Tuna Oil-Enriched Toddler Formula Enhances DHA Status in Indonesian Toddlers

Docosahexaenoic acid (DHA) is essential for brain and cognitive development in toddlers; however, global intakes often fall below recommended levels. This study evaluated the bioavailability of DHA from commercial toddler formulas fortified with either microencapsulated high-DHA fish oil powder or high-DHA fish oil. A double-blind, randomized controlled trial was conducted in 120 healthy Indonesian toddlers aged 2-3 years. Participants were assigned to one of three groups: (A) dry-blended formula with microencapsulated high-DHA fish oil powder, (B) unfortified control formula, or (C) wet-mixed high-DHA fish oil formula. Bioavailability was assessed using both blood and fecal fatty acid levels. Both DHA-fortified formulas increased blood DHA levels, total omega-3 fatty acids, and the Omega-3 Index. However, only the microencapsulated DHA formula led to statistically significant improvements compared with the control. Apparent DHA digestibility and the incremental area under the curve (iAUC) for blood DHA were significantly higher in the microencapsulated DHA formula group compared with the high-DHA fish oil formula group. Adherence and intake were also highest in the microencapsulated group, possibly due to improved palatability, although sensory characteristics were not directly assessed. While improvements in DHA status were statistically significant, the overall magnitude of change was modest, and its clinical significance remains uncertain. Nonetheless, microencapsulation may offer advantages for enhancing DHA bioavailability in young children. Higher DHA dosages or longer intake durations may be needed to achieve Omega-3 Index levels exceeding 8% in populations with low baseline status.