Muthayya S, Eilander A, Transler C, Thomas T, Van Der Knaap HCM, Srinivasan K et al. Effect of fortification with multiple micronutrients and n 2 3 fatty acids on growth and cognitive performance in Indian schoolchildren: the CHAMPION ( Children ’ s Health and Mental Performance Influenced by Optimal Nutrition ) Study 1-3. Am J Clin Nutr 89: 1766-1775

Division of Nutrition, St John's Research Institute, St John's National Academy of Health Sciences, Bangalore, India.
American Journal of Clinical Nutrition (Impact Factor: 6.77). 05/2009; 89(6):1766-75. DOI: 10.3945/ajcn.2008.26993
Source: PubMed


Fortification with multiple micronutrients has been shown to improve growth and cognitive performance among children in developing countries, but it is unknown whether higher concentrations are more effective than lower concentrations.
We compared the effect of 2 different concentrations of a combination of micronutrients and n-3 (omega-3) fatty acids on indicators of growth and cognitive performance in low-income, marginally nourished schoolchildren in Bangalore, India.
In a 2-by-2 factorial, double-blind, randomized controlled trial, 598 children aged 6-10 y were individually allocated to 1 of 4 intervention groups to receive foods fortified with either 100% or 15% of the Recommended Dietary Allowance of micronutrients in combination with either 900 mg alpha-linolenic acid plus 100 mg docosahexaenoic acid or 140 mg alpha-linolenic acid for 12 mo. Anthropometric and biochemical assessments were performed at baseline and 12 mo. Cognitive performance was measured at baseline and at 6 and 12 mo.
The high micronutrient treatment significantly improved linear growth at 12 mo (0.19 cm; 0.01, 0.36) and short-term memory at 6 mo (0.11 SD; 0.01, 0.20) and was less beneficial on fluid reasoning at 6 (-0.10 SD; -0.17, -0.03) and 12 (-0.12 SD; -0.20, -0.04) mo than was the low micronutrient treatment, whereas no differences were observed on weight, retrieval ability, cognitive speediness, and overall cognitive performance. No significant differences were found between the n-3 treatments.
The high micronutrient treatment was more beneficial for linear growth than was the low micronutrient treatment. However, with some small differential effects, higher micronutrient concentrations were as effective as lower concentrations on cognitive performance. This trial was registered at as NCT00467909.

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    • "Furthermore, in subjects with ADHD, higher levels of DHA were associated with lower attention problems, both at baseline and follow-up. The detected increase in DHA levels was more modest than in earlier studies where DHA was measured in plasma or erythrocytes (Muthayya et al, 2009; Osendarp et al, 2007). Cheek cell samples are more prone to contamination than blood samples and this may have contributed to this difference. "
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    ABSTRACT: Attention Deficit/ Hyperactivity Disorder (ADHD) is one of the most common child psychiatric disorders, and is often treated with stimulant medication. Non-pharmacological treatments include dietary supplementation with omega-3 fatty acids, although their effectiveness remains to be shown conclusively. In this study, we investigated the effects of dietary omega-3 fatty acid supplementation on ADHD symptoms and cognitive control in young boys with and without ADHD.Neuropsychopharmacology accepted article preview online, 19 March 2015. doi:10.1038/npp.2015.73.
    Full-text · Article · Mar 2015 · Neuropsychopharmacology: official publication of the American College of Neuropsychopharmacology
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    • "children for verbal and non-verbal ability. Fortified groups showed no significant changes in total cognitive performance at 0 and 16 weeks Muthayya et al (2009) 34 11 subtests comprising 6 KABC II, 2 WISC-R and 3 RAVLT tests; tests conducted at baseline, 6 and 12 months All groups had a significant improvement; high MN more beneficial than low MN at 6 months but not at 12 months; no significant differences between high and low n-3 fatty acids treatment. Overall, high MN as effective as low MN on cognitive performance Supple- ment-based Sungthong et al. (2004) 35 Test of Nonverbal Intelligence (TONI-2); school exam marks IQ score increased in all groups compared to baseline; however, IQ change in daily Fe group was sig less than weekly Fe and placebo groups. "
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    ABSTRACT: It is estimated that more than 200 million young children worldwide fail to reach their potential in cognitive development owing to undernutrition. Numerous studies have assessed the effects of micronutrient supplementation on growth and cognitive development in infants, toddlers and preschoolers. However, micronutrient interventions on the cognitive performance of older children are limited. This article seeks to provide an update on micronutrient interventions and cognitive outcomes among children aged 5-15 years in developing countries. A total of 13 randomized controlled trials published since 2000 were identified. Majority of these studies assessed the effects of micronutrient-fortified foods on various domains of cognitive function. Among key micronutrients assessed were iron, zinc, iodine and vitamin A. This review found a lack of consistency in the impact of micronutrient supplementation on intelligence, long term mental functions and school examination grades of the children. A beneficial effect of micronutrient supplementation on short term memory was more consistently reported. Overall, the evidence from this review for the impact of micronutrients on cognitive performance in older children remains equivocal. In light of the growing interest on the influence of nutrition on cognition, it is important that culturally-appropriate and sufficiently sensitive assessment tools be used for measuring the desired cognitive outcomes that are most likely to be affected by the nutrients under study.
    Full-text · Article · Sep 2012 · Asia Pacific Journal of Clinical Nutrition
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    • "ofDHA,and consumptionofasupplementofapproximately 100mgday -1for2monthsreducedupperrespiratory infectionsdramatically(Minnsetal.2010).Few studieshavelookedatfunctionalconsequencesofn-3 LCPUFAsupplementationlaterinchildhoodin developingcountries.Oneofthefewstudiesthatdid, theCHAMPIONstudy(Muthayyaetal.2009),found nofunctionaleffectsongrowthorcognitiveperfor- mancein600Indianschoolchildrenaftersupplemen- tationwithalowdoseofDHA(100mgday -1for12 months).Othernewstudieshavefoundindicationsof beneficialeffectsofn-3LCPUFAsupplementation onillnessandimmunefunctioninchildrenin low-andhigh-incomecountries(Pastoretal.2006; "
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    ABSTRACT: The present review of determinants of infant fatty acid status was undertaken as part of a conference on 'Fatty acid status in early life in low-income countries: determinants and consequences'. Emphasis is placed on the essential fatty acids, and particularly the physiologically important long chain polyunsaturated fatty acids (LCPUFAs) of 20 and 22 carbons. We are unaware of any studies of determinants of infant fatty acid status in populations with a cultural dietary pattern with low amounts of linoleic acid (LA, 18:2n-6) and α-linolenic acid (ALA,18:3n-3). Many reports suggest that there may be adverse health effects related to the increased proportion of LA in relation to ALA, which have occurred worldwide due to the increased availability of vegetable oils high in LA. The issue of dietary n-6 to n-3 balance may apply to infant fatty acid status both during fetal and post-natal life; however, this review focuses on the n-3 and n-6 LCPUFA, in particular, docosahexaenoic acid (DHA, 22:6n-3) and arachidonic acid (AA, 20:4n-6), which are the predominant n-3 and n-6 LCPUFA found in cell membranes. The evidence that these fatty acids are preferentially transferred from maternal to fetal circulation across the placenta, and the sources and mechanisms for this transfer, are reviewed. We also address the sources of DHA and AA for the newborn including human milk DHA and AA and the factors that influence maternal DHA status and consequently the amount of DHA available for transfer to the fetus and infant via human milk.
    Full-text · Article · Apr 2011 · Maternal and Child Nutrition
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