Docosahexaenoic Acid Supplementation and

Neurocognitive Development

Maria Aguilar

Why neurocognitive development?

Neurocognitive development is an important part of infant development

Sets the foundation for success or failure in learning and life

I would like to continue my education in infant/childhood development

Outline DHA background

DHA in the brain

Thesis

Studies: Baboons, DHA insufficiency, and supplementation

Discussion

Limitations

Conclusion

What is DHA? Omega-3 long-chain polyunsaturated fatty acid

(LCPUFA)

One of the most abundant LCPUFAs found in the central nervous system (CNS)

Obtained in small amounts from precursors Linoleic and α-linolenic acid

Available through diet from preformed sources like fatty fish and fish oil supplementation

Recommendations No specific DHA recommendation

The Dietary Guidelines for Americans 2010, reports there is evidence that intake of eight to ten ounces of seafood low in methyl mercury per week aids in visual and cognitive development.

DHA In The Brain Third trimester of gestation is the

time of greatest DHA accumulation in the brain during this timeframe

DHA is found in higher concentrations in grey matter compared to white matter

Grey matter Location of most of the

brain’s neurons, specifically cell bodies

Roles in cognitive skills and tasks

White matter Myelinated axons which

connects grey areas of the brain together

Carry nerve impulses between neurons Myelin helps increase the

speed of transmission of nerve signals

Thesis“To develop a better understanding of the role of DHA in infant neurocognitive development; both prenatally

and postnatally, trials in brain development, DHA insufficiency, and supplementations need to be

compared in order to determine if an increase of DHA intake is necessary to promote development”.

“The influence of long chain polyunsaturate supplementation on docosahexaenoic acid and arachidonic acid in baboon neonate

central nervous system.”

12 baboon neonates born ~182 days gestation chosen and split into 3 groups of 4 per group

Each group fed a different formula for twelve weeks Control formula: did not contain DHA and ARA (C) Formula 2: contained 0.33% DHA and 0.67% ARA (L) Formula 3: contained 1% DHA and 0.67% ARA (L3)

Blinded study

Data Collection At 12 weeks the baboons were euthanized and tissue was

collected from the precentral gyrus (site involved in planning, control, and voluntary movements) of the cerebral cortex and used for a microarray analysis

A microarray analysis is used to test DNA fragments to measure the expression levels of a large number of genes

Gene expression is the process by which the information from a gene is used

Results Changes were reported in expression levels of 1108

probe sets between L2/C formulas and L3/C formulas

More probes resulted to be upregulated in the cerebral cortex in response to formula containing ARA and DHA.

Probes that showed upregulation where characterized having functions ranging from lipid metabolism, development, visual perception, G-protein and signal transduction, regulation of transcription cell cycle, and others.

Values go through either an inverse/reciprocal transformation or a logarithmic transformation, which is why some numbers are negative and some are positive

"Omega-3 Fatty Acid Deficiency in Infants before Birth Identified Using a Randomized Trial of

Maternal DHA Supplementation in Pregnancy."

Double blind, randomized trial

Had to be within 16 weeks of gestation, not taking any kind of lipid or fatty acid supplementation, and not expected to have any complications throughout the rest of the pregnancy

Mothers socio-demographic characteristics and IQ assessed

400 mg/d DHA or a placebo containing corn and soybean oil (Does not contain DHA). 114 women in DHA group 103 women in placebo group

Results Infants who received the placebo had a higher risk

of not reaching the same level of language skills as the DHA group.

Infants in the placebo group were at increased risk of not reaching the same visual acuity level as the DHA group Ability for the eye to see fine detail

“Effects of Early Maternal Docosahexaenoic Acid Intake on

Neuropsychological Status and Visual Acuity at Five Years of Age of Breast-Fed

Term Infants” Mothers given either a capsule containing 200

mg/d of DHA or a capsule containing vegetable oil from the time of delivery until 4 months postpartum 60 mothers in DHA group 59 mothers in control group

Infants were breastfed during this 4 month timeframe

Results Children’s whose mothers received the DHA supplementation had a

significantly higher Bayley Psychomotor Development Index (PDI) at 30 months of age compared to children whose mothers received the placebo PDI: Refers to motor skill, conceptual functioning, and psychological

functioning

Children were followed for 5 years and assessed on their visual function and neurodevelopmental outcomes Results showed there were no significant differences between the two

groups in visual function Neurodevelopmental outcomes showed no difference between the groups on

measures of gross motor development, fine motor development, perceptual/visual motor development, verbal skills, or emerging executive factors

Children whose mothers received the DHA supplement performed better on the sustained attention subtest of the Leiter International Performance Scale

Discussion Results of prenatal and postnatal supplementation

studies varied depending on the timing of DHA supplementation and age in which the assessment was conducted Studies found that DHA was more beneficial

prenatally and in the early stages of infancy compared to later in childhood

DHA in the body is able to reach levels low enough to affect neurocognitive development

Limitations Unethical

Subject adherence was not the best in the studies

Information is up for individual interpretations because studies conducted hold different limits and different tests are used to analyze the data

Most research included ARA so it was hard finding studies that only focused on DHA supplementation

Should DHA supplementation be included in prenatal vitamin

recommendations?

Prenatal supplementations have been recommended for women who are pregnant or trying to become pregnant, to improve their health and the health of their offspring.

Inconclusive results

More research still needs to be done in order to make a decision

Conclusion There seems to be more data that shows

DHA supplementation might be more beneficial to infants born preterm than infants born at term

More beneficial in early stages of infancy compared to later in childhood

Still can not come to the conclusion that DHA should be added to prenatal supplementation until more research is done.

References Diaz, Guan-Yeu, Andrea T. Hsieh, Eszter A. Sarkadi-Nagy, Vasuki

Wijendran, and Peter W. Nathanielsz. "The influence of long chain polyunsaturate supplementation on docosahexaenoic acid and arachidonic acid in baboon neonate central nervous system." BioMed Cental Medicine 3.11 (2005). PubMed. Web. 1 Jan. 2016

Mulder, Kelly A., D. Janette King, and Sheila M. Innis. "Omega-3 Fatty Acid Deficiency in Infants before Birth Identified Using a Randomized Trial of Maternal DHA Supplementation in Pregnancy." PLOS ONE 9.1. PubMed. Web. 1 Feb. 2016.

Jensen, Craig L., Robert G. Voigt, Antonio M. Llorente, Sarika U. Peters, and Thomas C. Prager. "Effects of Early Maternal Docosahexaenoic Acid Intake on Neuropsychological Status and Visual Acuity at Five Years of Age of Breast-Fed Term Infants." The Journal of Pediatrics 157.6 (2010). PubMed. Web. 1 Feb. 2016.

Photo Credit http://www.nurturedbydesign.com/en/thezaky/medical-

staff_outcome_proposition.php

https://en.wikipedia.org/wiki/Docosahexaenoic_acid

http://www.precisionnutrition.com/fish-oil-dangerous

https://www.studyblue.com/notes/note/n/histology-of-nerve-lab/deck/7869708

https://www.studyblue.com/notes/note/n/histology-of-nerve-lab/deck/7869708

http://biosocialmethods.isr.umich.edu/epigenetics-tutorial/epigenetics-tutorial-gene-expression-from-dna-to-protein/

http://www.inwealthandhealth.com/prenatal-dha-its-just-as-important-as-your-prenatal-vitamin/