Cognitive function in 18-month-old term infants of the DIAMOND study: A randomized, controlled clinical trial with multiple dietary levels of docosahexaenoic acid

• Published in: Early human development 2011-03, Vol.87 (3), p.223-230
• Main Authors: Drover, James R, Hoffman, Dennis R, Castañeda, Yolanda S, Morale, Sarah E, Garfield, Sharon, Wheaton, Dianna H, Birch, Eileen E
• Format: Article
• Language: English
• Subjects: Advanced Basic Science; Age; Arachidonic acid; Biological and medical sciences; Child Development - drug effects; Child Development - physiology; Children; Clinical trials; Cognition - drug effects; Cognition - physiology; Cognitive ability; Cognitive development; Dietary Fats, Unsaturated - administration & dosage; Dietary supplements; Docosahexaenoic acid; Docosahexaenoic Acids - administration & dosage; Double-Blind Method; Embryology: invertebrates and vertebrates. Teratology; Feeding trials; Female; Fundamental and applied biological sciences. Psychology; Humans; Infant; Infant Formula - administration & dosage; Infant Formula - chemistry; Infant formulas; Infant Nutritional Physiological Phenomena - drug effects; Infants; Male; Mental development; Neonatal and Perinatal Medicine; Prospective Studies; Statistics, Nonparametric
• ISSN: 0378-3782; 1872-6232
• DOI: 10.1016/j.earlhumdev.2010.12.047

Abstract Background Studies investigating cognitive outcomes following docosahexaenoic acid (DHA) supplementation of infant formula yield conflicting results, perhaps due to inadequate dietary concentrations. Aim To determine the optimal DHA concentration in term formula to support cognitive maturation. Design This was a double-masked, randomized, controlled, prospective trial. A total of 181 infants were enrolled at 1–9 days of age and assigned randomly to receive one of four term infant formulas with one of four levels of docosahexaenoic acid: Control (0% DHA), 0.32% DHA, 0.64% DHA, or 0.96% DHA. All DHA-supplemented formulas contained 0.64% arachidonic acid (ARA). Infants were fed the assigned formulas until 12 months of age. One hundred forty-one children completed the 12-month feeding trial and were eligible for this study. Cognitive function was assessed in 131 children at 18 months of age using the Bayley Scales of Infant Development II (BSID II). Results There were no diet group differences on the Mental Development Index (MDI), the Psychomotor Development Index (PDI), or the Behavior Rating Scale (BRS) of the BSID II. However, when the scores of children who received any of the three DHA-supplemented formulas were combined and compared to control children, a significant difference emerged: the MDI scores of DHA-supplemented children were higher (104.1 v. 98.4; p = 0.02). Conclusions These results suggest that dietary supplementation of DHA during the first year of life leads to enhanced cognitive development at 18 months of age. DHA concentration of 0.32% is adequate to improve cognitive function; higher concentrations did not confer additional benefit.