title: Omega-3 supplementation during the first 5 years of life and later academic performance: a randomised controlled trial.
abstract: OBJECTIVE
  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).
  
  
  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.
authors.affiliation: Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia.
authors.forename: B K
authors.initials: BK
authors.lastname: Brew
authors.affiliation: 1] Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia [2] Sydney Local Health District, Sydney, NSW, Australia.
authors.forename: B G
authors.initials: BG
authors.lastname: Toelle
authors.affiliation: Center for Weight and Health, College of Natural Resources and School of Public Health, University of California, Berkeley, CA, USA.
authors.forename: K L
authors.initials: KL
authors.lastname: Webb
authors.affiliation: 1] Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden [2] Astrid Lindgren Children's Hospital, Lung and Allergy Unit, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Almqvist
authors.affiliation: Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia.
authors.forename: G B
authors.initials: GB
authors.lastname: Marks
mesh_terms: D001724:Birth Weight; D001942:Breast Feeding; D002648:Child; D002675:Child, Preschool; D003071:Cognition / Q000187:drug effects; D004032:Diet; D019587:Dietary Supplements; D004521:Educational Measurement; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage* / Q000097:blood*; D005260:Female; D005395:Fish Oils / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007858:Learning; D008297:Male; D015596:Nutrition Assessment; D010349:Patient Compliance; D012959:Socioeconomic Factors; D016896:Treatment Outcome
chemical_list: D015525:Fatty Acids, Omega-3; D005395:Fish Oils