Long-Chain Polyunsaturated Fatty Acids, Homocysteine at Birth and Fatty Acid Desaturase Gene Cluster Polymorphisms are Associated with Children's Processing Speed up to Age 9 Years.

Both pre- and early postnatal supplementation with docosahexaenoic acid (DHA), arachidonic acid (AA) and folate have been related to neural development, but their long-term effects on later neural function remain unclear. We evaluated the long-term effects of maternal prenatal supplementation with fish-oil (FO), 5-methyltetrahydrofolate (5-MTHF), placebo or FO + 5-MTHF, as well as the role of fatty acid desaturase (FADS) gene cluster polymorphisms, on their offspring's processing speed at later school age. This study was conducted in NUHEAL children at 7.5 (n = 143) and 9 years of age (n = 127). Processing speed tasks were assessed using Symbol Digit Modalities Test (SDMT), Children Color Trails Test (CCTT) and Stroop Color and Word Test (SCWT). Long-chain polyunsaturated fatty acids, folate and total homocysteine (tHcy) levels were determined at delivery from maternal and cord blood samples. FADS and methylenetetrahydrofolate reductase (MTHFR) 677 C > T genetic polymorphisms were analyzed. Mixed models (linear and logistic) were performed. There were significant differences in processing speed performance among children at different ages (p < 0.001). The type of prenatal supplementation had no effect on processing speed in children up to 9 years. Secondary exploratory analyses indicated that children born to mothers with higher AA/DHA ratio at delivery (p < 0.001) and heterozygotes for FADS1 rs174556 (p < 0.05) showed better performance in processing speed at 9 years. Negative associations between processing speed scores and maternal tHcy levels at delivery were found. Our findings suggest speed processing development in children up to 9 years could be related to maternal factors, including AA/DHA and tHcy levels, and their genetic background, mainly FADS polymorphism. These considerations support that maternal prenatal supplementation should be quantitatively adequate and individualized to obtain better brain development and mental performance in the offspring.

The effect of diet on the physical and mental development of children: views of parents and teachers in four European countries.

Although the impact of diet on physical health is an important public health issue, less attention has been devoted to the relationship between nutrition and children's mental development. The views of parents and teachers about the extent to which diet affects physical and mental development of children were compared in four European countries. An online questionnaire (developed in English and translated) was circulated through a market research agency. Participants were parents or teachers of children aged 4-10 years without learning or behavioural issues. Questionnaires were returned by 1606 parents (401 in England, Germany and Hungary; 403 in Spain) and 403 teachers (100 in each country, except for 103 in Hungary). Teachers were older than parents (35·3 % v. 18·3 % over 45 years; P<0·001) and less likely to smoke (15·9 % v. 26·3 %, P<0·001). There was no difference between the proportions of parents and teachers who felt that a child's physical development depended very much/extremely (v. moderately/slightly/not at all) on diet (overall 79·8 %). Lower proportions of both groups thought that mental development was very much/extremely influenced by diet (67·4 %). In the regression modelling, believing that physical and mental performance was greatly influenced by diet was significantly and positively associated with living in Hungary, scoring higher on a measure of General Health Interest and (parents only) level of education attained. Differences existed among countries in most views. Lower levels of awareness of the importance of diet for brain development and cognition (compared with physical health outcomes) indicate the potential for educating consumers, especially parents with lower educational attainment.

Importance of mental performance in parental choice of food for children aged 4-10 years: a study in four European countries.

OBJECTIVE: Typically, attention focuses on how nutrition affects physical health. The present study investigated the importance that parents attach to the impact of diet on mental performance when choosing food for their child. DESIGN: Questionnaire. SETTING: Four European countries. SUBJECTS: Parents of children aged 4-10 years (n 1574): England (n 397), Germany (n 389), Hungary (n 398) and Spain (n 390). RESULTS: Most parents (80-85 %) considered the effect of food on four elements of mental performance (child's ability to learn, attention, behaviour, mood) to be moderately, very, extremely (v. slightly, not at all) important in food choices; over 90 % considered healthiness of food and making food appealing to their child important; 79·8 % cost; 76·8 % convenience. Belief that food affects mental performance was 57·4 % (ability to learn), 60·5 % (attention); less than 40 % of parents agreed they were aware which foods had an effect. Parents with lower general interest in healthy eating were less likely to consider the effect of food on mental performance elements as important. Respondents from Germany were more likely to rate mental performance as important (except behaviour); those in Hungary less likely. The most important influence on parents' decisions about feeding their child was their own experience, except Spain, where family/friends/health professionals were more important. CONCLUSIONS: Nutrition affects brain development and cognitive functioning. Low prioritisation of the effect of food on mental performance indicates potential for educating parents.

Folate and long-chain polyunsaturated fatty acid supplementation during pregnancy has long-term effects on the attention system of 8.5-y-old offspring: a randomized controlled trial.

BACKGROUND: During fetal and perinatal periods, many nutrients, such as long-chain polyunsaturated fatty acids [contained in fish oil (FO)] and folate, are important in achieving normal brain development. Several studies have shown the benefits of early nutrition on children's neurocognitive development. However, the evidence with regard to the attention system is scarce. OBJECTIVES: The aim of this study was to analyze the long-term effects of FO, 5-methyltetrahydrofolate (5-MTHF), or FO+5-MTHF prenatal supplementation on attention networks. DESIGN: Participants were 136 children born to mothers from the NUHEAL (Nutraceuticals for a Healthy Life) project (randomly assigned to receive FO and/or 5-MTHF or placebo prenatal supplementation) who were recalled for a new examination 8.5 y later. The response conflict-resolution ability (using congruent and incongruent conditions)), alerting, and spatial orienting of attention were evaluated with behavioral measures (Attention Network Test), electroencephalography/event-related potentials (ERPs), and standardized low-resolution brain electromagnetic tomography (sLORETA). RESULTS: Children born to mothers supplemented with 5-MTHF alone solved the response conflict more quickly than did the placebo and the FO+5-MTHF groups (all P < 0.05). Differences between ERP amplitudes for the conflict conditions were also observed. sLORETA analysis showed higher activation of the right midcingulate cortex for the incongruent condition. In addition, a significant slowing down of response speed depending on the warning cue in the 5-MTHF and FO groups was observed. CONCLUSIONS: Folate supplementation during pregnancy, rather than FO or FO+5-MTHF supplementation, improves children's ability to solve response conflicts. This advantage seems to be based on the higher activation of the midcingulate cortex, indicating that early nutrition influences the functionality of specific brain areas involved in executive functions. This trial was registered at clinicaltrials.gov as NCT01180933.

Low n-3 long-chain polyunsaturated fatty acids in newly diagnosed celiac disease in children with preexisting type 1 diabetes mellitus.

OBJECTIVE: Fat malabsorption can occur in celiac disease (CD) owing to villus atrophy and inflammation of small intestinal mucosa. Abnormal fatty acid (FA) status of intestinal mucosa in children with CD was reported earlier. Previously we found significantly reduced availability of n-3 long-chain polyunsaturated fatty acids (n-3 LCPUFA) in children and young adults with type 1 diabetes mellitus (DM). The aim of this study was to investigate FAs in plasma lipid classes in children with newly diagnosed CD with or without preexisting DM. METHODS: FA composition of plasma samples of children with untreated CD only (n = 20) and with preexisting DM (CDDM, n = 8) were compared with those of healthy controls (n = 21). Detailed analysis of phospholipid, triacylglycerol, and sterol ester FAs was performed by high-resolution capillary gas-liquid chromatography. RESULTS: Significantly decreased docosapentaenoic (C22:5n-3), docosahexaenoic (C22:6n-3), n-3 polyunsaturated fatty acids (n-3 PUFA), and n-3 LCPUFA values were found in CDDM group compared with controls and patients with CD. When compared with healthy controls, no significant difference was found in plasma FAs of children with newly diagnosed CD only. CONCLUSIONS: Children with CDDM showed marked signs of reduced availability of n-3 PUFA and n-3 LCPUFA in circulating lipids. Although different tissues express membrane FAs differently, our present study suggests that CD on its own does not necessarily lead to detectable disturbances of essential FA metabolism in plasma and supports the concept that DM has significant impact on plasma FA composition in children.

Contribution of n-3 long-chain polyunsaturated fatty acids to human milk is still low in Hungarian mothers.

UNLABELLED: Maternal diet has decisive influence on the fatty acid composition of human milk. Fifteen years ago, we found outstandingly low contribution of docosahexaenoic acid (DHA) to human milk in a small group of Hungarian mothers. The major aim of the present study was to investigate whether DHA status in human milk in Hungary changed during the last 15 years. We aimed to examine the fatty acid composition of human milk at three different stages of lactation (3rd day, 6th week, and 6th month) in healthy Hungarian mothers. Fatty acid composition of human milk lipids was determined by gas chromatograph with flame ionization detector. Contribution of arachidonic acid to the fatty acid composition of human milk significantly decreased during lactation (0.91 [0.38] in colostrum, 0.53 [0.17] at 6th week, and 0.46 [0.13] at 6th month, p < 0.01). The contribution of DHA significantly decreased from colostrum to the 6th week of lactation (0.29 [0.12] and 0.14 [0.04], p < 0.01), without further changes by 6 months (0.12 [0.10]). CONCLUSION: The contribution of DHA to the fatty acid composition of mature human milk in Hungarian mothers is still among the lowest values ever reported in the literature.

A qualitative interview study on effects of diet on children's mental state and performance. Evaluation of perceptions, attitudes and beliefs of parents in four European countries.

Nutrition is one of the many factors that influence a child's cognitive development and performance. Understanding the relationship between nutrition and mental performance in children is important in terms of their attainment and productivity both in school and later life. Since parents are seen as nutritional gatekeepers for their children's diets, their views and beliefs are of crucial importance. The present study aims to qualitatively examine parents' perceptions of the relationship between diet and mental performance of children. The study was conducted with a total of 124 parents in four European countries using a semi-structured interview schedule. Parents speak of the effects of diet at two levels; the nature of the effects of diet and the characteristics of the foods responsible for these effects. Mental outcomes are related to diet, with the effects perceived to be associated with attention and concentration, often mediated by effects on children's mood and behaviour. Parents categorise foods as 'good' or 'bad' with positive effects related generally to a healthy balanced diet while negative effects are perceived to be associated with sugary and fatty foods. Understanding parental perceptions is important for many purposes including the targeting of dietary advice and prioritising of public health issues.