Randomised open-label trial of docosahexaenoic acid-enriched fish oil and fish meal on cognitive and behavioural functioning in Omani children

Al-Ghannami, Samia S., Al-Adawi, Samir, Ghebremeskel, Kebreab, Hussein, Izzeldin S., Min, Yoeju, Jeyaseelan, Lakshmanan, Al-Shammakhi, Saleh M., Mabry, Ruth M. and Al-Oufi, Hamed S. (2018) Randomised open-label trial of docosahexaenoic acid-enriched fish oil and fish meal on cognitive and behavioural functioning in Omani children. Nutrition. ISSN 0899-9007

Abstract

Objective: Examine the effect of docosahexaenoic acid (DHA) enriched fish oil supplement and fish meal on cognitive and behavioural functioning manifested as attention-deficit/hyperactivity disorder in primary school students (9-10 years old) in Muscat, Oman.

Methods: Randomised open-label trial involving two types of intervention: fish oil supplement or one serving (100 gram) of fish per weekday for 12 weeks. Red cell total lipid docosahexaenoic acid levels were assessed. Verbal Fluency Test, Buschke Selective Reminding Test, and Trail Making Test were used to measure cognitive functioning. Behavioural functioning was assessed using a standardised Arabic version of the National Initiative for Children’s Health Quality Vanderbilt Assessment Scales. All measurements were carried out before and after intervention.

Results: DHA levels increased by 72% and 64% in fish oil (Mean: 3.6% to 6.2%) and fish meal (Mean: 3.4% to 5.6%) group, respectively (p=0.000). The Trail Making Test was the only cognitive test that demonstrated marked differences between groups: median inter-quartile range difference between pre and post intervention in the Trail Making Part B score was 61.5 (SE: 19.3, 103.2) in the fish oil vs. Fish meal group, 24.5 (SE: -15.2, 74.7, p=0.005). The Vanderbilt Assessment Scales also showed significant differences between groups (p<0.001).

Conclusion: This study contributes to available evidence on the cognitive and behavioural benefits of DHA in healthy school children. Consideration should be made to expand the food fortification programme as part of broader policy to improve child health.

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