Institute of Marine Research (IMR), P.O Box 1870 Nordnes, NO-5817, Bergen, Norway.
Regional Centre for Child and Youth Mental Health, Uni Research Health, Bergen, Norway.
BMC Med. 2018 Mar 12;16(1):41. doi: 10.1186/s12916-018-1020-z.
Marine resources including fatty fish are important sources of n-3 long chain polyunsaturated fatty acids (n-3 LC-PUFAs), which are important for brain development. To our knowledge, this is the first randomized controlled trial (RCT) investigating the impact of fatty fish on cognition in preschool children. The purpose of the trial was to investigate whether an increased intake of fatty fish compared to meat improves cognitive function in children 4-6 years old.
The children (n = 232) in this two-armed RCT, Fish Intervention Studies-KIDS (FINS-KIDS) were recruited from 13 kindergartens in Bergen, Norway. They were randomly assigned to lunch meals with fatty fish (herring/mackerel) or meat (chicken/lamb/beef) three times a week for 16 weeks. The fish and meat were weighed before and after the meals to record the exact consumption (dietary compliance). The primary outcome was cognitive function measured by the Wechsler Preschool and Primary Scale of Intelligence, 3rd edition (WPPSI-III) and fine-motor coordination measured by the 9-Hole Peg Test (9-HPT) at pre- and post-intervention. Biological samples (blood, urine, hair), and questionnaires to the caregivers were included at both time points. Linear mixed effect models with a random intercept for kindergarten were used to analyze changes from pre- to post-intervention in the primary outcome variables.
There were 218 children included in the trial (105 in the fish, and 113 in the meat group). The children consumed a mean (standard deviation) of 2070 (978) g fish or 2675 (850) g meat from the study meals (p < 0.0001). The fish group had a significant increase of red blood cell n-3 LC-PUFAs. The intervention had no effect on the WPPSI-III scores (mean change total raw score; fish group 17.7, 95% confidence interval (CI) 14.8-20.7 vs meat group 17.8, 95% CI 15.0-20.6, p = 0.97) in the main analyses. In the sub-analyses, adjusting for dietary compliance, the fish group showed a higher improvement on total raw score (20.4, 95% CI 17.5-23.3) compared to the meat group (15.2, 95% CI 12.4-18.0, p = 0.0060); docosahexaenoic acid mediated this effect.
There was no beneficial effect of fatty fish compared to meat on cognitive functioning in the preschool children. When considering dietary compliance, we found a beneficial effect of fatty fish on cognitive scores.
ClinicalTrials.gov, NCT02331667 December 17, 2014.
海洋资源包括富含脂肪的鱼类，是 n-3 长链多不饱和脂肪酸（n-3 LC-PUFAs）的重要来源，这些脂肪酸对大脑发育很重要。据我们所知，这是第一项调查富含脂肪的鱼类对学龄前儿童认知影响的随机对照试验（RCT）。该试验的目的是调查与肉类相比，增加富含脂肪的鱼类摄入是否能改善 4-6 岁儿童的认知功能。
这项为期 16 周、有 232 名儿童参与的双盲随机对照试验（Fish Intervention Studies-KIDS，FINS-KIDS），是在挪威卑尔根的 13 所幼儿园招募的。他们被随机分配到每周三次午餐食用富含脂肪的鱼类（鲱鱼/鲭鱼）或肉类（鸡肉/羊肉/牛肉）。在餐前和餐后对鱼和肉进行称重，以记录准确的食用量（饮食依从性）。主要结局指标是韦氏学前和小学智力量表，第三版（WPPSI-III）测量的认知功能和 9 孔钉板测试（9-HPT）测量的精细运动协调能力，在干预前后进行测量。还包括生物样本（血液、尿液、头发）和对照顾者的问卷调查，在两个时间点都进行了测量。采用线性混合效应模型，对幼儿园进行随机截距，以分析主要结局变量从干预前到干预后的变化。
共有 218 名儿童参与了试验（105 名在鱼组，113 名在肉组）。儿童从研究餐中平均（标准差）食用 2070（978）克鱼或 2675（850）克肉（p<0.0001）。鱼组的红细胞 n-3 LC-PUFAs 显著增加。干预对 WPPSI-III 评分（总原始分数的平均变化；鱼组 17.7，95%置信区间（CI）14.8-20.7 与肉组 17.8，95%CI 15.0-20.6，p=0.97）没有影响。在亚分析中，调整饮食依从性后，鱼组的总原始分数（20.4，95%CI 17.5-23.3）较肉组（15.2，95%CI 12.4-18.0，p=0.0060）有更高的改善，二十二碳六烯酸介导了这种效果。
与肉类相比，富含脂肪的鱼类对学龄前儿童的认知功能没有有益的影响。当考虑饮食依从性时，我们发现富含脂肪的鱼类对认知评分有有益的影响。
ClinicalTrials.gov，NCT02331667 2014 年 12 月 17 日。
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