Department of Population and Family Health, Institute of Health, Jimma University, Jimma, Ethiopia.
Department of Food Technology, Safety, and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium.
J Nutr. 2019 Mar 1;149(3):505-512. doi: 10.1093/jn/nxy202.
The n-3 (ω-3) long-chain polyunsaturated fatty acid (LC-PUFA) docosahexaenoic acid (DHA) is essential for optimal brain development. There is a lack of evidence on the effect of postnatal n-3 LC-PUFA supplementation on child development in low-income countries.
We evaluated the efficacy of fish-oil supplementation through lactation or complementary food supplementation on the development of children aged 6-24 mo in rural Ethiopia.
We conducted a double-blind randomized controlled trial of n-3 LC-PUFA supplementation for 12 mo using fish-oil capsules [maternal intervention: 215 mg DHA + 285 mg eicosapentaenoic acid (EPA)] or a fish-oil-enriched complementary food supplement (child intervention: 169 mg DHA + 331 mg EPA). In total, 360 pairs of mothers and infants aged 6-12 mo were randomly assigned to 4 arms: maternal intervention and child control, child intervention and maternal control, maternal and child intervention, and maternal and child control. Primary outcomes were overall developmental performance with the use of a culturally adapted Denver II test that assesses personal-social, language, fine-motor, and gross-motor domains and social-emotional developmental performance using the Ages and Stages Questionnaire: Social Emotional at baseline and at 6 and 12 mo. We used mixed-effects models to estimate intervention effects on developmental performance over time (intervention × time interaction).
The evolution in overall and social-emotional developmental performance over time did not differ across study arms (intervention × time: F = 1.09, P = 0.35, and F = 0.61, P = 0.61, respectively). Effects did not change after adjustment for child age, birth order, and nutritional status; maternal age and education; wealth; family size; and breastfeeding frequency. Children's developmental performance significantly decreased during study follow-up (β: -0.03 SDs/mo; 95% CI: -0.04, -0.01 SD/mo; P < 0.01).
n-3 LC-PUFA supplementation does not affect overall or social-emotional development of children aged 6-24 mo in a low-income setting. Follow-up of the cohort is recommended to determine whether there are long-term effects of the intervention. This trial was registered at clinicaltrials.gov as NCT01817634.
n-3（ω-3）长链多不饱和脂肪酸（LC-PUFA）二十二碳六烯酸（DHA）对大脑发育至关重要。然而，在低收入国家，产后补充 n-3 LC-PUFA 对儿童发育的影响仍缺乏证据。
我们评估了通过哺乳期或辅食补充鱼油对埃塞俄比亚农村地区 6-24 月龄儿童发育的影响。
我们开展了一项为期 12 个月的 n-3 LC-PUFA 补充双盲随机对照试验，使用鱼油胶囊（母亲干预：215mg DHA+285mg 二十碳五烯酸（EPA））或富含鱼油的辅食补充剂（儿童干预：169mg DHA+331mg EPA）。共有 360 对 6-12 月龄的母亲和婴儿随机分为 4 组：母亲干预和儿童对照、儿童干预和母亲对照、母亲和儿童干预、母亲和儿童对照。主要结局为使用经过文化适应性调整的丹佛发育筛查测验 II（评估个人-社会、语言、精细运动和大运动领域）和年龄与阶段问卷（社交情绪）评估的整体发育表现，评估基线、6 个月和 12 个月时的社会情绪发育表现。我们使用混合效应模型估计干预对随时间变化的发育表现的影响（干预×时间交互作用）。
研究期间，各组的整体和社会情绪发育表现随时间的变化没有差异（干预×时间：F=1.09，P=0.35，F=0.61，P=0.61）。在调整儿童年龄、出生顺序和营养状况、母亲年龄和教育程度、财富、家庭规模和母乳喂养频率后，效果没有改变。研究随访期间，儿童的发育表现显著下降（β：-0.03 标准差/月；95%CI：-0.04，-0.01 标准差/月；P<0.01）。
在低收入环境中，n-3 LC-PUFA 补充剂不会影响 6-24 月龄儿童的整体或社会情绪发育。建议对该队列进行随访，以确定干预是否存在长期影响。本试验在 clinicaltrials.gov 注册，编号为 NCT01817634。
