title: Reduction of the n-6:n-3 long-chain PUFA ratio during pregnancy and lactation on offspring body composition: follow-up results from a randomized controlled trial up to 5 y of age.
abstract: BACKGROUND
  It has been hypothesized that the n-6:n-3 (ω-6:ω-3) long-chain polyunsaturated fatty acid (LCPUFA) ratio in the maternal diet during the prenatal and early postnatal phase positively affects the body composition of the offspring. However, only limited data from prospective human intervention studies with long-term follow-up are available.
  
  
  OBJECTIVE
  We assessed the long-term effects of a reduced n-6:n-3 LCPUFA ratio in the diets of pregnant and lactating women [1020 mg docosahexaenoic acid (DHA) plus 180 mg eicosapentaenoic acid (EPA)/d together with an arachidonic acid-balanced diet compared with a control diet] on the body weights and compositions of their offspring from 2 to 5 y of age with a focus on the 5-y results.
  
  
  METHODS
  Participants in the randomized controlled trial received follow-up assessments with annual body-composition measurements including skinfold thickness (SFT) measurements (primary outcome), a sonographic assessment of abdominal subcutaneous and preperitoneal fat, and child growth. In addition, abdominal MRI was performed in a subgroup of 5-y-old children. For the statistical analysis, mixed models for repeated measures (MMRMs) were fit with the use of data from each visit since birth (except for MRI).
  
  
  RESULTS
  Maternal LCPUFA supplementation did not significantly influence the children's sum of 4 SFTs [means ± SDs at 5 y of age: intervention, 23.9 ± 4.7 mm (n = 57); control, 24.5 ± 5.0 mm (n = 55); adjusted mean difference, -0.5 (95% CI: -2.2, 1.2)], growth, or ultrasonography measures at any time point in the adjusted MMRM model (all P values < 0.05). Results were consistent with abdominal MRI measurements (n = 44) at 5 y of age, which showed no significant differences in subcutaneous and visceral adipose tissue volumes and ratios.
  
  
  CONCLUSIONS
  The current study provides no evidence that a dietary reduction of the n-6:n-3 LCPUFA ratio in the maternal diet during pregnancy and lactation is a useful early preventive strategy against obesity at preschool age. This trial was registered at clinicaltrials.gov as NCT00362089.
authors.affiliation: Else Kröner-Fresenius-Center for Nutritional Medicine.
authors.forename: Christina
authors.initials: C
authors.lastname: Brei
authors.affiliation: Else Kröner-Fresenius-Center for Nutritional Medicine.
authors.forename: Lynne
authors.initials: L
authors.lastname: Stecher
authors.affiliation: Forschergruppe Diabetes, and Institute of Diabetes Research, Helmholtz Zentrum München, Munich, Germany; and.
authors.forename: Daniela
authors.initials: D
authors.lastname: Much
authors.affiliation: Else Kröner-Fresenius-Center for Nutritional Medicine.
authors.forename: Marie-Theres
authors.initials: MT
authors.lastname: Karla
authors.affiliation: Else Kröner-Fresenius-Center for Nutritional Medicine.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Amann-Gassner
authors.affiliation: Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany;
authors.forename: Jun
authors.initials: J
authors.lastname: Shen
authors.affiliation: Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany;
authors.forename: Carl
authors.initials: C
authors.lastname: Ganter
authors.affiliation: Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany;
authors.forename: Dimitrios C
authors.initials: DC
authors.lastname: Karampinos
authors.affiliation: Else Kröner-Fresenius-Center for Nutritional Medicine.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Brunner
authors.affiliation: Else Kröner-Fresenius-Center for Nutritional Medicine, ZIEL-Institute for Food and Health, Nutritional Medicine Unit, Technische Universität München, Freising, Germany hans.hauner@tum.de.
authors.forename: Hans
authors.initials: H
authors.lastname: Hauner
mesh_terms: D050153:Abdominal Fat / Q000000981:diagnostic imaging; D000328:Adult; D001823:Body Composition; D015992:Body Mass Index; D001835:Body Weight; D002675:Child, Preschool; D004032:Diet; D004042:Dietary Fats, Unsaturated / Q000008:administration & dosage*; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D043371:Fatty Acids, Omega-6 / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D007774:Lactation; D008279:Magnetic Resonance Imaging; D063766:Pediatric Obesity / Q000517:prevention & control; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D039401:Prenatal Nutritional Physiological Phenomena; D012885:Skinfold Thickness; D011795:Surveys and Questionnaires; D014463:Ultrasonography
chemical_list: D004042:Dietary Fats, Unsaturated; D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6
keywords: LCPUFA; body composition; obesity; preschool age; prevention