Fish oil-supplementation from 9 to 12 months of age affects infant attention in a free-play test and is related to change in blood pressure

Published:September 16, 2013DOI:



      This intervention examined whether fish-oil-supplementation in late infancy modifies free-play test scores and if this is related to blood pressure (BP) and mean RR interval.

      Patients and methods

      83 Danish 9-month-old infants were randomized to ±fish oil (FO) (3.4±1.1 mL/d) for 3 months and 61 of these completed the free-play-test before and after the intervention.


      Most of the free-play scores changed during the intervention, but the intervention affected only the number of looks away from the toy, which was increased in +FO and decreased in −FO (p=0.037). The increased numbers of looks away were associated with an increase in erythrocyte eicosapentaenoic acid (r=0.401, p=0.017, n=35) and were also associated with a decrease in systolic-BP (r=−0.511, p<0.001, n=52).


      The results indicate that n-3 fatty acid intake also in late infancy can influence brain development and that the cognitive and cardiovascular effects may be related.


      ANS (autonomic nervous system), BP (blood pressure (systolic SBP & diastolic DBP)), CNS (central nervous system), DHA (docosahexaenoic acid), ECG (electro-cardiogram), EPA (eicosapentaenoic acid), FA% (fatty acids given as area percentage), FO (fish oil), HR (heart rate), LCPUFA (long-chain polyunsaturated fatty acid), RBC (red blood cell)


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        • Farquharson J.
        • Cockburn F.
        • Patrick W.A.
        • Jamieson E.C.
        • Logan R.W.
        Infant cerebral cortex phospholipid fatty-acid composition and diet.
        Lancet. 1992; 340: 810-813
        • Makrides M.
        • Neumann M.A.
        • Byard R.W.
        • Simmer K.
        • Gibson R.A.
        Fatty acid composition of brain, retina, and erythrocytes in breast- and formula-fed infants.
        Am. J. Clin. Nutr. 1994; 60: 189-194
        • Horta B.L.
        • Bahl R.
        • Martinés J.C.
        • Victora C.G.
        WHO: Evidence on the Long-Term Effect of Breastfeeding. Systematic Reviews and Meta-Analyses.
        World Health Organization, Geneva, Switzerland2007
        • Simmer K.
        • Patole S.K.
        • Rao S.C.
        Long-chain polyunsaturated fatty acid supplementation in infants born at term.
        Cochrane Database of Syst. Rev. (2011),. 2011;
        • Martinez M.
        • Mougan I.
        Fatty acid composition of human brain phospholipids during normal development.
        J. Neurochem. 1998; 71: 2528-2533
        • Cheatham C.L.
        • Colombo J.
        • Carlson S.E.
        n-3 fatty acids and cognitive and visual acuity development: methodologic and conceptual considerations.
        Am J. Clin. Nutr. 2006; 83: 1458S-1466S
        • Colombo J.
        • Carlson S.E.
        Is the measure the message: the BSID and nutritional interventions.
        Pediatrics. 2012; 129: 1166-1167
        • Wainwright P.E.
        • Colombo J.
        Nutrition and the development of cognitive functions: interpretation of behavioral studies in animals and human infants.
        Am. J. Clin. Nutr. 2006; 84: 961-970
        • Kannass K.N.
        • Oakes L.M.
        The development of attention and its relations to language in infancy and toddlerhood.
        J. Cogn. Dev. 2008; 9: 222-246
        • Walden T.A.
        • Ogan T.A.
        The development of social referencing.
        Child Dev. 1988; 59: 1230-1240
        • Frith C.D.
        Social cognition.
        Phil. Trans. R. Soc. B Biol. Sci. 2008; 363: 2033-2039
        • Pivik R.T.
        • Dykman R.
        • Jing H.
        • Gilchrist J.
        • Badger T.
        Early infant diet and the omega-3 fatty acid DHA: effects on resting cardiovascular activity and behavioral development during the first half-year of life.
        Dev. Neuropsychol. 2009; 34: 139-158
        • Colombo J.
        • Carlson S.E.
        • Cheatham C.L.
        • Fitzgerald-Gustafson K.M.
        • Kepler A.
        • Doty T.
        Long-chain polyunsaturated fatty acid supplementation in infancy reduces heart rate and positively affects distribution of attention.
        Pediatr. Res. 2011; 70: 406-410
        • Mozaffarian D.
        • Geelen A.
        • Brouwer I.A.
        • Geleijnse J.M.
        • Zock P.L.
        • Katan M.B.
        Effect of fish oil on heart rate in humans: a meta-analysis of randomized controlled trials.
        Circulation. 2005; 112: 1945-1952
        • Lauritzen L.
        • Christensen J.H.
        • Damsgaard C.T.
        • Michaelsen K.F.
        The effect of fish oil supplementation on heart rate in healthy Danish infants.
        Pediatr. Res. 2008; 64: 610-614
        • Damsgaard C.T.
        • Schack-Nielsen L.
        • Michaelsen K.F.
        • Fruekilde M.B.
        • Hels O.
        • Lauritzen L.
        Fish oil affects blood pressure and the plasma lipid profile in healthy Danish infants.
        J. Nutr. 2006; 136: 94-99
        • Folch J.
        • Lees M.
        • Sloane Stanley G.H.
        A simple method for the isolation and purification of total lipids from animal tissues.
        J. Biol. Chem. 1957; 226: 497-509
        • Colombo J.
        • Kannass K.N.
        • Shaddy D.J.
        • Kundurthi S.
        • Maikranz J.M.
        • Anderson C.J.
        • Blaga O.M.
        • Carlson S.E.
        Maternal DHA and the development of attention in infancy and toddlerhood.
        Child Dev. 2004; 75: 1254-1267
        • Kannass K.N.
        • Colombo J.
        • Carlson S.E.
        Maternal DHA levels and toddler free-play attention.
        Dev. Neuropsychol. 2009; 34: 159-174
        • Walden T.A.
        • Kim G.
        Infants' social looking toward mothers and strangers.
        Int. J. Behav. Dev. 2005; 29: 356-360
        • Lawson K.R.
        • Ruff H.A.
        Early attention and negative emotionality predict later cognitive and behavioural function.
        Int. J. Behav. Dev. 2004; 28: 157-165
        • Colombo J.
        Recent advances in infant cognition: implications for long-chain polyunsaturated fatty acid supplementation studies.
        Lipids. 2001; 36: 919-926
        • Forsyth J.S.
        • Willatts P.
        • Agostoni C.
        • Bissenden J.
        • Casaer P.
        • Boehm G.
        Long chain polyunsaturated fatty acid supplementation in infant formula and blood pressure in later childhood: follow up of a randomised controlled trial.
        BMJ. 2003; 326: 953
        • Gustafson K.M.
        • Carlson S.E.
        • Colombo J.
        • Yeh H.W.
        • Shaddy D.J.
        • Li S.
        • Kerling E.H.
        Effects of docosahexaenoic acid supplementation during pregnancy on fetal heart rate and variability: a randomized clinical trial.
        Prostagland Leuk Essent Fatty. 2013; 88: 331-338
        • Fox N.A.
        • Porges S.W.
        The relationship between neonatal heart period pattern and developmental outcome.
        Child Dev. 1985; 56: 28-37
        • Porges S.W.
        • Doussard-Roosevelt J.A.
        • Portales A.L.
        • Greenspan S.I.
        Infant regulation of the vagal “brake” predicts child behavior problems: a psychobiological model for social behavior.
        Dev. Psychobiol. 1996; 29: 697-712
        • Doussard-Roosevelt J.A.
        • McClenny B.D.
        • Porges S.W.
        Neonatal cardiac vagal tone and school-age developmental outcome in very low birth weight infants.
        Dev. Psychobiol. 2001; 38: 56-66
        • Elsner B.
        • Pauen S.
        • Jeschonek S.
        Physiological and behavioral parameters of infants' categorization: changes in heart rate and duration of examining across trials.
        Dev. Sci. 2006; 9: 551-556
        • Gustafson K.M.
        • Colombo J.
        • Carlson S.E.
        Docosahexaenoic acid and cognitive function: is the link mediated by the autonomic nervous system?.
        Prostagland Leuk Essent Fatty. 2008; 79: 135-140
        • Richards J.E.
        • Turner E.D.
        Extended visual fixation and distractibility in children from six to twenty-four months of age.
        Child Dev. 2001; 72: 963-972
        • Osika W.
        • Montgomery S.M.
        • Dangardt F.
        • Wahrborg P.
        • Gan L.M.
        • Tideman E.
        • Friberg P.
        Anger, Depression and anxiety associated with endothelial function in childhood and adolescence.
        Arch. Dis. Child. 2011; 96: 38-43
        • Mozaffarian D.
        • Geelen A.
        • Brouwer I.A.
        • Geleijnse J.M.
        • Zock P.L.
        • Katan M.B.
        Effect of fish oil on heart rate in humans—a meta-analysis of randomized controlled trials.
        Circulation. 2005; 112: 1945-1952
        • Geleijnse J.M.
        • Giltay E.J.
        • Grobbee D.E.
        • Donders A.R.
        • Kok F.J.
        Blood pressure response to fish oil supplementation: metaregression analysis of randomized trials.
        J. Hypertens. 2002; 20: 1493-1499
        • Schwartz J.
        • Dube K.
        • Sichert-Hellert W.
        • Kannenberg F.
        • Kunz C.
        • Kalhoff H.
        • Kersting M.
        Modification of dietary polyunsaturated fatty acids via complementary food enhances n-3 long-chain polyunsaturated fatty acid synthesis in healthy infants: a double blinded randomised controlled trial.
        Arch. Dis. Child. 2009; 94: 876-882
        • Welch A.A.
        • Lund E.
        • Amiano P.
        • Dorronsoro M.
        • Brustad M.
        • Kumle M.
        • Rodriguez M.
        • Lasheras C.
        • Janzon L.
        • Jansson J.
        • Luben R.
        • Spencer E.A.
        • Overvad K.
        • Tjønneland A.
        • Clavel-Chapelon F.
        • Linseisen J.
        • Klipstein-Grobusch K.
        • Benetou V.
        • Zavitsanos X.
        • Tumino R.
        • Galasso R.
        • Bueno-de-Mesquita H.B.
        • Ocke M.C.
        • Charrondiere U.R.
        • Slimani N.
        Variability of fish consumption within the 10 European countries participating in the European Investigation into Cancer and Nutrition (EPIC) study.
        Public Health Nutrition. 2002; 5: 1273-1285