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

Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, Swiss Federal Institute of Technology Zürich, Switzerland.
American Journal of Clinical Nutrition (Impact Factor: 6.77). 10/2012; 96(6). DOI: 10.3945/ajcn.112.041004
Source: PubMed

ABSTRACT

BACKGROUND: Little is known about the combined effects of iron and n-3 (omega-3) fatty acid (FA) supplementation on cognitive performance. The provision of either DHA/EPA or iron alone in rats with combined iron and n-3 FA deficiency has been reported to exacerbate cognitive deficits associated with deficiency. OBJECTIVE: We investigated the effects of iron and DHA/EPA supplementation, alone and in combination, in children with poor iron and n-3 FA status. DESIGN: In a 2-by-2 factorial trial, children with iron deficiency (ID) (n = 321; aged 6-11 y) were allocated to receive 1) iron (50 mg) plus DHA/EPA (420/80 mg), 2) iron plus placebo, 3) placebo plus a mixture of DHA and EPA (DHA/EPA), or 4) placebo plus placebo as oral supplements (4/wk) for 8.5 mo. Cognition was assessed at baseline and endpoint by using the Hopkins Verbal Learning Test (HVLT) and subscales of the Kaufman Assessment Battery for Children. RESULTS: Both iron and DHA/EPA significantly increased weight-for-age z scores. Iron increased the number of words recalled at HVLT recall 2 (intervention effect: 0.90; 95% CI: 0.18, 1.62), and in anemic children, iron increased scores in the Atlantis Delayed test (1.51; 95% CI: 0.03, 2.99) and HVLT recall 2 (2.02; 95% CI: 0.55, 3.49). DHA/EPA showed no benefit in any of the cognitive tests but decreased Atlantis test scores (-2.48; 95% CI: -3.99, -0.96) in children who were anemic at baseline and decreased Atlantis delayed scores (-0.9; 95% CI: -1.45, -0.36) in girls with ID, whereas boys tended to perform better. CONCLUSIONS: In children with poor iron and n-3 FA status, iron supplementation improved verbal and nonverbal learning and memory, particularly in children with anemia. In contrast, DHA/EPA supplementation had no benefits on cognition and impaired working memory in anemic children and long-term memory and retrieval in girls with ID. The trial was registered at clinicaltrials.gov as NCT01092377.

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    • "This study (Fig. 1) was part of an 8.5 month randomized, placebocontrolled , double-blind, two-by-two factorial intervention which investigated the effects of 50 mg iron, and a mixture of 420 mg DHA and 80 mg EPA per day, alone and in combination, on cognitive function and infectious morbidity in 6–11-y-old rural ID South African children [11] [20]. "

    Full-text · Dataset · Jan 2016
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    • "This study (Fig. 1) was part of an 8.5 month randomized, placebocontrolled , double-blind, two-by-two factorial intervention which investigated the effects of 50 mg iron, and a mixture of 420 mg DHA and 80 mg EPA per day, alone and in combination, on cognitive function and infectious morbidity in 6–11-y-old rural ID South African children [11] [20]. "
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    ABSTRACT: We recently reported that iron supplementation increased respiratory morbidity in iron deficient South African children. This increase, however, was attenuated when iron was provided in combination with a mixture of DHA/EPA. To explore potential underlying mechanisms, we examined the effects of iron and DHA/EPA, alone and in combination, on plasma lipid-derived immune modulator concentrations and related gene expression in peripheral blood mononuclear cells (PBMC). DHA/EPA decreased inflammatory 12-hydroxyeicosatetraenoic acid and tended to increase anti-inflammatory and pro-resolving 17-hydroxydocosahexaenoic acid (17-HDHA), while iron decreased 17-HDHA. However, in combination with iron, the anti-inflammatory effect of DHA/EPA was maintained. These biochemical changes may explain the prevention of iron-induced respiratory morbidity that we observed when iron was supplemented in combination with DHA/EPA during the 8.5 month randomised controlled trial and might lead to a safer approach of delivering iron supplementation. The study was registered at clinicaltrials.gov as NCT01092377.
    Full-text · Article · Dec 2015
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    ABSTRACT: Pemberian pangan yang difortifikasi zat multi gizi mikro pada ibu hamil meningkatkan perkembangan motorik bayi Multi micronutrients fortified supplementary food in pregnant mother to increase infants motor development ABSTRACT Background: Many factors influence the growth and development of an infant but nutrition is the most important factor. One way to improve the nutritional status of infant is by providing supplementary feeding fortified with multiple micronutrients to mother during pregnancy. Nutritional interventions during pregnancy will provide a better nutrient reserves or deposits for the mother and fetus. Objectives: To analyze the impact of multi micronutrients fortified supplementary food in provision pregnant mother on motor development and anemia status of infant in tree sub-districts of Bogor Distritc namely: Leuwiliang, Leuwisadeng and Ciampea. Methods: A total of 120 infant follow up were with prospective cohort. From 120 infants were selected 40 infants as fortified groups (pregnant mothers was received fortified food (vermicelli, milk and biscuit) with multi-nutrients i.e. iron, iodine, zinc, folic acid, vitamin C and vitamin A), 40 infants as unfortified groups (pregnant mothers was received non fortified foods) and 40 infants as control groups (pregnant mother did not receive any experiment food). Data family characteristics, maternal BMI, maternal nutrition and infant feeding, caring, morbidity is obtained uses questionnaire. Measurement of motor development uses methods of the health department the Republic of Indonesia. To know the counfounding factors that influence motor development and anemia status were analyzed with Ancova test. To know the effect of food fortification in pregnant women on motor development and anemia status uses logistic regression. Result: Multi micronutrients fortified supplementary food in pregnant mother had effect on infants motor development 77% better than other groups. Multi micronutrients fortified supplementary food in pregnant mother able to withstand the rate of decrease hemoglobin and hematocrit infants up to age 6 months. Where in infants 6 months of age Hb < 90 g / L in the fortified group does not exist, while the group without fortification (8.3%) and controls (11.11%). Conclution: Multi micronutrients fortified supplementary food in pregnant mother had effect on infants motor development better than other groups.
    Full-text · Article · Jun 2012
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