explain approximately 20 % of the intervention effect. These exploratory associations indicate that increased fish intake might explain some of the increase in reading performance and inattention in the study.
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50
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Cooper RE, Tye C, Kuntsi J, Vassos E, Asherson P. Omega-3 polyunsaturated fatty acid supplementation and cognition: A systematic review and meta-analysis. J Psychopharmacol 2015; 29:753-63. [PMID: 26040902 DOI: 10.1177/0269881115587958] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Omega-3 polyunsaturated fatty acids (n-3 PUFAs) are promoted as cognitive enhancers with consumption recommended in the general population and those with neurocognitive deficits such as attention deficit hyperactivity disorder (ADHD). However, evidence from randomised placebo-controlled trials is inconclusive. AIMS This study aimed to conduct a systematic review and meta-analysis examining the effect of n-3 PUFA supplementation on cognition in healthy populations and those with ADHD and related disorders (RDs). METHODS Databases were searched for randomised controlled trials (RCTs) in adults and school-aged children (who were healthy and typically developing (TD) or had ADHD or a related-neurodevelopmental disorder (ADHD+RD) which assessed the effects of n-3 PUFA on cognition. RESULTS In the 24 included studies n-3 PUFA supplementation, in the whole sample and the TD and ADHD+RD subgroup, did not show improvements in any of the cognitive performance measures. In those with low n-3 PUFA status, supplementation improved short-term memory. CONCLUSIONS There is marginal evidence that n-3 PUFA supplementation effects cognition in those who are n-3 PUFA deficient. However, there is no evidence of an effect in the general population or those with neurodevelopmental disorders. This has important implications given the widespread advertisement and consumption of n-3 PUFA; claims of cognitive benefit should be narrowed.
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Affiliation(s)
- Ruth E Cooper
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London London, UK
| | - Charlotte Tye
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London London, UK
| | - Jonna Kuntsi
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London London, UK
| | - Evangelos Vassos
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London London, UK
| | - Philip Asherson
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London London, UK
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