Time to blog a few
more thoughts about the world of paediatric neuropsychology.
One issue that is always topical is dietary
supplements and fish oil in particular as a means of improving cognition or
behaviour. As is the case for adults,
dietary supplements for children and readily available, some parents are strong
advocates, others more neutral and yet others active avoiders. My own personal view has been that if a
child’s diet is adequate then there is nothing much to be gained, but I have
never really looked at the literature and it is something that parents ask
about from time to time. A basic survey
of the literature initially had me feeling like I might be missing something
with my neutral position on this issue. Titles referring to enhanced sporting performance with dietary
supplements, gains in IQ with prenatal fish oil supplements and a proposal to
roll out fish oil to children in remote indigenous communities (Sinn et al.,
2011). At this stage, I’m really
beginning to feel like I have deprived my children of the secret to a healthy
and happy life (as well as a few IQ points).
However, reading on beyond the titles the evidence seems less
compelling. While this is by no means
an exhaustive comment on the literature, null findings were not uncommon
despite alluring titles. Null effects
included a link between prenatal fish oil and cognitive function in mid
childhood (Campoy et al., 2011; Makrides et al., 2010); prenatal fish oil and prevention
of maternal depression (Makrides et al., 2010), dietary supplements and real
improvement in sports performance (Evans et al., 2012), fish oil enriched
formula and intelligence (Scott et al., 1998).
Although I am now
feeling a bit better about not drip feeding my kids fresh fish or fish oil, I wondered
where the evidence for the behavioural benefits of fish oil actually comes from
– there surely must be some scientific evidence.... and there is. In an influential study, Hebbelm et al. (2007) document a protective
relationship between higher maternal seafood intake and verbal IQ, with a
detrimental effect apparent for mothers eating nil or very little seafood. Results persisted when socio-economic factors
were considered. In a Swedish study, Kim
et al. (2010) found that teenage boys who ate fish at least once a week had
better school performance. I wonder
though if fish consumption could be a marker of a healthy lifestyle or if
findings generalise to cultures who traditionally don’t eat as much fish? Other studies have focused on clinical groups,
typically ADHD and learning difficulties with these studies showing mixed
results that seem to suggest some individuals respond better than others (Bloch
et al., 2011; Portwood, 2006). To date,
however, research has not yet identified the factors associated with a good
response.
The literature looks a
bit mixed and I am still not compelled to run out and by fish oil supplements
but we all enjoyed fish for dinner last night.
Shame the kids ate theirs watching Spongebob!
For those of you going
to CCN in Launceston, I hope you have a wonderful time and make the most of the
opportunities for learning and networking.
Please let me know if anyone would like to post anything on the blog.
Linda and Frank
References
Bloch MH &
Qawasmi A. (2011). Omega-3 fatty acid supplementation for the treatment of
children with attention-deficit/hyperactivity disorder symptomatology:
systematic review and meta-analysis.
Journal of the American Academy of Child & Adolescent Psychiatry,
50(10), 991-1000.
Campoy C,
Escolano-Margarit MV, Ramos R, Parrilla-Roure M, Csabi G, Beyer J, et al.
(2011). Effects of prenatal fish-oil and 5-methyltetrahydrofolate
supplementation on cognitive development of children at 6.5 y of age. American Journal of Clinical Nutrition, 94(6
Suppl), 1880S-1888S.
Cheatham CL,
Nerhammer AS, Asserhoj M, Michaelsen KF & Lauritzen L. (2011). Fish oil
supplementation during lactation: effects on cognition and behavior at 7 years
of age. Lipids, 46(7), 637-45.
Escolano-Margarit
MV, Ramos R, Beyer J, Csabi G, Parrilla-Roure M, Cruz F, et al. (2011).
Prenatal DHA status and neurological outcome in children at age 5.5 years are
positively associated. Journal of
Nutrition, 141(6), 1216-23.
Evans MW Jr, Ndetan
H, Perko M, Williams R & Walker C. (2012). Dietary supplement use by children
and adolescents in the United States to enhance sport performance: results of
the National Health Interview Survey.
Journal of Primary Prevention, 33(1), 3-12.
Hibbeln JR, Davis
JM, Steer C, Emmett P, Rogers I, Williams C, et al. (2007). Maternal seafood
consumption in pregnancy and neurodevelopmental outcomes in childhood (ALSPAC
study): an observational cohort study.
Lancet, 369(9561), 578-85
Kim JL, Winkvist A,
Aberg MA, Aberg N, Sundberg R, Toren K, et al. (2010). Fish consumption and
school grades in Swedish adolescents: a study of the large general
population. Acta Paediatrica, 99(1),
72-7.
Kremmyda LS,
Vlachava M, Noakes PS, Diaper ND, Miles EA & Calder PC. (2011). Atopy risk
in infants and children in relation to early exposure to fish, oily fish, or
long-chain omega-3 fatty acids: a systematic review. Clinical Reviews in Allergy & Immunology,
41(1), 36-66.
Makrides M, Gibson
RA, McPhee AJ, Yelland L, Quinlivan J, Ryan P, et al. (2010). Effect of DHA
supplementation during pregnancy on maternal depression and neurodevelopment of
young children: a randomized controlled trial.
JAMA, 304(15), 1675-83.
Portwood MM. (2006). The role of
dietary fatty acids in children's behaviour and learning. Nutrition & Health, 18(3), 233-47.
(2012) Docosahexaenoic
Acid for Reading, Cognition and Behavior in Children Aged 7–9 Years: A
Randomized, Controlled Trial (The DOLAB Study). PLoS ONE 7(9):
e43909. doi:10.1371/journal.pone.0043909
Sinn N, Cooper P & O'Dea K.
(2011). Fish oil supplementation, learning and behaviour in Indigenous
Australian children from a remote community school: a pilot feasibility
study. Australian & New Zealand
Journal of Public Health, 35, 493-4. doi:10.1111/j.1753-6405.2011.00765.x
Scott DT, Janowsky
JS, Carroll RE, Taylor JA, Auestad N & Montalto MB. (1998). Formula
supplementation with long-chain polyunsaturated fatty acids: are there
developmental benefits?. Pediatrics,
102(5), E59.
