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Neither n-3 long-chain PUFA supplementation of mothers through lactation nor of offspring in a complementary food affects child overall or social-emotional development : a 2 × 2 factorial randomized controlled trial in rural Ethiopia

(2019) JOURNAL OF NUTRITION. 149(3). p.505-512
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Abstract
Background: The n-3 (omega-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. Objective: 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. Methods: 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 x time interaction). Results: The evolution in overall and social-emotional developmental performance over time did not differ across study arms (intervention x 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 (beta: -0.03 SDs/mo; 95% CI: -0.04, -0.01 SD/mo; P < 0.01). Conclusions: 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.
Keywords
fish oil, docosahexaenoic acid, child development, breastfeeding, complementary feeding, developing country, POLYUNSATURATED FATTY-ACID, DOCOSAHEXAENOIC ACID, ARACHIDONIC-ACID, TERM INFANTS, INCOME COUNTRIES, PRETERM INFANTS, BRAIN-FUNCTION, VISUAL-ACUITY, GROWTH, PREGNANCY

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Citation

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MLA
Alemayehu, Alemayehu et al. “Neither N-3 Long-chain PUFA Supplementation of Mothers Through Lactation nor of Offspring in a Complementary Food Affects Child Overall or Social-emotional Development : a 2 × 2 Factorial Randomized Controlled Trial in Rural Ethiopia.” JOURNAL OF NUTRITION 149.3 (2019): 505–512. Print.
APA
Alemayehu, A., Huybregts, L., Wondafrash Kibebew, M., Kolsteren, P., Belachew, T., Worku, B. N., Abessa, T. G., et al. (2019). Neither n-3 long-chain PUFA supplementation of mothers through lactation nor of offspring in a complementary food affects child overall or social-emotional development : a 2 × 2 factorial randomized controlled trial in rural Ethiopia. JOURNAL OF NUTRITION, 149(3), 505–512.
Chicago author-date
Alemayehu, Alemayehu, Lieven Huybregts, Mekitie Wondafrash Kibebew, Patrick Kolsteren, Tefera Belachew, Berhanu N Worku, Teklu G Abessa, and Kimberley Bouckaert. 2019. “Neither N-3 Long-chain PUFA Supplementation of Mothers Through Lactation nor of Offspring in a Complementary Food Affects Child Overall or Social-emotional Development : a 2 × 2 Factorial Randomized Controlled Trial in Rural Ethiopia.” Journal of Nutrition 149 (3): 505–512.
Chicago author-date (all authors)
Alemayehu, Alemayehu, Lieven Huybregts, Mekitie Wondafrash Kibebew, Patrick Kolsteren, Tefera Belachew, Berhanu N Worku, Teklu G Abessa, and Kimberley Bouckaert. 2019. “Neither N-3 Long-chain PUFA Supplementation of Mothers Through Lactation nor of Offspring in a Complementary Food Affects Child Overall or Social-emotional Development : a 2 × 2 Factorial Randomized Controlled Trial in Rural Ethiopia.” Journal of Nutrition 149 (3): 505–512.
Vancouver
1.
Alemayehu A, Huybregts L, Wondafrash Kibebew M, Kolsteren P, Belachew T, Worku BN, et al. Neither n-3 long-chain PUFA supplementation of mothers through lactation nor of offspring in a complementary food affects child overall or social-emotional development : a 2 × 2 factorial randomized controlled trial in rural Ethiopia. JOURNAL OF NUTRITION. 2019;149(3):505–12.
IEEE
[1]
A. Alemayehu et al., “Neither n-3 long-chain PUFA supplementation of mothers through lactation nor of offspring in a complementary food affects child overall or social-emotional development : a 2 × 2 factorial randomized controlled trial in rural Ethiopia,” JOURNAL OF NUTRITION, vol. 149, no. 3, pp. 505–512, 2019.
@article{8585345,
  abstract     = {Background: The n-3 (omega-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. 
Objective: 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. 
Methods: 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 x time interaction). 
Results: The evolution in overall and social-emotional developmental performance over time did not differ across study arms (intervention x 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 (beta: -0.03 SDs/mo; 95% CI: -0.04, -0.01 SD/mo; P < 0.01). 
Conclusions: 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.},
  author       = {Argaw, Alemayehu and Huybregts, Lieven and Wondafrash Kibebew, Mekitie and Kolsteren, Patrick and Belachew, Tefera and Worku, Berhanu N and Abessa, Teklu G and Bouckaert, Kimberley},
  issn         = {0022-3166},
  journal      = {JOURNAL OF NUTRITION},
  keywords     = {fish oil,docosahexaenoic acid,child development,breastfeeding,complementary feeding,developing country,POLYUNSATURATED FATTY-ACID,DOCOSAHEXAENOIC ACID,ARACHIDONIC-ACID,TERM INFANTS,INCOME COUNTRIES,PRETERM INFANTS,BRAIN-FUNCTION,VISUAL-ACUITY,GROWTH,PREGNANCY},
  language     = {eng},
  number       = {3},
  pages        = {505--512},
  title        = {Neither n-3 long-chain PUFA supplementation of mothers through lactation nor of offspring in a complementary food affects child overall or social-emotional development : a 2 × 2 factorial randomized controlled trial in rural Ethiopia},
  url          = {http://dx.doi.org/10.1093/jn/nxy202},
  volume       = {149},
  year         = {2019},
}

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