The effect of maternal fish oil supplementation during lactation on body composition and blood pressure in 13-year old children

Abstract

Background: It has long been recognized that the long-chain n-3 polyunsaturated fatty acid (n-3 LCPUFA), docosahexaenoic acid (DHA) accumulates in the brain during the first years of life and that this is potentially affected by dietary intake. Breast-feeding has been linked to several beneficial health outcomes, several of which have been suggested to be due to the presence of n-3 LCPUFA in breast milk. Based on data from rodents, perinatal intake of n-3 LCPUFA has also been speculated to play a programming role in relation to later body composition and blood pressure. Objective: To investigate the long-term effect of supplementation with fish oil during the first four months of lactation on body composition and blood pressure in 13-year old children. Design: In a randomized controlled trial mothers with a low fish intake (below the population median) were administered with either fish oil or olive oil during the first four months of lactation. The trial also included a high-fish intake reference group. Of the 149 children who completed the intervention period a total of 60 children were followed up at 13 years with 21 from the HF-group, 20 from the FO-group, and 19 from the OO-group. Blood pressure and anthropometric measurements was measured, diet was assessed by an electronic food frequency questionnaire and pubertal stage was assessed by Tanner Scales. Diet and puberty are factors that are considered to affect body composition and blood pressure. Results: In body composition, no significant differences were found between the two randomized groups, when adjusting for ponderal index at birth and sex. However, the FO group had a significantly larger non-adjusted mean head circumference compared to the OO-group (p=0.029). Significant group*sex interactions were found in MAP (p=0.038) and DBP (p=0.019). The girls from the FO-group had a tendency towards a lower MAP compared to the girls from the OO-group (p=0.079. A significant positive association between MAP and maternal RBC-DHA (p=0.028) and between DHA in maternal breast milk and MAP (p=0.043) were found in boys A tendency towards a positive association between maternal RBC-DHA and DBP in boys was found (p=0.05). Conclusion: The significant difference in blood pressure observed between the boys from the two randomized groups at 7-year was no longer evident at 13-year. The difference in body composition observed at 2.5 years, was at 7 years diminished, and now we observed no significant difference in body composition at 13 years. I found a significant sex*group interaction in mean arterial and diastolic blood pressure, which indicated that the effect of the intervention differs between boys and girls. Due to a 4 small sample size in the randomized groups, the results might be inaccurate, and further studies are need to confirm these findings,

Baggrund; Man har længe kendt til at den langkædede polyumættede fedtsyre docosahexaensyre (DHA) akkumulerer I hjernen i det første leveår hvilket sandsynligvis er påvirket af kostindtag. Amning har været forbundet med flere gavnlige sundhedsmæssige tilstande, hvoraf flere er blevet foreslået at skyldes tilstedeværelsen af n-3 LCPUFA i modermælk. Baseret på data fra gnavere, har perinatal indtag af n-3-LCPUFA også blevet spekuleret at spille et programmerings rolle i forhold til senere kropssammensætning og blodtryk. Formål: At undersøge langtidseffekten af et dagligt tilskud af fiskeolie til mødre I de første fire måneder af amme perioden på kropssammensætning og blodtryk i 13-årige børn Design: I et dobbelblindet interventionsstudie blev ammende mødre med et lavt fiskeindtag randomiseret til tilskud med 4.5g/d fiskeolie eller olivenolie. Derudover blev en referencegruppe af mødre med et højt fiskeindtag inkluderet I studiet. Ud af de 149 børn som gennemførte interventionsperioden deltog 60 børn I dette 13-års opfølgningsstudie, hvoraf 20 fra fiskeolie-gruppen, 19 fra olivenolie gruppen og 21 fra referencegruppen. Ved 13 år målte jeg vækst, kropssammensætning og blodtryk. Kostoplysninger var samlet ind med et madfrekvens-spørgeskema og pubertetsstatus var vurderet ved brug af Tanner Scales. Kost og pubertet har begge en potential indvirkning på kropssammensætning og blodtryk. Resultater; Ingen signifikante forskelle var fundet i kropssammensætning mellem de to randomiserede grupper efter justering for ponderal index ved fødslen og køn. FO-gruppen et signifikant større hovedomkreds sammenlignet med OO-gruppen (p=0.029). En signifikant gruppe*køn interaktion blev fundet i middel arterielt blodtryk (p=0-038) and diastolisk blodtryk (0.019). Pigerne fra FO-gruppen havde en tendens til et lavere blodtryk sammenlignet med pigerne fra OO-gruppen (p=0.079). En signifikant positiv association mellem middel arterielt blodtryk og indholdet af DHA I moderens røde blodceller (0.028) og mellem indholdet af DHA I moderens brystmælk og middle arterielt blodtryk (p=0.043) var fundet I drengene. Derudover havde OO-gruppen et signifikant større energiindtag end FO-gruppen (p=0.002). 5 Konklusion: Den signifikante forskel I blodtryk observeret mellem drengene fra de to randomiserede grupper ved 7 år var ikke længere synlig ved 13 år. Forskellen I kropssammensætning observeret ved 2.5 år var ved 7 år reduceret og ikke længere synlig ved 13 år. I stedet fandt jeg signifikant gruppe*køn interaktion i middel arterielt og diastolisk blodtryk, som indikerer at effekten af interventionen er forskellig mellem køn. Stikprøven for dette opfølgningsstudie var imidlertid lille for de to randomiserede grupper, og flere fremtidige studier er nødvendige for at bekræfte disse resultater.