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Published on: June 28, 2019
Docosahexaenoic and Arachidonic Acid Supplementation of Toddlers Born Preterm Does Not Affect Short-Term Growth or
Taniqua T Ingol1, Rui Li1, Kelly M Boone2
1Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
Insights
Supplementing preterm toddlers with DHA and arachidonic acid (AA) showed no short-term effects on growth or adiposity. Post-hoc analysis indicated potential slower linear growth in females receiving DHA + AA.
Area of Science:
- Pediatric Nutrition
- Clinical Trials
- Growth and Development
Background:
- Dietary docosahexaenoic acid (DHA) intake is often low in US toddlers.
- Healthy physical growth is a key clinical objective for preterm infants.
- Assessing the impact of DHA and arachidonic acid (AA) supplementation on growth is crucial.
Purpose of the Study:
- To evaluate the effects of DHA and AA supplementation on growth and adiposity in toddlers born preterm.
- To determine if 180 days of supplementation impacts key growth parameters.
Main Methods:
- The Omega Tots trial was a randomized, placebo-controlled study.
- Participants: toddlers born <35 weeks gestation (10-16 months corrected age).
- Intervention: daily oral DHA + AA (200 mg each) or placebo for 180 days; outcomes measured at baseline and completion.
Main Results:
- No significant differences in growth or adiposity were observed between the DHA + AA and placebo groups.
- Weight-for-age z-score changes were 0.1 for DHA + AA vs. 0.0 for placebo (P=0.99).
- Post-hoc analysis revealed a significant interaction by sex, suggesting slower linear growth in females receiving DHA + AA.
Conclusions:
- Daily DHA + AA supplementation for 180 days did not result in short-term growth or adiposity differences in preterm toddlers.
- Supplementation after the first year of life is unlikely to impact short-term growth or adiposity.
- Further research may be needed to explore sex-specific effects.
Background:
Dietary DHA intake among US toddlers is low. Healthy physical growth is an important objective for the clinical care of children born preterm.
Objectives:
The aim of the trial was to examine the effects of supplementing toddlers born preterm with DHA and arachidonic acid (AA) for 180 d on growth and adiposity.
Methods:
Omega Tots, a randomized placebo-controlled trial, was conducted between April 2012 and March 2017. Children born at <35 wk gestation who were 10-16 mo in corrected age were assigned to receive daily oral supplements of DHA and AA (200 mg each, "DHA + AA") or corn oil (placebo) for 180 d. Prespecified secondary outcomes included weight, length, head circumference, mid-upper arm circumference, triceps and subscapular skinfolds, BMI, and their respective z scores, and body fat percentage, which were measured at baseline and trial completion. Mixed-effects regression was used to compare the change in outcomes between the DHA + AA and placebo groups, controlling for baseline values.
Results:
Among 377 children included in the analysis (median corrected age = 15.7 mo, 48.3% female), 348 (92.3%) had growth or adiposity data at baseline and trial end. No statistically significant differences between the DHA + AA and placebo groups in growth or adiposity outcomes were observed. For instance, the change in weight-for-age z scores was 0.1 for the DHA + AA group and 0.0 for the placebo group (effect size = 0.01, P = 0.99). However, post-hoc subgroup analyses revealed a statistically significant interaction between treatment group and sex, suggesting somewhat slower linear growth for females assigned to the DHA + AA group compared with the placebo group.
Conclusions:
Among toddlers born preterm, daily supplementation with DHA + AA for 180 d resulted in no short-term differences in growth or adiposity compared with placebo. If DHA supplementation is implemented after the first year of life, it can be expected to have no effect on short-term growth or adiposity. This trial is registered with clinicaltrials.gov as NCT02199808.
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