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10-year cognition in preterms after random assignment to fatty acid supplementation in infancy
Elizabeth B Isaacs1, Sarah Ross, Kathy Kennedy
1Medical Research Council Childhood Nutrition Research Centre, University College London Institute of Child Health, London, England. e.isaacs@ich.ucl.ac.uk
Insights
Long-chain polyunsaturated fatty acid (LCPUFA) supplementation in infancy did not improve overall cognition in later childhood. However, specific benefits were observed for girls in literacy and for formula-fed infants in IQ and memory.
Area of Science:
- Neuroscience
- Nutritional Science
- Developmental Psychology
Background:
- Infant nutrition significantly impacts cognitive development.
- Long-chain polyunsaturated fatty acids (LCPUFAs), such as docosahexaenoic acid (DHA), are crucial for brain development.
- Previous research suggests potential cognitive benefits of LCPUFA supplementation in infancy.
Purpose of the Study:
- To evaluate the long-term cognitive effects of LCPUFA supplementation in formerly preterm infants.
- To investigate general and specific cognitive improvements up to age 9 years.
- To explore potential moderating effects of gender and feeding type (breast milk vs. formula).
Main Methods:
- A randomized controlled trial involving 107 preterm infants followed up to a mean age of 128 months.
- Infants received either LCPUFA-supplemented formula (0.5% DHA) or control formula from birth to 9 months.
- Cognitive function was assessed using a comprehensive battery, with supplementary analyses for gender and feeding group interactions.
Main Results:
- No significant overall cognitive differences were found between the LCPUFA and control groups.
- Significant gender-specific effects: girls showed improved literacy with LCPUFA supplementation.
- Significant feeding-group-specific effects: infants receiving only formula (no breast milk) showed improved verbal IQ, full-scale IQ, and memory with LCPUFA supplementation.
Conclusions:
- LCPUFA supplementation in infancy does not yield overall cognitive benefits into later childhood for preterm infants.
- Evidence suggests gender-specific (literacy in girls) and diet-specific (formula-fed infants) cognitive effects.
- LCPUFAs may contribute to the cognitive advantages associated with breast milk, warranting further investigation with larger sample sizes.
Objective:
To test the hypothesis that long-chain polyunsaturated fatty acid (LCPUFA) supplementation in infancy would improve cognition into later childhood (after 9 years) at both general and specific levels.
Methods:
A comprehensive cognitive battery was completed by 107 formerly preterm infants (mean age: 128 months). As infants, they had been assigned randomly to receive LCPUFA-supplemented (N = 50) or control (N = 57) formula, between birth and 9 months; the docosahexaenoic acid level (DHA) in the supplemented formulas was 0.5%. In addition to randomized comparisons, we planned supplementary analyses to examine the effects of both gender and feeding group (those receiving some maternal breast milk versus those receiving none).
Results:
There were no significant differences between randomized diet groups on any cognitive measure. There was significant interaction between gender and supplementation; girls only showed beneficial effects of LCPUFAs on literacy. Significant interaction also occurred between feeding group and supplementation; increases of 0.7 SD in verbal IQ, full-scale IQ, and memory scores were found for the LCPUFA group, but only for infants who received only formula and no maternal breast milk.
Conclusions:
The results of this post-9-year cognitive follow-up study in a randomized trial of LCPUFA-supplemented formula for preterm infants suggest no overall group effects but indicate that gender-specific and diet-specific effects may exist. The data provide some evidence that LCPUFAs are a key factor in the cognitive benefits of breast milk. Caution is advised in data interpretation because of the small groups used.
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