title: Cognitive function in 18-month-old term infants of the DIAMOND study: a randomized, controlled clinical trial with multiple dietary levels of docosahexaenoic acid.
abstract: BACKGROUND
  Studies investigating cognitive outcomes following docosahexaenoic acid (DHA) supplementation of infant formula yield conflicting results, perhaps due to inadequate dietary concentrations.
  
  
  OBJECTIVE
  To determine the optimal DHA concentration in term formula to support cognitive maturation.
  
  
  METHODS
  This was a double-masked, randomized, controlled, prospective trial. A total of 181 infants were enrolled at 1-9 days of age and assigned randomly to receive one of four term infant formulas with one of four levels of docosahexaenoic acid: Control (0% DHA), 0.32% DHA, 0.64% DHA, or 0.96% DHA. All DHA-supplemented formulas contained 0.64% arachidonic acid (ARA). Infants were fed the assigned formulas until 12 months of age. One hundred forty-one children completed the 12-month feeding trial and were eligible for this study. Cognitive function was assessed in 131 children at 18 months of age using the Bayley Scales of Infant Development II (BSID II).
  
  
  RESULTS
  There were no diet group differences on the Mental Development Index (MDI), the Psychomotor Development Index (PDI), or the Behavior Rating Scale (BRS) of the BSID II. However, when the scores of children who received any of the three DHA-supplemented formulas were combined and compared to control children, a significant difference emerged: the MDI scores of DHA-supplemented children were higher (104.1 v. 98.4; p=0.02).
  
  
  CONCLUSIONS
  These results suggest that dietary supplementation of DHA during the first year of life leads to enhanced cognitive development at 18 months of age. DHA concentration of 0.32% is adequate to improve cognitive function; higher concentrations did not confer additional benefit.
authors.affiliation: Memorial University of Newfoundland, St. John's, NL, Canada. jrdrover@mun.ca
authors.forename: James R
authors.initials: JR
authors.lastname: Drover
authors.forename: Dennis R
authors.initials: DR
authors.lastname: Hoffman
authors.forename: Yolanda S
authors.initials: YS
authors.lastname: Castañeda
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Morale
authors.forename: Sharon
authors.initials: S
authors.lastname: Garfield
authors.forename: Dianna H
authors.initials: DH
authors.lastname: Wheaton
authors.forename: Eileen E
authors.initials: EE
authors.lastname: Birch
mesh_terms: D002657:Child Development / Q000187:drug effects / Q000502:physiology*; D003071:Cognition / Q000187:drug effects / Q000502:physiology*; D004042:Dietary Fats, Unsaturated / Q000008:administration & dosage*; D004281:Docosahexaenoic Acids / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007223:Infant; D041943:Infant Formula / Q000008:administration & dosage* / Q000737:chemistry; D007227:Infant Nutritional Physiological Phenomena / Q000187:drug effects*; D008297:Male; D011446:Prospective Studies; D018709:Statistics, Nonparametric
chemical_list: D004042:Dietary Fats, Unsaturated; D004281:Docosahexaenoic Acids