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Borasio F, De Cosmi V, D’Oria V, Scaglioni S, Syren MLE, Turolo S, Agostoni C, Coniglio M, Molteni M, Antonietti A, Lorusso ML. Associations between Dietary Intake, Blood Levels of Omega-3 and Omega-6 Fatty Acids and Reading Abilities in Children. Biomolecules 2023; 13:biom13020368. [PMID: 36830737 PMCID: PMC9952928 DOI: 10.3390/biom13020368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023] Open
Abstract
Lower levels of omega-3 polyunsaturated fatty acids (PUFAs) have been described in individuals with reading difficulties, but the degree and the nature of such deficiencies as well as the role of nutrition are a matter of debate. The aim of the present study was to investigate the associations between PUFA blood levels, nutritional status, and reading/writing/phonological awareness performances in 42 school-age children with varying levels of reading ability. Significant correlations were found between PUFA levels (specific omega-6/omega-3 ratios), the ratio of omega-6-derived calories to the total amount of calories and reading scores. Mediation analysis showed a mediating effect of fatty acids on the association between reading speed scores and nutritional status. Moderation analysis, moreover, showed that the associations of omega-6/omega-3 ratios in the blood and Kcal omega-6/Kcal total in dietary intake were moderated by reading speed performances. Results of the mediation and moderation models confirm that the associations of dietary intake with PUFA levels in the blood vary depending on learning abilities. Reading skills appear to be sensitive to the effects of a complex set of favorable conditions related to the presence of higher omega-3 blood levels. These conditions may reflect the action of dietary as well as genetic and epigenetic mechanisms.
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Affiliation(s)
- Francesca Borasio
- Scientific Institute IRCSS E. Medea, Unit of Child Psychopathology, 23842 Bosisio Parini, Italy
- Department of Psychology, Catholic University of the Sacred Heart, 20123 Milan, Italy
| | - Valentina De Cosmi
- Department of Clinical and Community Sciences, University of Milan, 20122 Milan, Italy
| | - Veronica D’Oria
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Anestesia e Terapia Intensiva Donna-Bambino, 20122 Milan, Italy
| | - Silvia Scaglioni
- Fondazione De Marchi, Department of Pediatrics, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | | | - Stefano Turolo
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, SC Nephrology Dialysis and Pediatric Transplantation, 20122 Milan, Italy
| | - Carlo Agostoni
- Department of Clinical and Community Sciences, University of Milan, 20122 Milan, Italy
- SC Pediatria-Immunoreumatologia, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Marilena Coniglio
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, SC Child and Adolescent Neuropsychiatry, 20122 Milan, Italy
| | - Massimo Molteni
- Scientific Institute IRCSS E. Medea, Unit of Child Psychopathology, 23842 Bosisio Parini, Italy
| | - Alessandro Antonietti
- Department of Psychology, Catholic University of the Sacred Heart, 20123 Milan, Italy
| | - Maria Luisa Lorusso
- Scientific Institute IRCSS E. Medea, Unit of Child Psychopathology, 23842 Bosisio Parini, Italy
- Correspondence:
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Barón-Mendoza I, González-Arenas A. Relationship between the effect of polyunsaturated fatty acids (PUFAs) on brain plasticity and the improvement on cognition and behavior in individuals with autism spectrum disorder. Nutr Neurosci 2020; 25:387-410. [PMID: 32338174 DOI: 10.1080/1028415x.2020.1755793] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objective: This work aimed to compile information about the neuronal processes in which polyunsaturated fatty acids (PUFAs) could modulate brain plasticity, in order to analyze the role of nutritional intervention with the ω-3 and ω-6 fatty acids as a therapeutic strategy for the Autism Spectrum Disorder (ASD)-related signs and symptoms.Methods: We reviewed different articles reporting the effect of PUFAS on neurite elongation, membrane expansion, cytoskeleton rearrangement and neurotransmission, considering the ASD-related abnormalities in these processes.Results: In accordance to the reviewed studies, it is clear that ASD is one of the neurological conditions associated with an impairment in neuronal plasticity; therefore, PUFAs-rich diet improvements on cognition and behavioral deficits in individuals with autism, could be involved with the regulation of neuronal processes implicated in the atypical brain plasticity related with this neurodevelopmental disorder.Discussion: The behavioral and cognitive improvement observed in individuals with ASD after PUFAs treatment might underlie, at least in part, in the ability of ω-3 and ω-6 fatty acids to induce neurite outgrowth, probably, through the dynamic regulation of the neuronal cytoskeleton along with the expansion of neuronal membranes. Furthermore, it might also be associated with an enhancement of the efficacy of synaptic transmission and the modulation of neurotransmitters release.
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Affiliation(s)
- Isabel Barón-Mendoza
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, CDMX, México
| | - Aliesha González-Arenas
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, CDMX, México
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Labrousse VF, Leyrolle Q, Amadieu C, Aubert A, Sere A, Coutureau E, Grégoire S, Bretillon L, Pallet V, Gressens P, Joffre C, Nadjar A, Layé S. Dietary omega-3 deficiency exacerbates inflammation and reveals spatial memory deficits in mice exposed to lipopolysaccharide during gestation. Brain Behav Immun 2018; 73:427-440. [PMID: 29879442 DOI: 10.1016/j.bbi.2018.06.004] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 05/21/2018] [Accepted: 06/03/2018] [Indexed: 01/03/2023] Open
Abstract
Maternal immune activation (MIA) is a common environmental insult on the developing brain and represents a risk factor for neurodevelopmental disorders. Animal models of in utero inflammation further revealed a causal link between maternal inflammatory activation during pregnancy and behavioural impairment relevant to neurodevelopmental disorders in the offspring. Accumulating evidence point out that proinflammatory cytokines produced both in the maternal and fetal compartments are responsible for social, cognitive and emotional behavioral deficits in the offspring. Polyunsaturated fatty acids (PUFAs) are essential fatty acids with potent immunomodulatory activities. PUFAs and their bioactive derivatives can promote or inhibit many aspects of the immune and inflammatory response. PUFAs of the n-3 series ('n-3 PUFAs', also known as omega-3) exhibit anti-inflammatory/pro-resolution properties and promote immune functions, while PUFAs of the n-6 series ('n-6 PUFAs' or omega-6) favor pro-inflammatory responses. The present study aimed at providing insight into the effects of n-3 PUFAs on the consequences of MIA on brain development. We hypothesized that a reduction in n-3 PUFAs exacerbates both maternal and fetal inflammatory responses to MIA and later-life defects in memory in the offspring. Based on a lipopolysaccharide (LPS) model of MIA (LPS injection at embryonic day 17), we showed that n-3 PUFA deficiency 1) alters fatty acid composition of the fetal and adult offspring brain; 2) exacerbates maternal and fetal inflammatory processes with no significant alteration of microglia phenotype, and 3) induces spatial memory deficits in the adult offspring. We also showed a strong negative correlation between brain content in n-3 PUFA and cytokine production in MIA-exposed fetuses. Overall, our study is the first to address the deleterious effects of n-3 PUFA deficiency on brain lipid composition, inflammation and memory performances in MIA-exposed animals and indicates that it should be considered as a potent environmental risk factor for the apparition of neurodevelopmental disorders.
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Affiliation(s)
- V F Labrousse
- INRA, Nutrition et Neurobiologie Intégrée, UMR 1286, 33076 Bordeaux, France; Univ. Bordeaux, Nutrition et Neurobiologie Intégrée, UMR 1286, 33076 Bordeaux, France
| | - Q Leyrolle
- INRA, Nutrition et Neurobiologie Intégrée, UMR 1286, 33076 Bordeaux, France; Univ. Bordeaux, Nutrition et Neurobiologie Intégrée, UMR 1286, 33076 Bordeaux, France; PROTECT, INSERM, Université Paris Diderot, Sorbonne Paris Cité, F-75019 Paris, France
| | - C Amadieu
- INRA, Nutrition et Neurobiologie Intégrée, UMR 1286, 33076 Bordeaux, France; Univ. Bordeaux, Nutrition et Neurobiologie Intégrée, UMR 1286, 33076 Bordeaux, France
| | - A Aubert
- INRA, Nutrition et Neurobiologie Intégrée, UMR 1286, 33076 Bordeaux, France; Univ. Bordeaux, Nutrition et Neurobiologie Intégrée, UMR 1286, 33076 Bordeaux, France
| | - A Sere
- INRA, Nutrition et Neurobiologie Intégrée, UMR 1286, 33076 Bordeaux, France; Univ. Bordeaux, Nutrition et Neurobiologie Intégrée, UMR 1286, 33076 Bordeaux, France
| | - E Coutureau
- Centre National de la Recherche Scientifique, Institut de Neurosciences Cognitives et Intégratives d'Aquitaine, Uité Mixte de Recherche 5287, 33076 Bordeaux, France; Université de Bordeaux, Institut de Neurosciences Cognitives et Intégratives d'Aquitaine, 33076 Bordeaux, France
| | - S Grégoire
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRA, Université Bourgogne Franche-Comté, Dijon, France
| | - L Bretillon
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRA, Université Bourgogne Franche-Comté, Dijon, France
| | - V Pallet
- INRA, Nutrition et Neurobiologie Intégrée, UMR 1286, 33076 Bordeaux, France; Univ. Bordeaux, Nutrition et Neurobiologie Intégrée, UMR 1286, 33076 Bordeaux, France
| | - P Gressens
- PROTECT, INSERM, Université Paris Diderot, Sorbonne Paris Cité, F-75019 Paris, France; Centre for the Developing Brain, Department of Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London SE1 7EH, United Kingdom
| | - C Joffre
- INRA, Nutrition et Neurobiologie Intégrée, UMR 1286, 33076 Bordeaux, France; Univ. Bordeaux, Nutrition et Neurobiologie Intégrée, UMR 1286, 33076 Bordeaux, France
| | - A Nadjar
- INRA, Nutrition et Neurobiologie Intégrée, UMR 1286, 33076 Bordeaux, France; Univ. Bordeaux, Nutrition et Neurobiologie Intégrée, UMR 1286, 33076 Bordeaux, France.
| | - S Layé
- INRA, Nutrition et Neurobiologie Intégrée, UMR 1286, 33076 Bordeaux, France; Univ. Bordeaux, Nutrition et Neurobiologie Intégrée, UMR 1286, 33076 Bordeaux, France.
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Crippa A, Agostoni C, Mauri M, Molteni M, Nobile M. Polyunsaturated Fatty Acids Are Associated With Behavior But Not With Cognition in Children With and Without ADHD: An Italian study. J Atten Disord 2018; 22:971-983. [PMID: 26861157 DOI: 10.1177/1087054716629215] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE This study aimed to investigate the relationship between polyunsaturated fatty acids (PUFAs) status, cognitive, and behavioral traits of ADHD in school-aged children. METHOD Seventy-three children with and without ADHD were assessed with cognitive tasks and behavioral rating scales including quality of life and global functioning at baseline of an intervention trial (clinicaltrials.gov NCT01796262). Correlation analyses were performed between the cognitive tasks/behavioral ratings and blood PUFA levels. RESULTS Children with ADHD had lower levels of DHA, omega-3 index, and total PUFA. PUFAs were positively associated with behavior but not consistently related to cognitive domains. CONCLUSION The present study confirms that children with ADHD display abnormal fatty acid profiles within an Italian setting. Furthermore, PUFAs were associated with behavior but not with cognition. Accordingly, for the first time, lower blood levels of PUFA were associated not only with symptoms of ADHD but also with a poorer quality of life.
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Affiliation(s)
| | - Carlo Agostoni
- 2 Pediatric Clinic, Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, University of Milan, Italy
| | | | | | - Maria Nobile
- 1 Scientific Institute, IRCCS Eugenio Medea, Lecco, Italy.,3 Villa San Benedetto Hospital, Hermanas Hospitalarias, FoRiPsi, Albese con Cassano, Italy
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Harel Y, Zuk L, Guindy M, Nakar O, Lotan D, Fattal‐Valevski A. The effect of subclinical infantile thiamine deficiency on motor function in preschool children. MATERNAL & CHILD NUTRITION 2017; 13:e12397. [PMID: 28133900 PMCID: PMC6866041 DOI: 10.1111/mcn.12397] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 09/29/2016] [Accepted: 10/03/2016] [Indexed: 11/29/2022]
Abstract
We investigated the long-term implications of infantile thiamine (vitamin B1) deficiency on motor function in preschoolers who had been fed during the first 2 years of life with a faulty milk substitute. In this retrospective cohort study, 39 children aged 5-6 years who had been exposed to a thiamine-deficient formula during infancy were compared with 30 age-matched healthy children with unremarkable infant nutritional history. The motor function of the participants was evaluated with The Movement Assessment Battery for Children (M-ABC) and the Zuk Assessment. Both evaluation tools revealed statistically significant differences between the exposed and unexposed groups for gross and fine motor development (p < .001, ball skills p = .01) and grapho-motor development (p = .004). The differences were especially noteworthy on M-ABC testing for balance control functioning (p < .001, OR 5.4; 95% CI 3.4-7.4) and fine motor skills (p < .001, OR 3.2; 95% CI 1.8-4.6). In the exposed group, both assessments concurred on the high rate of children exhibiting motor function difficulties in comparison to unexposed group (M-ABC: 56% vs. 10%, Zuk Assessment: 59% vs. 3%, p < .001). Thiamine deficiency in infancy has long-term implications on gross and fine motor function and balance skills in childhood, thiamine having a crucial role in normal motor development. The study emphasizes the importance of proper infant feeding and regulatory control of breast milk substitutes.
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Affiliation(s)
- Yael Harel
- Department of Physical Therapy, The Stanley Steyer School of Health ProfessionsTel Aviv UniversityTel AvivIsrael
| | - Luba Zuk
- Department of Physical Therapy, The Stanley Steyer School of Health ProfessionsTel Aviv UniversityTel AvivIsrael
| | | | - Orly Nakar
- Maccabi Healthcare ServicesTel AvivIsrael
| | - Dafna Lotan
- Pediatric Neurology Unit, Dana Children's Hospital, Tel Aviv Sourasky Medical Center & Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
| | - Aviva Fattal‐Valevski
- Pediatric Neurology Unit, Dana Children's Hospital, Tel Aviv Sourasky Medical Center & Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
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Mesirow MS, Cecil C, Maughan B, Barker ED. Associations between Prenatal and Early Childhood Fish and Processed Food Intake, Conduct Problems, and Co-Occurring Difficulties. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2017; 45:1039-1049. [PMID: 27812905 PMCID: PMC5415431 DOI: 10.1007/s10802-016-0224-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Little is known about early life diet as a risk factor for early-onset persistent conduct problems (EOP CP). To investigate this, we used data from the Avon Longitudinal Study of Parents and Children, a UK-based prospective epidemiological birth cohort. 5727 mother-child pairs (49.9 % boys) monitored since pregnancy (delivery date between 1 April, 1991 and 31 December, 1992) reported intake of fish and processed foods at 32 weeks gestation and, for the child, at 3 years; EOP (n = 666) and Low conduct problem (Low CP, n = 5061) trajectories were measured from 4 to 13 years; hyperactivity and emotional difficulties were assessed in childhood (4-10 years) and early adolescence (12-13 years), in addition to potential confounding factors (family adversity, birth complications, income). Compared to Low CP, mothers of EOP children consumed less fish (p < 0.01) and more processed food (p < 0.05) prenatally, while EOP children consumed more processed food at 3 years (p < 0.05). For EOP, but not Low CP children, consuming less than two servings/week of fish (vs. two or more servings/week, p < 0.05), and one or more servings/day of processed food (vs. less than one serving/day, p < 0.01), was associated with higher emotional difficulties in early adolescence. CONCLUSIONS Findings suggest that prenatal and postnatal diets high in processed food, and low in fish, associate with an EOP CP trajectory and co-occurring difficulties in early adolescence. As small effect size differences were found, further studies are needed to investigate the long-term impact of early unhealthy diet.
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Affiliation(s)
- Maurissa Sc Mesirow
- Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Charlotte Cecil
- Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Barbara Maughan
- MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Edward D Barker
- Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK.
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Gustin K, Tofail F, Mehrin F, Levi M, Vahter M, Kippler M. Methylmercury exposure and cognitive abilities and behavior at 10years of age. ENVIRONMENT INTERNATIONAL 2017; 102:97-105. [PMID: 28216013 DOI: 10.1016/j.envint.2017.02.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 02/09/2017] [Accepted: 02/10/2017] [Indexed: 05/26/2023]
Abstract
BACKGROUND Methylmercury (MeHg) is a known developmental neurotoxicant present in fish, yet the impact of childhood exposure is uncertain, especially in children with poor nutrition. OBJECTIVES To evaluate associations of MeHg exposure with cognitive abilities and behavior in children from a poor rural area in Bangladesh. METHODS The MeHg exposure was assessed in 1434 ten-year-old children by measuring mercury concentrations in hair (hair-Hg), using inductively coupled plasma mass spectrometry. Cognitive abilities were assessed with the Wechsler Intelligence Scale for Children (4th edition), and behavior by the parent-report Strengths and Difficulties Questionnaire. RESULTS Children's median hair-Hg was 674μg/kg (range 70-17,561μg/kg). Concentrations did not differ by distance from scalp, indicating a similar exposure over time. No multivariable-adjusted associations were observed between the children's hair-Hg and their cognitive abilities. However, children in the highest tertile of hair-Hg had a lower prevalence of hyperactivity (OR: 0.61, 95% CI: 0.45-0.83) and peer relationship problems (OR: 0.58, 95% CI: 0.44-0.76), compared to children in the lowest tertile. The corresponding ORs were slightly stronger in children from families with lower socioeconomic status (OR: 0.56, 95% CI: 0.34-0.90 and OR: 0.48, 95% CI: 0.30-0.74) than in children from families with higher socioeconomic status (OR: 0.73, 95% CI: 0.49-1.08 and OR: 0.72, 95% CI: 0.51-1.02). Similar stronger ORs were observed in underweight children. CONCLUSION MeHg exposure was not associated with cognitive function, but inversely associated with certain adverse behavior. More studies are needed concerning the risk-benefit of different fish consumption in rural Bangladesh.
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Affiliation(s)
- Klara Gustin
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden
| | - Fahmida Tofail
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Fardina Mehrin
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Michael Levi
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden
| | - Marie Vahter
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden
| | - Maria Kippler
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden.
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Damsgaard CT, Lauritzen L, Hauger H, Vuholm S, Teisen MN, Ritz C, Hansen M, Niclasen J, Mølgaard C. Effects of oily fish intake on cardiovascular risk markers, cognitive function, and behavior in school-aged children: study protocol for a randomized controlled trial. Trials 2016; 17:510. [PMID: 27769289 PMCID: PMC5073969 DOI: 10.1186/s13063-016-1647-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 10/07/2016] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Most children in Western populations do not meet recommendations for fish consumption. Oily fish is an important source of n-3 long-chain polyunsaturated fatty acids (LCPUFA), which reduce blood pressure and plasma triacylglycerol in adults and may affect cognitive development and behavior. However, to our knowledge, the potential effects of oily fish on cardiometabolic health, cognitive function, and behavior in children have not been investigated. The aim of the FiSK Junior study is to investigate the effects of oily fish consumption on cardiovascular risk markers, cognitive function, and behavior in healthy children. METHODS/DESIGN We are conducting a randomized controlled trial with 8- to 9-year-old Danish children, comparing the effect of consuming 300 g/week of oily fish with poultry (control) for 12 weeks between August 2016 and June 2017. The primary outcomes are blood pressure and fasting plasma triacylglycerol, which will be measured at baseline and endpoint. In addition, we will assess erythrocyte fatty acid composition (compliance), heart rate, plasma cholesterol, markers of glucose homeostasis, growth and body composition, dietary intake, and physical activity and sleep. We will also examine effects on cognitive function (attention, memory, and executive functions) by using standardized tests, behavior and emotions by administering parent-rated questionnaires and child interviews, and we will measure physiological stress response and cortisol levels. We need 150 children to complete the trial to detect a between-groups difference of 2.7 mmHg in diastolic blood pressure and 0.13 mmol/L in plasma triacylglycerol; thus, we aim to recruit 200 children. All outcomes will be analyzed in completer analysis supplemented with sensitivity analyses for the primary outcomes, and attention will be given to potential sex and genotype specificity. DISCUSSION The results of the FiSK Junior study are expected to fill important gaps in the current knowledge about the importance of dietary fish and n-3 LCPUFA for children's health and development, and may be used when setting dietary recommendations. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02809508 . Registered on 22 June 2016.
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Affiliation(s)
- Camilla T. Damsgaard
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg C, Denmark
| | - Lotte Lauritzen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg C, Denmark
| | - Hanne Hauger
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg C, Denmark
| | - Stine Vuholm
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg C, Denmark
| | - Marie N. Teisen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg C, Denmark
| | - Christian Ritz
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg C, Denmark
| | - Max Hansen
- Division of Risk Assessment and Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - Janni Niclasen
- Department of Psychology, Faculty of Social Science, University of Copenhagen, Copenhagen, Denmark
- Centre for Collaborative Health, Aarhus University, Aarhus C, Denmark
| | - Christian Mølgaard
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg C, Denmark
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Gajos JM, Beaver KM. The effect of omega-3 fatty acids on aggression: A meta-analysis. Neurosci Biobehav Rev 2016; 69:147-58. [DOI: 10.1016/j.neubiorev.2016.07.017] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 06/09/2016] [Accepted: 07/18/2016] [Indexed: 10/21/2022]
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Tan ML, Ho JJ, Teh KH. Polyunsaturated fatty acids (PUFAs) for children with specific learning disorders. Cochrane Database Syst Rev 2016; 9:CD009398. [PMID: 27678554 PMCID: PMC6457739 DOI: 10.1002/14651858.cd009398.pub3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND About 5% of school children have a specific learning disorder, defined as unexpected failure to acquire adequate abilities in reading, writing or mathematics that is not a result of reduced intellectual ability, inadequate teaching or social deprivation. Of these events, 80% are reading disorders. Polyunsaturated fatty acids (PUFAs), in particular, omega-3 and omega-6 fatty acids, which normally are abundant in the brain and in the retina, are important for learning. Some children with specific learning disorders have been found to be deficient in these PUFAs, and it is argued that supplementation of PUFAs may help these children improve their learning abilities. OBJECTIVES 1. To assess effects on learning outcomes of supplementation of polyunsaturated fatty acids (PUFAs) for children with specific learning disorders.2. To determine whether adverse effects of supplementation of PUFAs are reported in these children. SEARCH METHODS In November 2015, we searched CENTRAL, Ovid MEDLINE, Embase, PsycINFO, 10 other databases and two trials registers. We also searched the reference lists of relevant articles. SELECTION CRITERIA Randomised controlled trials (RCTs) or quasi-RCTs comparing PUFAs with placebo or no treatment in children younger than 18 years with specific learning disabilities, as diagnosed in accordance with the fifth (or earlier) edition of theDiagnostic and Statistical Manual of Mental Disorders (DSM-5), or the 10th (or earlier) revision of the International Classification of Diseases (ICD-10) or equivalent criteria. We included children with coexisting developmental disorders such as attention deficit hyperactivity disorder (ADHD) or autism. DATA COLLECTION AND ANALYSIS Two review authors (MLT and KHT) independently screened the titles and abstracts of articles identified by the search and eliminated all studies that did not meet the inclusion criteria. We contacted study authors to ask for missing information and clarification, when needed. We used the GRADE approach to assess the quality of evidence. MAIN RESULTS Two small studies involving 116 children, mainly boys between 10 and 18 years of age, met the inclusion criteria. One study was conducted in a school setting, the other at a specialised clinic. Both studies used three months of a combination of omega-3 and omega-6 supplements as the intervention compared with placebo. Although both studies had generally low risk of bias, we judged the risk of reporting bias as unclear in one study, and as high in the other study. In addition, one of the studies was funded by industry and reported active company involvement in the study.None of the studies reported data on the primary outcomes of reading, writing, spelling and mathematics scores, as assessed by standardised tests.Evidence of low quality indicates that supplementation of PUFAs did not increase the risk of gastrointestinal disturbances (risk ratio 1.43, 95% confidence interval 0.25 to 8.15; two studies, 116 children). Investigators reported no other adverse effects.Both studies reported attention deficit hyperactivity disorder (ADHD)-related behaviour outcomes. We were unable to combine the results in a meta-analysis because one study reported findings as a continuous outcome, and the other as a dichotomous outcome. No other secondary outcomes were reported.We excluded one study because it used a cointervention (carnosine), and five other studies because they did not provide a robust diagnosis of a specific learning disorder. We identified one ongoing study and found three studies awaiting classification. AUTHORS' CONCLUSIONS Evidence is insufficient to permit any conclusions about the effect of PUFAs on the learning abilities of children with specific learning disorders. Well-designed RCTs with clearly defined populations of children with specific learning disorders who have been diagnosed by standardised diagnostic criteria are needed.
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Affiliation(s)
- May Loong Tan
- Penang Medical CollegeDepartment of Paediatrics4 Jalan Sepoy LinesGeorgetownPenangMalaysia10450
| | - Jacqueline J Ho
- Penang Medical CollegeDepartment of Paediatrics4 Jalan Sepoy LinesGeorgetownPenangMalaysia10450
| | - Keng Hwang Teh
- Hospital Sultanah BahiyahDepartment of PediatricsKm6, Jalan LanggarAlor SetarKedahMalaysia05460
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van der Wurff ISM, Bakker EC, Hornstra G, Kirschner PA, Gielen M, Godschalk RWL, Kremers S, Zeegers MP, de Groot RHM. Association between prenatal and current exposure to selected LCPUFAs and school performance at age 7. Prostaglandins Leukot Essent Fatty Acids 2016; 108:22-9. [PMID: 27154361 DOI: 10.1016/j.plefa.2016.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 03/04/2016] [Accepted: 03/04/2016] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Long-chain polyunsaturated fatty acids (LCPUFAs) are important for brain functioning and might, thus, influence cognition and school performance. However, research investigating LCPUFAs relationships with school performance is limited. The objective of this study was to determine the association between levels of the LCPUFAs docosahexaenoic acid (DHA), arachidonic acid (AA), eicosapentaenoic acid (EPA) and n-6 docosapentaenoic acid (Osbond acid, ObA) at study entry, 22 weeks of pregnancy, 32 weeks of pregnancy, at partus, in umbilical cord plasma and child's plasma at age 7 and school performance scores at age 7. METHODS Data from the Maastricht Essential Fatty Acid Birth cohort (MEFAB) were used for this study. Fatty acid levels of plasma phospholipids were measured in maternal blood plasma at study entry, 22 weeks of pregnancy, 32 weeks of pregnancy and partus. Childs fatty acid levels of plasma phospholipids were measured a in umbilical cord blood plasma, and in blood plasma of the child at age 7. Scores on national standardised tests for spelling, reading and arithmetic at age 7 were obtained via the school (scores were available for 149, 159 and 155 children, respectively). Associations between LCPUFA levels and school performance scores were analysed with categorical regression analyses with correction for covariates (smoking, maternal education, sex, breastfeeding, maternal intelligence, birth weight and BMI at age 7). RESULTS Significant (p<0.001) associations between DHA level at age 7 and both reading (β=0.158) and spelling (β=0.146) were found. Consistent significant negative associations were observed between all maternal DHA plasma levels and arithmetic scores at age 7 (all p<0.001, all β<-0.019). Additional significant negative associations were observed between maternal LCPUFA plasma levels at study entry and both reading and spelling scores at age 7; these associations were less consistent. CONCLUSION Plasma DHA levels at age 7 were positively associated with reading and spelling scores at age 7. Consistent significant negative associations between maternal plasma DHA levels and arithmetic scores of the child at age 7 were found. Although this is an observational study, which cannot proof causality, the consistent negative associations observed between maternal plasma DHA levels and the arithmetic scores of the children at age 7 calls upon prudence when considering DHA supplementation during pregnancy.
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Affiliation(s)
- I S M van der Wurff
- Faculty of Psychology and Educational Sciences, Welten Institute, Open University of the Netherlands, Heerlen, The Netherlands.
| | - E C Bakker
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - G Hornstra
- Maastricht University (retired) and Nutrisearch, Gronsveld, The Netherlands
| | - P A Kirschner
- Faculty of Psychology and Educational Sciences, Welten Institute, Open University of the Netherlands, Heerlen, The Netherlands
| | - M Gielen
- NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - R W L Godschalk
- NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - S Kremers
- NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - M P Zeegers
- NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands; CAPHRI School for Public Health and Primary Care Maastricht University, Maastricht, The Netherlands
| | - R H M de Groot
- Faculty of Psychology and Educational Sciences, Welten Institute, Open University of the Netherlands, Heerlen, The Netherlands; NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
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Socio-economic differences in cardiometabolic risk markers are mediated by diet and body fatness in 8- to 11-year-old Danish children: a cross-sectional study. Public Health Nutr 2016; 19:2229-39. [PMID: 26926594 DOI: 10.1017/s1368980015003766] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To explore whether socio-economic differences exist in cardiometabolic risk markers in children and whether lifestyle-related factors potentially mediate these differences. DESIGN Cross-sectional study including measurements of fasting blood lipids, glucose, homeostasis model assessment of insulin resistance (HOMA-IR), blood pressure and heart rate. Potential mediators examined were fat mass index (FMI); intakes of fruit, vegetables, dietary fibre and added sugar; whole-blood n-3 long-chain PUFA (LCPUFA) as a biomarker of fish intake; and physical activity and sedentary time. SETTING Nine primary schools in Denmark. SUBJECTS Children aged 8-11 years (n 715). RESULTS Children of parents with the shortest compared with longest education had higher TAG by 0·12 (95 % CI 0·04, 0·21) mmol/l and HOMA-IR by 0·36 (0·10, 0·62), whereas children of parents with a vocational education had higher total cholesterol by 0·14 (0·02, 0·27) mmol/l and LDL cholesterol by 0·14 (0·03, 0·25) mmol/l compared with children of parents with the longest education; all P<0·05. FMI explained 25 % of the difference in TAG, 64 % of the difference in HOMA-IR and 21-29 % of the differences in cholesterols. FMI and whole-blood n-3 LCPUFA combined explained 42 % of the difference in TAG, whereas FMI, whole-blood n-3 LCPUFA and dietary fibre explained 89 % of the difference in HOMA-IR. CONCLUSIONS Socio-economic differences were present in blood lipids and insulin resistance among 8- to 11-year-olds and were mediated by body fatness, whole-blood n-3 LCPUFA and dietary fibre. These lifestyle factors may be targets in public initiatives to reduce socio-economic differences. Confirmation in longitudinal studies and trials is warranted.
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Lassek WD, Gaulin SJC. Linoleic and docosahexaenoic acids in human milk have opposite relationships with cognitive test performance in a sample of 28 countries. Prostaglandins Leukot Essent Fatty Acids 2014; 91:195-201. [PMID: 25172360 DOI: 10.1016/j.plefa.2014.07.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 07/20/2014] [Accepted: 07/30/2014] [Indexed: 01/30/2023]
Abstract
Polyunsaturated fatty acids play critical roles in brain development and function, and their levels in human breast milk closely reflect the long-term diet. The fatty acid contents of human milk samples from 28 countries were used to predict averaged 2009 and 2012 test scores in mathematics, reading, and science from the Program for International Student Assessment. All test scores were positively related to milk docosahexaenoic acid (r=0.48 to 0.55), and negatively related to linoleic acid (r=-0.28 to -0.56). Together, these two human milk fatty acids explained 46% to 48% of the variance in scores, with no improvement in predictive power when socioeconomic variables were added to the regression. The (log) ratio of linoleic to arachidonic acid was negatively related to scores (r=-0.45 to -0.48). Statistical effects were similar for the two sexes. In a separate US sample, estimated dietary linoleic was negatively related to the levels of all long-chain n-3 and n-6 plasma fatty acids. High levels of dietary linoleic may impair cognition by decreasing both docosahexaenoic and arachidonic acids in the brain.
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Affiliation(s)
- W D Lassek
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 Desoto Street, Pittsburgh, PA 15213, United States.
| | - S J C Gaulin
- Department of Anthropology, University of California at Santa Barbara, Santa Barbara, CA 93106-3210, United States
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Omega-3 supplementation during the first 5 years of life and later academic performance: a randomised controlled trial. Eur J Clin Nutr 2014; 69:419-24. [PMID: 25117999 DOI: 10.1038/ejcn.2014.155] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Revised: 06/10/2014] [Accepted: 06/13/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Consumption of oily fish more than once per week has been shown to improve cognitive outcomes in children. However, it is unknown whether similar benefits can be achieved by long-term omega-3 fatty acid supplementation. The objective was to investigate the effect of omega-3 fatty acid supplementation during the first 5 years of life on subsequent academic performance in children by conducting a secondary analysis of the CAPS (Childhood Asthma Prevention Study). SUBJECTS/METHODS A total of 616 infants with a family history of asthma were randomised to receive tuna fish oil (high in long-chain omega-3 fatty acids, active) or Sunola oil (low in omega-3 fatty acids, control) from the time breastfeeding ceased or at the age of 6 months until the age of 5 years. Academic performance was measured by a nationally standardised assessment of literacy and numeracy (National Assessment Program Literacy and Numeracy (NAPLAN)) in school years 3, 5, 7 and 9. Plasma omega-3 fatty acid levels were measured at regular intervals until 8 years of age. Between-group differences in test scores, adjusted for maternal age, birth weight and maternal education, were estimated using mixed-model regression. RESULTS Among 239 children, there were no significant differences in NAPLAN scores between active and control groups. However, at 8 years, the proportion of omega-3 fatty acid in plasma was positively associated with the NAPLAN score (0.13 s.d. unit increase in score per 1% absolute increase in plasma omega-3 fatty acid (95% CI 0.03, 0.23)). CONCLUSIONS Our findings do not support the practice of supplementing omega-3 fatty acids in the diet of young children to improve academic outcomes. Further exploration is needed to understand the association between plasma omega-3 fatty acid levels at 8 years and academic performance.
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Hawkey E, Nigg JT. Omega-3 fatty acid and ADHD: blood level analysis and meta-analytic extension of supplementation trials. Clin Psychol Rev 2014; 34:496-505. [PMID: 25181335 DOI: 10.1016/j.cpr.2014.05.005] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 05/06/2014] [Accepted: 05/18/2014] [Indexed: 11/18/2022]
Abstract
UNLABELLED Interest in the value of omega-3 (n-3) fatty acid supplementation for treatment of ADHD remains high. No prior meta-analysis has examined whether ADHD is associated with alterations in blood lipid levels and meta-analyses of supplementation have reached conflicting conclusions. METHODS We report two new meta-analyses. Study 1 examined blood levels of omega-3 fatty acids in relation to ADHD. Study 2 examined a larger sample of randomized intervention trials than previously reported. RESULTS Study 1 included 9 studies (n=586) and found lower overall blood levels of n-3 in individuals with ADHD versus controls (g=0.42, 95% CI=0.26-0.59; p<.001). Study 2 included 16 studies (n=1408) and found that n-3 supplementation improved ADHD composite symptoms; using the best available rating and reporter (g=0.26, 95% CI=0.15-0.37; p<.001). Supplementation showed reliable effects on hyperactivity by parent and teacher report, but reliable effects for inattention only by parent report. CONCLUSIONS Omega-3 levels are reduced in children with ADHD. Dietary supplementation appears to create modest improvements in symptoms. There is sufficient evidence to consider omega-3 fatty acids as a possible supplement to established therapies. However it remains unclear whether such intervention should be confined to children with below normal blood levels.
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Affiliation(s)
- Elizabeth Hawkey
- Department of Behavioral Neuroscience, School of Medicine, Oregon Health & Science University, Portland, OR, United States
| | - Joel T Nigg
- Department of Behavioral Neuroscience, School of Medicine, Oregon Health & Science University, Portland, OR, United States; Department of Psychiatry, School of Medicine, Oregon Health & Science University, Portland, OR, United States.
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Woo HD, Kim DW, Hong YS, Kim YM, Seo JH, Choe BM, Park JH, Kang JW, Yoo JH, Chueh HW, Lee JH, Kwak MJ, Kim J. Dietary patterns in children with attention deficit/hyperactivity disorder (ADHD). Nutrients 2014; 6:1539-53. [PMID: 24736898 PMCID: PMC4011050 DOI: 10.3390/nu6041539] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 03/17/2014] [Accepted: 03/28/2014] [Indexed: 11/17/2022] Open
Abstract
The role of diet in the behavior of children has been controversial, but the association of several nutritional factors with childhood behavioral disorders has been continually suggested. We conducted a case-control study to identify dietary patterns associated with attention deficit hyperactivity disorder (ADHD). The study included 192 elementary school students aged seven to 12 years. Three non-consecutive 24-h recall (HR) interviews were employed to assess dietary intake, and 32 predefined food groups were considered in a principal components analysis (PCA). PCA identified four major dietary patterns: the "traditional" pattern, the "seaweed-egg" pattern, the "traditional-healthy" pattern, and the "snack" pattern. The traditional-healthy pattern is characterized by a diet low in fat and high in carbohydrates as well as high intakes of fatty acids and minerals. The multivariate-adjusted odds ratio (OR) of ADHD for the highest tertile of the traditional-healthy pattern in comparison with the lowest tertile was 0.31 (95% CI: 0.12-0.79). The score of the snack pattern was positively associated with the risk of ADHD, but a significant association was observed only in the second tertile. A significant association between ADHD and the dietary pattern score was not found for the other two dietary patterns. In conclusion, the traditional-healthy dietary pattern was associated with lower odds having ADHD.
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Affiliation(s)
- Hae Dong Woo
- Molecular Epidemiology Branch, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Korea.
| | - Dong Woo Kim
- Molecular Epidemiology Branch, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Korea.
| | - Young-Seoub Hong
- Department of Preventive Medicine, College of Medicine, Dong-A University, Dong-A University Hospital, 26, Daesingongwon-ro, Seo-gu, Busan 602-715, Korea.
| | - Yu-Mi Kim
- Department of Preventive Medicine, College of Medicine, Dong-A University, Dong-A University Hospital, 26, Daesingongwon-ro, Seo-gu, Busan 602-715, Korea.
| | - Ju-Hee Seo
- Heavy Metal Exposure Environmental Health Center, Dong-A University, 32, Daesingongwon-ro, Seo-gu, Busan 602-714, Korea.
| | - Byeong Moo Choe
- Department of Psychiatry, College of Medicine, Dong-A University, Dong-A University Hospital, 26 Daesingongwon-ro, Seo-gu, Busan 602-715, Korea.
| | - Jae Hong Park
- Department of Psychiatry, College of Medicine, Dong-A University, Dong-A University Hospital, 26 Daesingongwon-ro, Seo-gu, Busan 602-715, Korea.
| | - Je-Wook Kang
- Department of Child and Adolescent Psychiatry, College of Medicine, Inje University Busan Paik Hospital, 75 Bokji-ro, Busanjin-gu, Busan 614-735, Korea.
| | - Jae-Ho Yoo
- Department of Pediatrics, College of Medicine, Dong-A University, Dong-A University Hospital, 26 Daesingongwon-ro, Seo-gu, Busan 602-715, Korea.
| | - Hee Won Chueh
- Department of Pediatrics, College of Medicine, Dong-A University, Dong-A University Hospital, 26 Daesingongwon-ro, Seo-gu, Busan 602-715, Korea.
| | - Jung Hyun Lee
- Department of Pediatrics, Kosin University Gospel Hospital, 262, Gamcheon-ro, Seo-gu, Busan 602-702, Korea.
| | - Min Jung Kwak
- Department of Pediatrics, Pusan National University Hospital, Pusan National University School of Medicine, 179, Gudeok-ro, Seo-gu, Busan 602-739, Korea.
| | - Jeongseon Kim
- Molecular Epidemiology Branch, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Korea.
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Sheppard KW, Cheatham CL. Omega-6 to omega-3 fatty acid ratio and higher-order cognitive functions in 7- to 9-y-olds: a cross-sectional study. Am J Clin Nutr 2013; 98:659-67. [PMID: 23824723 DOI: 10.3945/ajcn.113.058719] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Biochemical and behavioral evidence has suggested that the ratio of n-6 (omega-6) to n-3 (omega-3) could be an important predictor of executive function abilities in children. OBJECTIVE We determined the relation between the ratio of n-6 to n-3 and cognitive function in children. We hypothesized that children with lower ratios of n-6 to n-3 fatty acids would perform better on tests of planning and working memory. DESIGN Seventy 7- to 9-y-old children completed three 24-h diet recalls and a subset of the Cambridge Neuropsychological Test Assessment Battery. Parents provided information on their demographics and children's diet histories. RESULTS Mean n-3 and mean n-6 intakes were related to the mean time spent on each action taken in the planning problem. The ratio of n-6 to n-3 significantly predicted performance on the working memory and planning problems. There was a significant interaction between the ratio and fatty acid intake; when children had high ratios, a higher intake of n-3 fatty acids predicted a better performance on the planning task than when children had lower n-3 intakes. When children had low ratios, a lower intake of n-3 and lower intake of n-6 predicted better performance than when intakes were higher. CONCLUSIONS The relation between cognitive abilities and the ratio of n-6 to n-3 may be mediated by an enzymatic affinity for n-3 fatty acids. The ratio of n-6 to n-3 should be considered an important factor in the study of fatty acids and cognitive development. This trial was registered at clinicaltrials.gov as NCT01823419.
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Affiliation(s)
- Kelly W Sheppard
- Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Kuratko CN, Barrett EC, Nelson EB, Norman S. The relationship of docosahexaenoic acid (DHA) with learning and behavior in healthy children: a review. Nutrients 2013; 5:2777-810. [PMID: 23877090 PMCID: PMC3738999 DOI: 10.3390/nu5072777] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 06/04/2013] [Accepted: 06/08/2013] [Indexed: 12/13/2022] Open
Abstract
Childhood is a period of brain growth and maturation. The long chain omega-3 fatty acid, docosahexaenoic acid (DHA), is a major lipid in the brain recognized as essential for normal brain function. In animals, low brain DHA results in impaired learning and behavior. In infants, DHA is important for optimal visual and cognitive development. The usual intake of DHA among toddlers and children is low and some studies show improvements in cognition and behavior as the result of supplementation with polyunsaturated fatty acids including DHA. The purpose of this review was to identify and evaluate current knowledge regarding the relationship of DHA with measures of learning and behavior in healthy school-age children. A systematic search of the literature identified 15 relevant publications for review. The search found studies which were diverse in purpose and design and without consistent conclusions regarding the treatment effect of DHA intake or biomarker status on specific cognitive tests. However, studies of brain activity reported benefits of DHA supplementation and over half of the studies reported a favorable role for DHA or long chain omega-3 fatty acids in at least one area of cognition or behavior. Studies also suggested an important role for DHA in school performance.
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Affiliation(s)
- Connye N. Kuratko
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-443-542-2552; Fax: +1-410-740-2985
| | - Erin Cernkovich Barrett
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-443-542-2552; Fax: +1-410-740-2985
| | - Edward B. Nelson
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-443-542-2552; Fax: +1-410-740-2985
| | - Salem Norman
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-443-542-2552; Fax: +1-410-740-2985
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19
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Karr JE, Alexander JE, Winningham RG. Omega-3 polyunsaturated fatty acids and cognition throughout the lifespan: A review. Nutr Neurosci 2013; 14:216-25. [DOI: 10.1179/1476830511y.0000000012] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Irmisch G, Richter J, Thome J, Sheldrick AJ, Wandschneider R. Altered serum mono- and polyunsaturated fatty acid levels in adults with ADHD. ACTA ACUST UNITED AC 2013; 5:303-11. [PMID: 23564274 DOI: 10.1007/s12402-013-0107-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 03/21/2013] [Indexed: 01/29/2023]
Abstract
Other than in children diagnosed with attention deficit hyperactivity disorder (ADHD), the connection between ADHD and lipids has not been sufficiently investigated so far in adults. Blood serum lipoproteins and fatty acids (FA) composition were measured and analyzed by colorimetry and gaschromatography in eight male and seven female adults diagnosed with ADHD as well as in 15 age- and gender-matched healthy control subjects. In ADHD patients, polyunsaturated FAs [docosahexaenoic, arachidonic and dihomogammalinolenic acid (p = 0.048; 0.003; 0.012)] showed lower concentrations, while monounsaturated acids (palmitoleic and oleic acid) as well as total and LDL cholesterol showed higher concentrations (p = 0.011; 0.005). ADHD scores positively correlated with palmitoleic (R = -0.56; p = 0.032), stearic (R = 0.53; p = 0.044), eicosapentaenoic (R = 0.62; p = 0.014), docosahexaenoic (R = 0.51; p = 0.050), gammalinolenic (R = 0.62; p = 0.018) and alphalinolenic acid (R = 0.56; p = 0.031) concentration. Even though the total and LDL cholesterol concentrations in blood serum were significantly higher among the ADHD patients than in controls, none of the ADHD symptom scores were significantly associated with any of the lipoproteine measures. We could demonstrate that a lack of polyunsaturated FAs in blood serum of subjects with ADHD persists into adulthood. Furthermore, we could show that adult ADHD symptomatology positively correlates with elevated levels of saturated stearic and monounsaturated FAs.
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Affiliation(s)
- G Irmisch
- Department of Psychiatry and Psychotheraphy, University of Rostock, Gehlsheimer Str.20, 18147 Rostock, Germany
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Tan ML, Ho JJ, Teh KH. Polyunsaturated fatty acids (PUFAs) for children with specific learning disorders. Cochrane Database Syst Rev 2012; 12:CD009398. [PMID: 23235675 DOI: 10.1002/14651858.cd009398.pub2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND About 5% of schoolchildren have a specific learning disorder, defined as an unexpected failure to acquire adequate abilities in reading, writing or mathematic skills not as a result of reduced intellectual ability, inadequate teaching or social deprivation. Of these, 80% are reading disorders. Polyunsaturated fatty acids (PUFAs), in particular omega-3 and omega-6 fatty acids, which are found abundantly in the brain and retina are important for learning. Some children with specific learning disorders have been found to be deficient in these PUFAs, and it is argued that supplementation of PUFAs may help these children improve their learning abilities. OBJECTIVES To assess the effects of polyunsaturated fatty acids (PUFAs) supplementation for children with specific learning disorders, on learning outcomes. SEARCH METHODS We searched the following databases in April 2012: CENTRAL (2012, Issue 4), MEDLINE (1948 to April Week 2 2012), EMBASE (1980 to 2012 Week 16), PsycINFO (1806 to April 2012), ERIC (1966 to April 2012), Science Citation Index (1970 to 20 April 2012), Social Science Citation Index (1970 to 20 April 2012), Conference Proceedings Citation Index-Science (1970 to 20 April 2012), Conference Proceedings Citation Index-Social Sciences and Humanites (1970 to 20 April 2012), Cochrane Database of Systematic Reviews (2012, Issue 4), DARE (2012, Issue 2) , ZETOC (24 April 2012) and WorldCat (24 April 2012). We searched the WHO International Clinical Trials Registry Platform and ClinicalTrials.gov on 24 April 2012. We also searched the reference lists of relevant articles identified by the searches. SELECTION CRITERIA Randomised or quasi-randomised controlled trials comparing polyunsaturated fatty acids (PUFAs) with placebo or no treatment in children aged below 18 years with specific learning disabilities diagnosed using DSM-IV, ICD-10 or equivalent criteria. We intended to include participants with co-existing developmental disorders such as attention deficit hyperactivity disorder (ADHD) or autism. DATA COLLECTION AND ANALYSIS Two authors (ML and KH) independently screened the titles and abstracts of the search results and eliminated all studies that did not meet the inclusion criteria. Authors were contacted for missing information and clarifications when needed. MAIN RESULTS We did not find any studies suitable for inclusion in the review. One study is awaiting classification as we were unable to get any information from the study author. AUTHORS' CONCLUSIONS There is insufficient evidence to draw any conclusion about the use of PUFAs for children with specific learning disorders. There is a need for well designed randomised studies to support or refute the use of PUFAs in this group of children.
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Affiliation(s)
- May Loong Tan
- Department of Paediatrics, Penang Medical College, Penang, Malaysia.
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Siponen SM, Ahonen RS, Kettis A, Hämeen-Anttila KP. Complementary or alternative? Patterns of complementary and alternative medicine (CAM) use among Finnish children. Eur J Clin Pharmacol 2012; 68:1639-45. [PMID: 22573133 DOI: 10.1007/s00228-012-1294-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Accepted: 04/13/2012] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this study was to measure patterns of complementary and alternative medicine (CAM) use among Finnish children and to explore whether CAM use among children is mainly complementary or alternative. METHODS We carried out a cross-sectional population-based survey in spring 2007. The study population consisted of a representative sample (n = 6,000) of Finnish children under 12 years of age. A questionnaire was sent to their parents, and 4,032 questionnaires were returned (response rate 67 %). Pearson's chi-square test and logistic regression analysis were conducted to measure factors associated with CAM use. RESULTS The prevalence of CAM use among children was 11 %. Fish oils and fatty acids (6 %) followed by probiotics (4 %) were the most commonly reported CAMs used. Being the first born, using vitamins and having at least one symptom predicted the use of CAMs. Parental use of vitamins and CAMs were also associated with CAM use among children. In the preceding 2 days, 3 % of children in the study had used only CAMs, and 7 % had used a CAM concomitantly with prescribed and/or over-the-counter medicines. CONCLUSIONS Our results indicate that the use of CAMs among Finnish children is mainly for improving health and alleviating symptoms, especially in families where at least one parent also uses these modalities. CAMs were mainly used as complementary rather than as an alternative to conventional care. Healthcare professionals should be aware of this complementary use of CAMs and medicines in patients to avoid risks of potential interactions.
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Affiliation(s)
- Sanna M Siponen
- School of Pharmacy/Social Pharmacy, University of Eastern Finland, P.O Box 1627, 70211, Kuopio, Finland.
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Kohlboeck G, Glaser C, Tiesler C, Demmelmair H, Standl M, Romanos M, Koletzko B, Lehmann I, Heinrich J. Effect of fatty acid status in cord blood serum on children's behavioral difficulties at 10 y of age: results from the LISAplus Study. Am J Clin Nutr 2011; 94:1592-9. [PMID: 22071708 DOI: 10.3945/ajcn.111.015800] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Little is known about the effect of fatty acid (FA) concentrations in cord blood on long-term behavioral outcomes. OBJECTIVE We assessed the effect of FAs in cord blood serum on children's behavioral difficulties at the age of 10 y. DESIGN A longitudinal study of 416 children from the population-based Influences of Lifestyle-Related Factors on the Immune System and the Development of Allergies in Childhood (LISAplus) birth cohort from Munich was conducted. Individual glycerophospholipid FAs in blood were analyzed in venous cord blood. Data on children's behavior were collected with a parent-reported Strength and Difficulties Questionnaire at 10 y of age. Zero-inflated Poisson regression models were applied and adjusted for sex, parental income, smoking during pregnancy, and dietary intake of arachidonic acid (AA) and DHA at 10 y. RESULTS A 1% increase in DHA in cord blood serum was found to decrease total difficulties by (exp)β(adj) = 0.93 (SE = 0.02, P < 0.0001) and hyperactivity or inattention by (exp)β(adj) = 0.94 (SE = 0.03, P < 0.04). Higher long-chain (LC) PUFA concentrations in cord blood serum were associated with fewer emotional symptoms [(exp)β(adj) = 0.95, SE = 0.03, P = 0.01], and similarly higher AA concentrations were associated with fewer emotional symptoms [(exp)β(adj) = 0.94, SE = 0.03, P = 0.03]. CONCLUSION Increased concentrations of DHA, LC-PUFAs, and AA in cord blood serum were associated with lower scores on a parent-completed behavioral screen. An appropriate FA supply to the developing fetus may be essential for optimal long-term behavioral outcomes in children.
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Affiliation(s)
- Gabriele Kohlboeck
- Helmholtz Zentrum Muenchen, German Research Center for Environmental Health, Institute of Epidemiology I, Neuherberg, Germany.
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Lassek WD, Gaulin SJC. Sex differences in the relationship of dietary Fatty acids to cognitive measures in american children. FRONTIERS IN EVOLUTIONARY NEUROSCIENCE 2011; 3:5. [PMID: 22065957 PMCID: PMC3206402 DOI: 10.3389/fnevo.2011.00005] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/15/2011] [Accepted: 10/14/2011] [Indexed: 11/16/2022]
Abstract
Because the first neurons evolved in an environment high in the n−3 (omega-3) fatty acid docosahexaenoic acid (DHA), this fatty acid became a major component of neural structure and function and makes up 10% of the dry weight of the human brain. Since n−3 fatty acids must come from the diet, this suggests a possible positive role for dietary n−3 fatty acids in cognition and a possible negative role for n−6 fatty acids, which compete with n−3 for access to critical enzymes. Because human females must provide DHA for the growth of the unusually large brains of their offspring from maternal fat stored during childhood, their need for DHA is especially great. We used stepwise regression to determine whether particular dietary fatty acids and other nutrients were related to cognitive performance in over 4000 American children aged 6–16 from the Third National Health and Nutrition Examination Survey; a variety of possible biological, social, and environmental risk factors were statistically controlled. In this context the only dietary factors related to cognitive performance were n−3 and n−6 fatty acids. Dietary n−3 fatty acids were positively related to cognitive test scores in male and female children, while n−6 showed the reverse relationship, significantly so in females. In female children the positive effects of n−3 intake were twice as strong as in males and exceeded the negative effects of lead exposure. This suggests that increasing dietary intake of n−3 and decreasing n−6 fatty acids may have cognitive benefits in children, especially in females.
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Affiliation(s)
- William D Lassek
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh Pittsburgh, PA, USA
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Froehlich TE, Anixt JS, Loe IM, Chirdkiatgumchai V, Kuan L, Gilman RC. Update on environmental risk factors for attention-deficit/hyperactivity disorder. Curr Psychiatry Rep 2011; 13:333-44. [PMID: 21779823 PMCID: PMC3277258 DOI: 10.1007/s11920-011-0221-3] [Citation(s) in RCA: 127] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurobehavioral disorder affecting 5% to 10% of children. Although considered to be a highly familial disorder, ADHD heritability estimates of 60% to 80% highlight the considerable role that environmental factors may still play in disorder susceptibility. Proposed ADHD environmental risk factors include prenatal substance exposures, heavy metal and chemical exposures, nutritional factors, and lifestyle/psychosocial factors. This paper reviews the literature published in 2010 investigating the association between environmental risk factors and ADHD or related symptomatology. Sources of risk factor exposure and the proposed mechanism by which each exposure is linked to ADHD-related neurobehavioral changes are also reported. Methodologic limitations of the current literature are discussed, and guidelines for future study are proposed. An improved understanding of the role that environmental factors play in ADHD etiology is critical to future ADHD prevention efforts.
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Affiliation(s)
- Tanya E. Froehlich
- Cincinnati Children’s Hospital, 3333 Burnet Avenue, MLC 4002, Cincinnati, OH 45229, USA
| | - Julia S. Anixt
- Cincinnati Children’s Hospital, 3333 Burnet Avenue, MLC 4002, Cincinnati, OH 45229, USA
| | - Irene M. Loe
- Stanford University School of Medicine, 750 Welch Road, Suite 315, Palo Alto, CA 94304, USA
| | | | - Lisa Kuan
- Cincinnati Children’s Hospital, 3333 Burnet Avenue, MLC 4002, Cincinnati, OH 45229, USA
| | - Richard C. Gilman
- Cincinnati Children’s Hospital, 3333 Burnet Avenue, MLC 4002, Cincinnati, OH 45229, USA
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Irmisch G, Thome J, Reis O, Hässler F, Weirich S. Modified magnesium and lipoproteins in children with attention deficit hyperactivity disorder (ADHD). World J Biol Psychiatry 2011; 12 Suppl 1:63-5. [PMID: 21812620 DOI: 10.3109/15622975.2011.600292] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Polyunsaturated fatty acids (PUFAs) have shown to be helpful in the therapy of ADHD. Various stabilizing co-factors may contribute to this effect, as like magnesium (Mg). Mg supports fatty acid enzyme activity and is essential for the neuronal activity. However, the way of Mg to influence psychic processes, particularly in ADHS, is not yet known precisely. Therefore, in this study the concentrations of further lipid parameters were assessed. We intended to prove, if there is a lack of Mg and someone different lipoprotein concentration in ADHD patients compared to controls. METHODS In nine boys with ADHD (8.2 ± 0.6 years) and 11 controls (7.9 ± 0.87 years), blood serum Mg, total cholesterol, triglycerides, Lipoprotein Lipase, total Phospholipids, Apolipoproteins a and b, HDL- and LDL-cholesterol were measured, under two different stressful conditions. RESULTS In ADHD, Mg and HDL concentrations were significantly higher and Apob lower than in controls. CONCLUSIONS Contrary to our supposition, in ADHD was no lack, but an excess of Mg. HDL was hightened and Apob lowered. Lipoprotein metabolism seems to be modified in ADHD.
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Affiliation(s)
- Gisela Irmisch
- Department of Psychiatry and Psychotherapy, Rostock University, Rostock, Germany.
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Parr JW. Attention-Deficit Hyperactivity Disorder and the Athlete: New Advances and Understanding. Clin Sports Med 2011; 30:591-610. [DOI: 10.1016/j.csm.2011.03.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Fish Oil Supplementation During Lactation: Effects on Cognition and Behavior at 7 Years of Age. Lipids 2011; 46:637-45. [DOI: 10.1007/s11745-011-3557-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2011] [Accepted: 03/23/2011] [Indexed: 10/18/2022]
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