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 - Tập 12 Số 10 - Trang 3115
I.S.M. van der Wurff1, Barbara J. Meyer2, Renate H. M. de Groot1,3
1Conditions for Lifelong Learning, Faculty of Educational Sciences, Open University of the Netherlands, 6419 Heerlen, The Netherlands
2School of Medicine, Lipid Research Centre, Molecular Horizons, Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia
3NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6200 Maastricht, The Netherlands

Tóm tắt

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.

Từ khóa


Tài liệu tham khảo

Hu, 2019, Marine Omega-3 Supplementation and Cardiovascular Disease: An Updated Meta-Analysis of 13 Randomized Controlled Trials Involving 127 477 Participants, J. Am. Heart Assoc., 8, e013543, 10.1161/JAHA.119.013543

Appleton, 2010, Updated Systematic Review and Meta-Analysis of the Effects of N-3 Long-Chain Polyunsaturated Fatty Acids on Depressed Mood, Am. J.Clin. Nutr., 91, 757, 10.3945/ajcn.2009.28313

Middleton, P., Gomersall, J.C., Gould, J.F., Shepherd, E., Olsen, S.F., and Makrides, M. (2018). Omega-3 Fatty Acid Addition During Pregnancy. Cochrane Database Syst. Rev., 11.

Sydenham, E., Dangour Alan, D., and Lim, W.-S. (2012). Omega 3 Fatty Acid for the Prevention of Cognitive Decline and Dementia. Cochrane Database Syst. Rev., 6.

Stonehouse, 2014, Does Consumption of LC Omega-3 Pufa Enhance Cognitive Performance in Healthy School-Aged Children and Throughout Adulthood? Evidence From Clinical Trials, Nutrients, 6, 2730, 10.3390/nu6072730

Agostoni, C., Nobile, M., Ciappolino, V., Delvecchio, G., Tesei, A., Turolo, S., Crippa, A., Mazzocchi, A., Altamura, C.A., and Brambilla, P. (2017). The Role of Omega-3 Fatty Acids in Developmental Psychopathology: A Systematic Review on Early Psychosis, Autism, and ADHD. Int. J. Mol. Sci., 18.

Parletta, 2013, Nutritional Modulation of Cognitive Function and Mental Health, J. Nutr. Biochem., 24, 725, 10.1016/j.jnutbio.2013.01.002

Bazinet, 2014, Polyunsaturated Fatty Acids and Their Metabolites in Brain Function and Disease, Nat. Rev. Neurosci., 15, 771, 10.1038/nrn3820

Dyall, 2015, Long-Chain Omega-3 Fatty Acids and the Brain: A Review of the Independent and Shared Effects of EPA, DPA and DHA, Front. Aging Neurosci., 7, 15, 10.3389/fnagi.2015.00052

Kuratko, 2013, The Relationship of Docosahexaenoic Acid (DHA) with Learning and Behavior in Healthy Children: A review, Nutrients, 5, 2777, 10.3390/nu5072777

Taylor, R., and Connock, M. (2007). Effects of Oily Fish/Omega-3 Fatty Acids on Behavioural, Cogitative and Educational Outcomes of Normal School Children: A Systematic Review. Dep. Public Health Epidemiol. Rep., 58.

Frensham, 2012, Influences of Micronutrient and Omega-3 Fatty Acid Supplementation on Cognition, Learning, and Behavior: Methodological Considerations and Implications for Children and Adolescents in Developed Societies, Nutr. Rev., 70, 594, 10.1111/j.1753-4887.2012.00516.x

Ryan, 2010, Effects of Long-Chain Polyunsaturated Fatty Acid Supplementation on Neurodevelopment in Childhood: A Review of Human Studies, Prostaglandins Leukot. Essent. Fat. Acids, 82, 305, 10.1016/j.plefa.2010.02.007

McCann, 2005, Is Docosahexaenoic Acid, an N-3 Long-Chain Polyunsaturated Fatty Acid, Required for Development of Normal Brain Function? an Overview of Evidence From Cognitive and Behavioral Tests in Humans and Animals, Am. J. Clin. Nutr., 82, 281, 10.1093/ajcn/82.2.281

Eilander, 2007, Effects of N-3 Long Chain Polyunsaturated Fatty Acid Supplementation on Visual and Cognitive Development Throughout Childhood: A Review of Human Studies, Prostaglandins Leukot. Essent. Fat. Acids, 76, 189, 10.1016/j.plefa.2007.01.003

Karr, 2011, Omega-3 Polyunsaturated Fatty Acids and Cognition Throughout the Lifespan: A Review, Nutr. Neurosci., 14, 216, 10.1179/1476830511Y.0000000012

Cooper, 2015, Omega-3 Polyunsaturated Fatty Acid Supplementation and Cognition: A Systematic Review and Meta-Analysis, J. Psychopharmacol., 29, 753, 10.1177/0269881115587958

Jiao, 2014, Effect of N- 3 Pufa Supplementation on Cognitive Function Throughout the Life Span From Infancy to Old Age: A Systematic Review and Meta-Analysis of Randomized Controlled Trials, Am. J. Clin. Nutr., 100, 1422, 10.3945/ajcn.114.095315

Kirby, 2010, Benefits of Omega-3 Supplementation for Schoolchildren: Review of the Current Evidence, Br. Educ. Res. J., 36, 699, 10.1080/01411920903111557

Meyer, B.J., and De Groot, R.H. (2017). Effects of Omega-3 Long Chain Polyunsaturated Fatty Acid Supplementation on Cardiovascular Mortality: The Importance of the Dose of DHA. Nutrients, 9.

Harris, 2004, The Omega-3 Index: A New Risk Factor for Death From Coronary Heart Disease?, Prev. Med., 39, 212, 10.1016/j.ypmed.2004.02.030

Milte, 2009, Polyunsaturated Fatty Acid Status in Attention Deficit Hyperactivity Disorder, Depression, and Alzheimer’s Disease: Towards an Omega-3 Index for Mental Health?, Nutr. Rev., 67, 573, 10.1111/j.1753-4887.2009.00229.x

Emery, S., Häberling, I., Berger, G., Walitza, S., Schmeck, K., Albert, T., Baumgartner, N., Strumberger, M., Albermann, M., and Drechsler, R. (2020). Omega-3 And Its Domain-Specific Effects on Cognitive Test Performance in Youths: A Meta-Analysis. Neurosci. Biobehav. Rev.

Griffith, L., van den Heuvel, E., Fortier, I., Hofer, S., Raina, P., Sohel, N., Payette, H., Wolfson, C., and Belleville, S. (2013). Harmonization of Cognitive Measures in Individual Participant Data and Aggregate Data Meta-Analysis, Agency for Healthcare Research and Quality.

Gogtay, 2004, Dynamic Mapping of Human Cortical Development During Childhood Through Early Adulthood, Proc. Natl. Acad. Sci. USA, 101, 8174, 10.1073/pnas.0402680101

Moher, 2009, Preferred Reporting Items for Systematic Reviews and Meta Analyses: The Prisma Statement, PLoS Med., 6, 1, 10.1371/journal.pmed.1000097

Antypa, 2009, Omega-3 Fatty Acids (Fish-Oil) and Depression-Related Cognition in Healthy Volunteers, J. Psychopharmacol., 23, 831, 10.1177/0269881108092120

Baumgartner, 2012, Effects of Iron and N-3 Fatty Acid Supplementation, Alone and in Combination, on Cognition in School Children: A Randomized, Double-Blind, Placebo-Controlled Intervention in South Africa, Am. J. Clin. Nutr., 96, 1327, 10.3945/ajcn.112.041004

Benton, 2013, Supplementation with DHA and the Psychological Functioning of Young Adults, Br. J. Nutr., 109, 155, 10.1017/S0007114512000566

Dalton, 2009, A Randomised Control Trial in Schoolchildren Showed Improvement in Cognitive Function After Consuming a Bread Spread, Containing Fish Flour From a Marine Source, Prostaglandins Leukot. Essent. Fatty Acids, 80, 143, 10.1016/j.plefa.2008.12.006

Esteve, 2011, Dha-Rich Fish Oil Improves Complex Reaction Time in Female Elite Soccer Players, J. Sports Sci. Med., 10, 301

Hamazaki, 1996, The Effect of Docosahexaenoic Acid on Aggression in Young Adults. a Placebo-Controlled Double-Blind Study, J. Clin. Investig., 97, 1129, 10.1172/JCI118507

Jackson, 2012, No Effect of 12 Weeks’ Supplementation with 1 G DHA-Rich or EPA-Rich Fish Oil on Cognitive Function or Mood in Healthy Young Adults Aged 18–35 Years, Br. J. Nutr., 107, 1232, 10.1017/S000711451100403X

Jackson, 2012, Docosahexaenoic Acid-Rich Fish Oil Modulates the Cerebral Hemodynamic Response to Cognitive Tasks in Healthy Young Adults, Biol. Psychol., 89, 183, 10.1016/j.biopsycho.2011.10.006

Karr, 2012, Omega-3 Polyunsaturated Fatty Acids and Cognition in a College-Aged Population, Exp. Clin. Psychopharmacol., 20, 236, 10.1037/a0026945

Kennedy, 2009, Cognitive and Mood Effects of 8 Weeks’ Supplementation with 400 mg or 1000 mg of the Omega-3 Essential Fatty Acid Docosahexaenoic Acid (DHA) in Healthy Children Aged 10-12 Years, Nutr. Neurosci., 12, 48, 10.1179/147683009X388887

Kirby, 2010, A Double-Blind, Placebo-Controlled Study Investigating the Effects of Omega-3 Supplementation in Children Aged 8-10 Years From a Mainstream School Population, Res. Dev. Disabil., 31, 718, 10.1016/j.ridd.2010.01.014

Long, 2013, A Double-Blind Trial of the Effect of Docosahexaenoic Acid and Vitamin and Mineral Supplementation on Aggression, Impulsivity, and Stress, Hum. Psychopharmacol. Clin. Exp., 28, 238, 10.1002/hup.2313

McNamara, 2010, Docosahexaenoic Acid Supplementation Increases Prefrontal Cortex Activation During Sustained Attention in Healthy Boys: A Placebo-Controlled, Dose-Ranging, Functional Magnetic Resonance Imaging Study, Am. J. Clin. Nutr., 91, 1060, 10.3945/ajcn.2009.28549

Montgomery, P., Spreckelsen, T.F., Burton, A., Burton, J.R., and Richardson, A.J. (2018). Docosahexaenoic Acid for Reading, Working Memory and Behavior in UK Children Aged 7-9: A Randomized Controlled Trial for Replication (the Dolab II Study). PLoS ONE, 13.

Muthayya, 2009, Effect of Fortification With Multiple Micronutrients and N-3 Fatty Acids on Growth and Cognitive Performance in Indian Schoolchildren: The Champion (Children’s Health and Mental Performance Influenced by Optimal Nutrition) Study, Am. J. Clin. Nutr., 89, 1766, 10.3945/ajcn.2008.26993

Osendarp, 2007, Effect of a 12-MO Micronutrient Intervention on Learning and Memory in Well-Nourished and Marginally Nourished School-Aged Children: 2 Parallel, Randomized, Placebo-Controlled Studies in Australia and Indonesia, Am. J. Clin. Nutr., 86, 1082, 10.1093/ajcn/86.4.1082

Parletta, 2013, Effects of Fish Oil Supplementation on Learning and Behaviour of Children From Australian Indigenous Remote Community Schools: A Randomised Controlled Trial, Prostaglandins Leukot. Essent. Fatty Acids, 89, 71, 10.1016/j.plefa.2013.05.001

Puente, 2014, Clinical Significance of Neuropsychological Improvement After Supplementation With Omega-3 in 8-12 Years Old Malnourished Mexican Children: A Randomized, Double-Blind, Placebo and Treatment Clinical Trial, Res. Dev. Disabil., 35, 861, 10.1016/j.ridd.2014.01.013

Richardson, A.J., Burton, J.R., Sewell, R.P., Spreckelsen, T.F., and Montgomery, P. (2012). Docosahexaenoic Acid for Reading, Cognition and Behavior in Children Aged 7-9 Years: A Randomized, Controlled Trial (the Dolab Study). PLoS ONE, 7.

Ryan, 2008, Assessing the Effect of Docosahexaenoic Acid on Cognitive Functions in Healthy, Preschool Children: A Randomized, Placebo-Controlled, Double-Blind Study, Clin. Pediatrics, 47, 355, 10.1177/0009922807311730

van der Wurff, I.S., von Schacky, C., Bergeland, T., Leontjevas, R., Zeegers, M.P., Jolles, J., Kirschner, P.A., and de Groot, R.H. (2019). Effect of 1 Year Krill Oil Supplementation on Cognitive Achievement of Dutch Adolescents: A Double-Blind Randomized Controlled Trial. Nutrients, 11.

Bos, 2015, Reduced Symptoms of Inattention After Dietary Omega-3 Fatty Acid Supplementation in Boys with and without Attention Deficit/Hyperactivity Disorder, Neuropsychopharmacology, 40, 2298, 10.1038/npp.2015.73

Cornu, 2018, A Double-Blind Placebo-Controlled Randomised Trial of Omega-3 Supplementation in Children with Moderate ADHD Symptoms, Eur. Child Adolesc. Psychiatry, 27, 377, 10.1007/s00787-017-1058-z

Crippa, 2019, Behavioral and Cognitive Effects of Docosahexaenoic Acid in Drug-Naive Children with Attention-Deficit/Hyperactivity Disorder: A Randomized, Placebo-Controlled Clinical Trial, Eur. Child Adolesc. Psychiatry, 28, 571, 10.1007/s00787-018-1223-z

Demmelmair, H., MacDonald, A., Kotzaeridou, U., Burgard, P., Gonzalez-Lamuno, D., Verduci, E., Ersoy, M., Gokcay, G., Alyanak, B., and Reischl, E. (2018). Determinants of Plasma Docosahexaenoic Acid Levels and Their Relationship to Neurological and Cognitive Functions in Pku Patients: A Double Blind Randomized Supplementation Study. Nutrients, 10.

Hirayama, 2004, Effect of Docosahexaenoic Acid-Containing Food Administration on Symptoms of Attention-Deficit/Hyperactivity Disorder—A Placebo-Controlled Double-Blind Study, Eur. J. Clin. Nutr., 58, 467, 10.1038/sj.ejcn.1601830

Kean, 2017, Reduced Inattention and Hyperactivity and Improved Cognition After Marine Oil Extract (Pcso-524a (R)) Supplementation in Children and Adolescents With Clinical and Subclinical Symptoms of Attention-Deficit Hyperactivity Disorder (ADHD): A Randomised, Double-Blind, Placebo-Controlled Trial, Psychopharmacology, 234, 403, 10.1007/s00213-016-4471-y

Rodriguez, 2019, Supplementation with High-Content Docosahexaenoic Acid Triglyceride in Attention-Deficit Hyperactivity Disorder: A Randomized Double-Blind Placebo-Controlled Trial, Neuropsychiatr. Dis. Treat., 15, 1193, 10.2147/NDT.S206020

Sinn, 2008, Cognitive Effects of Polyunsaturated Fatty Acids in Children With Attention Deficit Hyperactivity Disorder Symptoms: A Randomised Controlled Trial, Prostaglandins Leukot. Essent. Fatty Acids, 78, 311, 10.1016/j.plefa.2008.04.004

Stevens, 2003, EFA Supplementation in Children with Inattention, Hyperactivity, and Other Disruptive Behaviors, Lipids, 38, 1007, 10.1007/s11745-006-1155-0

Vaisman, 2008, Correlation Between Changes in Blood Fatty Acid Composition and Visual Sustained Attention Performance in Children with Inattention: Effect of Dietary N−3 Fatty Acids Containing Phospholipids, Am. J. Clin. Nutr., 87, 1170, 10.1093/ajcn/87.5.1170

Voigt, 2001, A Randomized, Double-Blind, Placebo-Controlled Trial of Docosahexaenoic Acid Supplementation in Children with Attention-Deficit/Hyperactivity Disorder, J. Pediatrics, 139, 189, 10.1067/mpd.2001.116050

Schwanda, 2014, Effect of Supplementation With Long-Chain Omega-3 Polyunsaturated Fatty Acids on Behavior and Cognition in Children with Attention Deficit/Hyperactivity Disorder (ADHD): A Randomized Placebo-Controlled Intervention Trial, Prostaglandins Leukot. Essent. Fatty Acids, 91, 49, 10.1016/j.plefa.2014.04.004

Stark, 2016, Translating Plasma and Whole Blood Fatty Acid Compositional Data Into the Sum of Eicosapentaenoic and Docosahexaenoic Acid in Erythrocytes, Prostaglandins Leukot. Essent. Fatty Acids, 104, 1, 10.1016/j.plefa.2015.11.002

2014, Iron Deficiency and Cognitive Functions, Neuropsychiatr. Dis. Treat., 10, 2087

Ani, 2001, A Review of Studies on the Effect of Iron Deficiency on Cognitive Development in Children, J. Nutr., 131, 649S, 10.1093/jn/131.2.649S

2005, Review of the Evidence Linking Protein and Energy to Mental Development, Public Health Nutr., 8, 1191, 10.1079/PHN2005805

2015, Omega-3 Fatty Acids in Cardiovascular Disease–An Uphill Battle, Prostaglandins Leukot. Essent. Fatty Acids, 92, 41, 10.1016/j.plefa.2014.05.004

Van Der Burg, K.P., Cribb, L., Firth, J., Karmacoska, D., and Sarris, J. (2019). Nutrient and Genetic Biomarkers of Nutraceutical Treatment Response in Mood and Psychotic Disorders: A Systematic Review. Nutr. Neurosci., 1–17.

Carney, 2016, Baseline Blood Levels of Omega-3 and Depression Remission: A Secondary Analysis of Data From a Placebo-Controlled Trial of Omega-3 Supplements, J. Clin. Psychiatry, 77, e138, 10.4088/JCP.14m09660

Meyer, 2019, Issfal Official Statement Number 6: The Importance of Measuring Blood Omega-3 Long Chain Polyunsaturated Fatty Acid Levels in Research, Prostaglandins Leukot. Essent. Fatty Acids, 157, 102029

Emmett, 2019, Non-Dietary Factors Associated with N-3 Long-Chain Pufa Levels in Humans–a Systematic Literature Review, Br. J. Nutr., 121, 793, 10.1017/S0007114519000138

Umhau, 2009, Imaging Incorporation of Circulating Docosahexaenoic Acid Into the Human Brain Using Positron Emission Tomography, J. Lipid Res., 50, 1259, 10.1194/jlr.M800530-JLR200

Willcutt, 2005, Validity of the Executive Function Theory of Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Review, Biol. Psychiatry, 57, 1336, 10.1016/j.biopsych.2005.02.006

Stevens, 1995, Essential Fatty Acid Metabolism in Boys with Attention-Deficit Hyperactivity Disorder, Am. J. Clin. Nutr., 62, 761, 10.1093/ajcn/62.4.761

Anand, 2017, Attention-Deficit/Hyperactivity Disorder and Inflammation: What Does Current Knowledge Tell Us? A Systematic Review, Front. Psychiatry, 8, 7, 10.3389/fpsyt.2017.00228

Buaud, 2014, Erythrocyte DHA Level as a Biomarker of Dha Status in Specific Brain Regions of N-3 Long-Chain Pufa-Supplemented Aged Rats, Br. J. Nutr., 112, 1805, 10.1017/S0007114514002529

Wijendran, 2004, Formula Feeding Potentiates Docosahexaenoic and Arachidonic Acid Biosynthesis in Term and Preterm Baboon Neonates, J. Lipid Res., 45, 71, 10.1194/jlr.M300106-JLR200

Sugasini, 2020, Plasma BDNF Is a More Reliable Biomarker Than Erythrocyte Omega-3 Index for the Omega-3 Fatty Acid Enrichment of Brain, Sci. Rep., 10, 1, 10.1038/s41598-020-67868-9

Thông tin
Thông tin xuất bản

Nutrients

Tập 12 Số 10

3115

Thông tin tác giả