Abstract
Omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA) are important constituents of the maturing brain and therefore considered crucial for brain development in utero and in early infancy. However, it is uncertain whether n-3 LCPUFA supplementation during pregnancy and lactation can have beneficial, sustainable effects on visual or cognitive development. Beneficial effects on child cognitive function after supplementation with EPA and DHA during pregnancy and lactation were observed at 4 years of age, but not at 3, 6 months or 7 years. In term infants LCPUFA when given in relative high dosages, seems to improve visual acuity, but not cognitive function. Evidence for an effect of LCPUFA supplementation of preterm infants remains inconclusive. In children older than 2 years of age, epidemiological evidence suggests an association between psychiatric or neurodevelopmental disorders and omega-3 fatty acid deficiencies. However, the evidence from randomized controlled trials exploring the impact of omega-3 fatty acids on cognitive performance or brain function in school-aged children is not conclusive. In conclusion, n-3 LCPUFA are highly present in the maturing brain and are important for normal brain functioning and development. When provided in relative high dosages, n-3 LCPUFA may improve visual acuity in term infants. However, it remains unclear whether supplementation with n-3 LCPUFA during pregnancy, early infancy, and childhood can improve cognitive function.
Highlights
There is considerable interest in the role of certain long chain polyunsaturated fatty acids (LCPUFA), in visual and cognitive development throughout childhood
Beneficial effects on visual acuity in term infants were seen with higher doses of docosahexaenoic acid (DHA) (0.35% or 0.36% in formula) and when measured by electrophysiological tests
Supportive evidence for a beneficial role of n-3 fatty acids in cognitive functioning is mainly coming from studies in specific patient groups (PKU) or children with developmental disorders (ADHD, neurophysiologic diseases, n-3 deficiency)
Summary
There is suggestive evidence for a beneficial effect of early exposure to n-3 fatty acids on children’s cognitive development. Positive findings on a beneficial effect of n-3 fatty acid supplementation or fish intake during pregnancy and/or lactation on developmental outcomes of the offspring (> 2 years) were reported from both observational studies and randomized controlled trials (RCTs) (figure 1). Three RCTs from high-income countries supplemented with n-3 fatty acids during pregnancy. Two of these trials reported improvements in problem solving at 9 months of age (Judge et al, 2007) or hand-eye coordination at 30 months of age (Dunstan et al, 2008).
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