Docosahexaenoic Acid for Reading, Cognition and Behavior in Children Aged 7–9 Years: A Randomized, Controlled Trial (The DOLAB Study)

Centre for Evidence-Based Intervention, University of Oxford, Oxford, United Kingdom.
PLoS ONE (Impact Factor: 3.23). 09/2012; 7(9):e43909. DOI: 10.1371/journal.pone.0043909
Source: PubMed


Omega-3 fatty acids are dietary essentials, and the current low intakes in most modern developed countries are believed to contribute to a wide variety of physical and mental health problems. Evidence from clinical trials indicates that dietary supplementation with long-chain omega-3 may improve child behavior and learning, although most previous trials have involved children with neurodevelopmental disorders such as attention-deficit/hyperactivity disorder (ADHD) or developmental coordination disorder (DCD). Here we investigated whether such benefits might extend to the general child population.

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    • "Results from several studies have shown that PUFA increases fasting glucose concentrations in people with type 2 diabetes mellitus and control groups (37–39) and that this might occur by decreasing the sensitivity of pancreatic β-cells to glucose (40). The satisfactory safety profile in several studies in adults and children (14, 27, 28) and its status as a food supplement makes fish oil-derived PUFA an attractive treatment adjunct to achieve greater glycemic stability in children with CHI. In our study, the primary objective of increased glycemic response was not achieved and the extent of glucose increment observed was lower than hypothesized in the trial protocol. "
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    ABSTRACT: Objective: Congenital hyperinsulinism (CHI) is a rare condition of hypoglycemia where therapeutic options are limited and often complicated by side-effects. Omega-3-polyunsaturated fatty acids (PUFA), which can suppress cardiac myocyte electrical activity, may also reduce ion channel activity in insulin-secreting cells. PUFA supplements in combination with standard medical treatment may improve glucose profile and may reduce glycemic variability in diazoxide-responsive CHI. Design: Open label pilot trial with MaxEPAR liquid (eicosapentaenoic and docosahexaenoic acid) PUFA (3 ml/day for 21 days) in diazoxide-responsive CHI patients (, EudraCT number 201100363333). Methods: Glucose levels were monitored pre-treatment, end of treatment, and at follow-up by subcutaneous continuous glucose monitoring systems (CGMS) in 13 patients (7 girls) who received PUFA. Outcome measures were an improved glucose profile, reduced glycemic variability quantified by a reduction in the frequency of glucose levels <4 and >10 mmol/l, and safety of PUFA. All children were analyzed either as intention to treat (n = 13) or as per protocol (n = 7). Results: Mean (%) CGMS glucose levels increased by 0.1 mmol/l (2%) in intention to treat and by 0.4 mmol/l (8%) in per protocol analysis (n = 7). The frequency of CGMS <4 mmol/l was significantly less at the end of treatment than in the pre-treatment period [556 (7%) vs. 749 (10%)]. Similarly, the frequency of CGMS >10 mmol/l, was also less at the end of treatment [27 (0.3%) vs. 49 (0.7%)]. Except for one child with increased LDL cholesterol, all safety parameters were normal. Conclusion: MaxEPAR was safe and reduced glycemic variability, but did not increase glucose profiles significantly in diazoxide-responsive CHI. The supplemental value of PUFA should be evaluated in a comprehensive clinical trial.
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    • "(Cohen's d=−0.343) (Richardson et al., 2012). "
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    • "Daily intakes of DHA (from fish, enriched foods, and supplements) of 200–250 mg·day –1 would most likely provide such levels of DHA in breast milk. Recently, Richardson et al. (2012) reported a highly significant improvement in reading ability scores when schoolchildren (ages 7–9 years), who were initially in the lower 10th or 20th percentiles with respect to reading ability, received daily DHA supplementation (600 mg·day –1 ) over 16 weeks relative to the placebo group. Numerous systematic reviews and meta-analyses based on randomized clinical trials as reported in peer-reviewed medical journals have been published during the past decade on DHA– EPA omega-3 fatty intakes (via diet and supplementation) and cardiovascular-related outcomes. "
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