title: The effects of docosahexaenoic acid-rich fish oil on behavior, school attendance rate and malaria infection in school children--a double-blind, randomized, placebo-controlled trial in Lampung, Indonesia.
abstract: BACKGROUND
  There are only a very limited number of reports of intervention studies on the effects of fish oil on behavior in normal school children.
  
  
  OBJECTIVE
  To observe the effects of fish oil on behavior and school attendance rates in school children.
  
  
  METHODS
  Fourth to sixth graders (mostly 9-12 years of age) of an elementary school in Lampung Province, Indonesia, were randomly divided into either a docosahexaenoic acid (DHA) group (n=116) or a control group (n=117) in a double-blind manner. The subjects in the DHA group took 6 fish oil capsules per day (0.65 g DHA and 0.10 g eicosapentaenoic acid (EPA)/day) for 3 months. Controls took soybean oil capsules. Two questionnaires were administered and blood was taken at the start and end of the study. Two questionnaires were administered at the start and end of the study: Hostility-Aggression Questionnaire for Children (HAQ-C) and Barratt Impulsiveness Scale, version 11 (BIS-11), for measurement of aggression and impulsivity, respectively. Attendance was recorded during the study period.
  
  
  RESULTS
  The concentrations of DHA and EPA in the phospholipid fraction in red blood cells were significantly increased in the DHA group. Behavior checked with HAQ-C or BIS-11 did not show any differences between groups. However, the odds ratio of inability to attend school regularly during the study period was 0.40 (95%CI: 0.23-0.71) in the DHA group compared with controls (p=0.002).
  
  
  CONCLUSIONS
  DHA-rich fish oil may improve the school attendance rate of children in Lampung, Indonesia.
authors.affiliation: Division of Clinical Application, Department of Clinical Sciences, Institute of Natural Medicine, University of Toyama, 2630 Sugitani, Toyama-City, Toyama 930-0194, Japan. keihama@inm.u-toyama.ac.jp
authors.forename: Kei
authors.initials: K
authors.lastname: Hamazaki
authors.forename: Din
authors.initials: D
authors.lastname: Syafruddin
authors.forename: Insan S
authors.initials: IS
authors.lastname: Tunru
authors.forename: Marina F
authors.initials: MF
authors.lastname: Azwir
authors.forename: Puji B S
authors.initials: PB
authors.lastname: Asih
authors.forename: Shigeki
authors.initials: S
authors.lastname: Sawazaki
authors.forename: Tomohito
authors.initials: T
authors.lastname: Hamazaki
mesh_terms: D002648:Child; D002652:Child Behavior / Q000187:drug effects* / Q000502:physiology; D004281:Docosahexaenoic Acids / Q000494:pharmacology*; D004311:Double-Blind Method; D015118:Eicosapentaenoic Acid / Q000494:pharmacology; D004912:Erythrocytes / Q000737:chemistry; D015525:Fatty Acids, Omega-3 / Q000494:pharmacology*; D005260:Female; D005395:Fish Oils; D006801:Humans; D007214:Indonesia; D008288:Malaria / Q000517:prevention & control*; D008297:Male; D016017:Odds Ratio; D010743:Phospholipids; D012574:Schools / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
chemical_list: D015525:Fatty Acids, Omega-3; D005395:Fish Oils; D010743:Phospholipids; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid