title: Effect of a 12-mo micronutrient intervention on learning and memory in well-nourished and marginally nourished school-aged children: 2 parallel, randomized, placebo-controlled studies in Australia and Indonesia.
abstract: BACKGROUND
  Little is known about the combined effect of micronutrients and essential fatty acids on cognitive function in school-aged children.
  
  
  OBJECTIVE
  We assessed the effect of micronutrients, long-chain n-3 fatty acids, or both on indicators of cognitive performance in well-nourished and marginally nourished school-aged children.
  
  
  METHODS
  Two 2-by-2 factorial randomized controlled double-blind trials were performed home-based in Adelaide, South Australia, and at 6 primary schools in Jakarta, Indonesia. A total of 396 children (aged 6-10 y) in Australia and 384 children in Indonesia were randomly allocated to receive a drink with a micronutrient mix (iron, zinc, folate, and vitamins A, B-6, B-12, and C), with docosahexanoic acid (DHA, 88 mg/d) and eicosapentaenoic acid (EPA, 22 mg/d), or with both or placebo 6 d/wk for 12 mo. Biochemical indicators were determined at baseline and 12 mo. Cognitive performance was measured at baseline, 6 mo, and 12 mo.
  
  
  RESULTS
  The micronutrient treatment significantly improved plasma micronutrient concentrations in Australian and Indonesian children. DHA+EPA treatment increased plasma DHA and total plasma n-3 fatty acids in both countries. The micronutrient treatment resulted in significant increases in scores on tests representing verbal learning and memory in Australia (estimated effect size: 0.23; 95% CI: 0.01, 0.46). A similar effect was observed among Indonesian girls (estimated effect size: 0.32; 95% CI: -0.01, 0.64). No effects were found on tests measuring general intelligence or attention. No effects of DHA+EPA on the factors of cognitive tests were observed.
  
  
  CONCLUSIONS
  In well-nourished school-aged children, fortification with multiple micronutrients can result in improvements in verbal learning and memory.
authors.affiliation: Unilever Food and Health Research Institute (UFHRI), Unilever R&D, Olivier van Noortlaan 120, 3133 AT Vlaardingen, Netherlands. saskia.osendarp@unilever.com
authors.forename: Saskia J M
authors.initials: SJ
authors.lastname: Osendarp
authors.forename: Katrine I
authors.initials: KI
authors.lastname: Baghurst
authors.forename: Janet
authors.initials: J
authors.lastname: Bryan
authors.forename: Eva
authors.initials: E
authors.lastname: Calvaresi
authors.forename: Donna
authors.initials: D
authors.lastname: Hughes
authors.forename: Mahdin
authors.initials: M
authors.lastname: Hussaini
authors.forename: Saskia J M
authors.initials: SJ
authors.lastname: Karyadi
authors.forename: B Jan-Willem
authors.initials: BJ
authors.lastname: van Klinken
authors.forename: Henk C M
authors.initials: HC
authors.lastname: van der Knaap
authors.forename: Widjaja
authors.initials: W
authors.lastname: Lukito
authors.forename: Widjaja
authors.initials: W
authors.lastname: Mikarsa
authors.forename: Catherine
authors.initials: C
authors.lastname: Transler
authors.forename: Carlene
authors.initials: C
authors.lastname: Wilson
mesh_terms: D001288:Attention / Q000187:drug effects; D001315:Australia; D002648:Child; D002664:Child Nutritional Physiological Phenomena / Q000187:drug effects / Q000502:physiology; D004311:Double-Blind Method; D005228:Fatty Acids, Essential / Q000008:administration & dosage / Q000378:metabolism; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage* / Q000378:metabolism; D005260:Female; D005527:Food, Fortified; D006304:Health Status; D006801:Humans; D007214:Indonesia; D007360:Intelligence / Q000187:drug effects; D007858:Learning / Q000187:drug effects*; D008297:Male; D008568:Memory / Q000187:drug effects*; D011939:Mental Recall / Q000187:drug effects; D018977:Micronutrients / Q000008:administration & dosage* / Q000378:metabolism; D009752:Nutritional Status; D016896:Treatment Outcome
chemical_list: D005228:Fatty Acids, Essential; D015525:Fatty Acids, Omega-3; D018977:Micronutrients