Effect of DHA supplementation during pregnancy on maternal depression and neurodevelopment of young children: a randomized controlled trial. Changes in Ponderal Index and Body Mass Index across Childhood and Their Associations with Fat Mass and Cardiovascular Risk Factors at Age 15 Measurement of body water by multifrequency bioelectrical impedance spectroscopy in a multiethnic pediatric population. Is the impedance index (ht2/R) significant in predicting total body water? Maternal Fish Oil Supplementation in Lactation and Growth during the First 2.5 Years of Life Effect of increasing breast milk docosahexaenoic acid on plasma and erythrocyte phospholipid fatty acids and neural indices of exclusively breast fed infants The Impact of Nutritional Fatty Acids during Pregnancy and Lactation on Early Human Adipose Tissue Development Nutrient intakes and status of preschool children in Adelaide, South Australia. Four-year follow-up of children born to women in a randomized trial of prenatal DHA supplementation.
CONTEXT Uncertainty about the benefits of dietary docosahexaenoic acid ( DHA ) for pregnant women and their children exists , despite international recommendations that pregnant women increase their DHA intakes . OBJECTIVE To determine whether increasing DHA during the last half of pregnancy will result in fewer women with high levels of depressive symptoms and enhance the neurodevelopmental outcome of their children . DESIGN , SETTING , AND PARTICIPANTS A double-blind , multicenter , r and omized controlled trial ( DHA to Optimize Mother Infant Outcome [ DOMInO ] trial ) in 5 Australian maternity hospitals of 2399 women who were less than 21 weeks ' gestation with singleton pregnancies and who were recruited between October 31 , 2005 , and January 11 , 2008 . Follow-up of children ( n = 726 ) was completed December 16 , 2009 . INTERVENTION Docosahexaenoic acid-rich fish oil capsules ( providing 800 mg/d of DHA ) or matched vegetable oil capsules without DHA from study entry to birth . MAIN OUTCOME MEASURES High levels of depressive symptoms in mothers as indicated by a score of more than 12 on the Edinburgh Postnatal Depression Scale at 6 weeks or 6 months postpartum . Cognitive and language development in children as assessed by the Bayley Scales of Infant and Toddler Development , Third Edition , at 18 months . RESULTS Of 2399 women enrolled , 96.7 % completed the trial . The percentage of women with high levels of depressive symptoms during the first 6 months postpartum did not differ between the DHA and control groups ( 9.67 % vs 11.19 % ; adjusted relative risk , 0.85 ; 95 % confidence interval [ CI ] , 0.70 - 1.02 ; P = .09 ) . Mean cognitive composite scores ( adjusted mean difference , 0.01 ; 95 % CI , -1.36 to 1.37 ; P = .99 ) and mean language composite scores ( adjusted mean difference , -1.42 ; 95 % CI , -3.07 to 0.22 ; P = .09 ) of children in the DHA group did not differ from children in the control group . CONCLUSION The use of DHA-rich fish oil capsules compared with vegetable oil capsules during pregnancy did not result in lower levels of postpartum depression in mothers or improved cognitive and language development in their offspring during early childhood . TRIAL REGISTRATION anzctr.org.au Identifier : ACTRN12605000569606 Background Little is known about whether associations between childhood adiposity and later adverse cardiovascular health outcomes are driven by tracking of overweight from childhood to adulthood and /or by vascular and metabolic changes from childhood overweight that persist into adulthood . Our objective is to characterise associations between trajectories of adiposity across childhood and a wide range of cardiovascular risk factors measured in adolescence , and explore the extent to which these are mediated by fat mass at age 15 . Methods and Findings Using data from the Avon Longitudinal Study of Parents and Children , we estimated individual trajectories of ponderal index ( PI ) from 0–2 years and BMI from 2–10 years using  r and om-effects linear spline models ( N = 4601 ) . We explored associations between PI/ BMI trajectories and DXA-determined total-body fat-mass and cardiovascular risk factors at 15 years ( systolic and diastolic blood pressure , fasting LDL- and HDL-cholesterol , triglycerides , C-reactive protein , glucose , insulin ) with and without adjustment for confounders . Changes in PI/ BMI during all periods of infancy and childhood were associated with greater DXA-determined fat-mass at age 15 . BMI changes in childhood , but not PI changes from 0–2 years , were associated with most cardiovascular risk factors in adolescence ; associations tended to be strongest for BMI changes in later childhood ( ages 8.5–10 ) , and were largely mediated by fat mass at age 15 . Conclusion Changes in PI/ BMI from 0–10 years were associated with greater fat-mass at age 15 . Greater increases in BMI from age 8.5–10 years are most strongly associated with cardiovascular risk factors at age 15 , with much of these associations mediated by fat-mass at this age . We found little evidence supporting previous reports that rapid PI changes in infancy are associated with future cardiovascular risk . This study suggests that associations between early overweight and subsequent adverse cardiovascular health are largely due to overweight children tending to remain overweight BACKGROUND Bioelectrical impedance spectroscopy ( BIS ) may provide a noninvasive , rapid method for the assessment of total body water ( TBW ) , extracellular water ( ECW ) , and intracellular water ( ICW ) . Few studies , however , have examined the accuracy of BIS in pediatric population s. OBJECTIVE Our objective was to evaluate the accuracy of  BIS  for the measurement of TBW , ECW , and ICW in healthy children . DESIGN Dual-energy X-ray absorptiometry ( DXA ) , total body potassium ( TBK ) , and BIS measurements were performed in 347 children ( 202 males and 145 females aged 4 - 18 y ) . The reference values for TBW , ECW , and ICW were defined by using a DXA+TBK model . BIS values were evaluated by using the method of Bl and and Altman . A r and omly selected calibration group ( n = 231 ) was used to derive new BIS constants that were tested in the remaining group ( n = 116 ) . RESULTS  BIS values were highly correlated with the reference values ( r(2 ) = 0.94 - 0.97 , P < 0.0001 ) , but differences between the BIS and DXA+TBK models for individuals were significant ( P < 0.001 ) . Use of new BIS constants reduced the mean differences between the BIS and DXA+TBK models ; the SDs of the mean differences were improved ( 1.8 L for TBW , 1.4 L for ICW , and 1.0 L for ECW ) for the total population . CONCLUSIONS On a population basis , BIS can be calibrated to replace the DXA+TBK model for the assessment of TBW , ECW , and ICW in healthy children . The accuracy of the BIS measurement in individual children may be refined further by using age- and sex-specific adjustments for the BIS calibration constants We investigated the general utility of bioelectrical impedance analysis ( BIA ) and the implication s of BIA theory in population s of various ages from infancy to adulthood by developing a single impedance equation . Four subject data sets representing 62 adults , 37 prepubertal children , 44 preschool children , and 32 premature low-birth-weight neonates were combined . Subjects were r and omly divided into a development group ( n = 116 ) and a cross-validation group ( n = 59 ) . The single best predictor of total body water ( TBW ) was height2/resistance ( ht2/R ) , which explained 99 % of the variation in TBW ( SEE = 1.67 kg ) . The addition of weight reduced the SEE to 1.41 kg . A significant bias was only seen in the preschool children . These results were confirmed in the cross-validation group and the best prediction formula was TBW = 0.59 ht2/R + 0.065 wt + 0.04 . We conclude that the impedance index ( ht2/R ) is a significant predictor of TBW and that there is some improvement in prediction of TBW by inclusion of a weight term Fish oil addition to infant formulas has raised concern on whether increased intake of n-3 long-chain polyunsaturated fatty acid ( n-3LCPUFA ) affects infant growth .  The objective of this study was to determine whether maternal fish oil supplementation during 0–4 mo of lactation influences growth in infancy and early childhood . In a r and omized , blinded intervention trial , lactating Danish mothers with a fish intake below the population median were r and omized to 4.5 g/d fish oil or olive oil . A reference group of 53 mothers with a fish intake in the highest quartile of the population and their infants were included in the study .  Head circumference , weight , length , skinfold thickness , and waist circumference of children were measured at 2 , 4 , and 9 mo and at 2.5 y. One hundred children completed the intervention trial , and 72 were followed up at 2.5 y together with 29 from the reference group .  Growth in weight , length , and head circumference did not differ between the r and omized groups up to 9 mo , but at 2.5 y , body composition differed significantly . Children in the fish oil group had larger waist circumference body mass index ( BMI ; 0.6 kg/m2 ; p = 0.022 ) , and head circumference compared with those in the olive oil group . Adjusted for sex , ponderal index at birth and current energy intake , BMI at 2.5 y was associated with docosahexaenoic acid in maternal erythrocytes after the intervention . In conclusion , the n-3LCPUFA intake of lactating mothers may be important for growth of young children . The long-term effect on weight and BMI remains to be investigated Objectives : To determine the effect of increasing docosahexaenoic acid ( DHA , 22 : 6 n-3 ) in breast milk on infant fatty acid profiles . A secondary aim was to examine aspects of neural development . Design and Setting Double blind , placebo controlled study of infants recruited from postnatal wards at Flinders Medical Centre . Subjects : Fifty-two healthy term infants who were breast fed for at least 12 weeks and were from middle class families . Intervention : Breast milk with DHA concentrations that ranged from 0.1–1.7 % of total fatty acids . This was achieved by supplementation of the maternal diet for the first 12 weeks post partum . Results : Breast milk DHA was related to infant plasma ( r=0.89 , P<0.001 ) and erythrocyte ( r=0.88 , P<0.001 ) phospholipids in a saturable curvilinear manner so that breast milk DHA above 0.8 % of total fatty acids result ed in little further increase in infant plasma or erythrocyte DHA levels . The rise in plasma and erythrocyte DHA was approximated by a fall in total n-6 polyunsaturated fatty acids . We could detect no relationship between visual evoked potential acuity ( measured at 12 and 16 weeks ) of infants by either the dietary grouping or the DHA status of individuals . A stepwise multiple regression showed that infant erythrocyte DHA at 12 weeks and home stimulation were the only independent factors associated with Bayley 's MDI at 1 y ( adjusted model r2=0.18 , P<0.005 ) ; while at 2 y gender and social score of the spouse were the only significant predictors of Bayley 's MDI ( adjusted model r2=0.22 , P<0.005 ) . Conclusions : Increasing breast milk DHA levels caused a dose dependent saturable increase in infant plasma and erythrocyte phospholipid DHA . There were no long-term effects of infant DHA status on indices of neurodevelopment . Sponsorship : Financial support was provided by Martek Biosciences , MD , USA and the National Health and Medical Research Council , Australia Recent observational studies suggest that mean birth weight and body fat growth in the first year of life have increased continuously over the last decades . Both elevated birth weight and early fat mass are potential risk factors for childhood obesity . Experimental and limited clinical data suggest that the dietary ratio of n–6 to n–3 fatty acids ( FAs ) during pregnancy is critical for early adipose tissue growth . The aim of this r and omized controlled study is to examine the effect of the supplementation with n–3 long-chain polyunsaturated FAs and reduction in the n–6/n–3 ratio in the diet of pregnant women/breast-feeding mothers on adipose tissue growth in their newborns using various methods for the assessment of body fat mass . Measurement of skinfold thickness in the newborn is the primary outcome parameter . Two hundred and four pregnant women will be recruited before the 15th week of gestation and r and omly assigned to either active intervention or an isocaloric control diet . This upcoming study will explore the potential of this dietary approach to limit early adipose tissue growth and may contribute to the development of a new strategy for the primary prevention of childhood obesity OBJECTIVE To determine the nutrient intakes and status of preschool children from a representative population sample in Adelaide . DESIGN , SETTING AND PARTICIPANTS Cross-sectional survey of children aged 1 - 5 years , using a stratified r and om sampling method and a doorknocking strategy , between September 2005 and July 2007 . MAIN OUTCOME MEASURES  Dietary intake  , assessed using a 3-day weighed-food diary ; anthropometrics , biomarkers of iron , zinc and vitamin B(12 ) , and fatty acid profiles assessed using st and ard methods . RESULTS Median energy intakes were within dietary recommendations for the age group . Overall energy contributions from carbohydrate , protein , fat and saturated fat intakes were 50 % , 17 % , 33 % and 16 % , respectively . The rates of inadequate intake of iron , zinc , calcium and vitamin C were low , as was the prevalence of iron deficiency ( 5 % ) . Only a minority of children achieved the adequate intake for n-3 long-chain polyunsaturated fatty acids  ( 32 % ) and  dietary fibre  ( 18 % ) . There was no association between socioeconomic status and intakes of macronutrients and key micronutrients . Fourteen per cent of children were obese ( BMI , > 95th percentile ) ; no association between BMI and energy intake was shown . CONCLUSIONS The dietary intake of children in the study was adequate for macronutrients and the majority of micronutrients . However , low intakes of fibre and n-3 long-chain polyunsaturated fatty acids and high saturated fat intakes have raised concerns that this dietary pattern may be associated with adverse long-term health effects Four-Year Follow-up of Children Born to Women in a R and omized Trial of Prenatal DHA Supplementation Despite the paucity of evidence , recommendations exist internationally for pregnant women to increase their docosahexaenoic acid ( DHA ) intake to optimize fetal brain development . Our r and omized controlled trial ( RCT ) , in which pregnant women were allocated to 800 mg/d of DHA or matched placebo , showed that children ’s mean cognitive , language , and motor scores did not differ between groups at 18 months , although fewer children in the DHA group had delayed development compared with controls.1 Surprisingly , girls in the DHA group had poorer language scores than girls in the control group.1 Herein we report neurodevelopmental outcomes at 4 years , which is when any subtle to moderate effects on development should have emerged and can be more reliably assessed
BACKGROUND The omega-3 ( n-3 ) long-chain polyunsaturated fatty acid ( LCPUFA ) docosahexaenoic acid ( DHA ) has proven effective at reducing fat storage in animal studies .
However , a systematic review of human trials showed a lack of quality data to support or refute this hypothesis .
OBJECTIVE We sought to determine whether maternal DHA supplementation during the second half of pregnancy results in a lower body mass index ( BMI ) and percentage of body fat  in children .