Omega-3 polyunsaturated fatty acid levels in childhood prospectively associate with academic performance beyond a healthy diet: findings from the multi-ethnic Asian GUSTO cohort study

Abstract:

Background: The influence of plasma docosahexaenoic acid (DHA) and overall omega-3 long chain polyunsaturated fatty acids (LC-PUFA) on child cognitive development is unclear.

Objective: We examined if plasma LC-PUFA levels are prospectively associated with academic performance in primary school children and if diet patterns modulate the relationship.

Methods: Children were from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort. Fasting LC-PUFA concentrations were measured using nuclear magnetic resonance (NMR) spectroscopy at 8 years of age (n=557). Dietary patterns were derived using principal component analysis from a validated food frequency questionnaire (FFQ) at age 7 years. Academic performance was assessed using the Wechsler Individual Achievement Test-III (WIAT-III) at age 9 years (n=288) and the Primary School Leaving Examination (PSLE) at age 12 years (n=408). The relationships of LC-PUFAs to academic performance scores were examined using multivariable linear regression models.

Results: Percent DHA at age 8 years was associated with higher reading fluency (β (95% CI) =3.54 (0.52, 6.56), p=0.022) and spelling scores (4.49 (0.02, 8.95), p=0.021) at age 9 years, and lower PSLE scores (β (95% CI) =-1.43 (-2.68, -0.618), p=0.025) (indicating better performance) at age 12 years. However, these associations were attenuated after adjusting for unhealthy dietary pattern. Total n-3 LC-PUFA at age 8 years was associated with higher reading fluency (β (95% CI) =1.55 (0.03, 3.07), p=0.046) scores at age 9 years, and lower PSLE scores (β (95% CI) =-0.83 (-1.42, -0.24), p=0.006) at age 12 years. The association with PSLE scores remained significant even after adjusting for healthy or unhealthy dietary patterns (β (95% CI) =-0.68 (-1.29, -0.08), p=0.028).

Conclusions: Higher plasma total n-3 LC-PUFA and DHA were prospectively associated with better academic performance in primary school children, but the relationship with DHA was modulated by an unhealthy dietary pattern. The results suggest that beyond DHA, total n-3 LC-PUFA status plays a significant role in the cognitive development of children.