Background
Early childhood is a period of rapid brain development, with increases in synapses rich in the omega-3 fatty acid, docosahexaenoic acid (22:6ω3, DHA) continuing well beyond infancy. Despite the importance of DHA to neural phospholipids, requirement of dietary DHA for neurodevelopment remains unclear.
Objective
To assess the dietary DHA and DHA status of young children, and determine the association with cognitive performance.
Methods
This was a cross-sectional study of healthy children (5–6 y), some of whom were enrolled in a follow up of a clinical trial (NCT00620672). Dietary intake data (n = 285) was assessed with a food frequency questionnaire (FFQ) and three 24-h recalls. Family characteristics were collected by questionnaire, and anthropometric data measured. Venous blood was collected, cognitive performance assessed using several age-appropriate tools including the Kaufman Assessment Battery for Children. Relationship between dietary DHA, red blood cell (RBC) DHA and child neurodevelopment test scores was determined using Pearson's correlation or Spearman's Rho, and quintiles of test scores compared by Mann-Whitney U-test.
Results
Child DHA intakes were highly variable, with a stronger association between RBC DHA and DHA intake assessed by FFQ (rho = 0.383, P < 0.001) compared to one or three 24-h recalls. Observed ethnic differences in DHA intake, status as well as neurodevelopmental test scores led to analysis of the association between DHA intake and status with neurodevelopment test scores for Caucasian children only (n = 190). Child RBC DHA status was associated with neurodevelopment test scores, including language (rho = 0.211, P = 0.009) and short-term memory (rho = 0.187, P = 0.019), but only short-term memory was associated with dietary DHA (rho = 0.221, P = 0.003).
Conclusions
Child RBC DHA but not dietary DHA was associated with multiple tests of cognitive performance. In addition, DHA intake was only moderately associated to RBC DHA, raising complex questions on the relationship between diet, DHA transfer to membrane lipids, and neural function.
Summary
In children 5–6y red blood cell (RBC) docosahexanoic acid (DHA), but not dietary intake of DHA is associated with multiple tests of cognitive performance, emphasizing complexity of DHA metabolism.