Randomized Controlled Trial of DHA Supplementation during Pregnancy: Child Adiposity Outcomes

Abstract

Investigating safe and effective interventions in pregnancy that lower offspring adiposity is important given the burden of obesity and subsequent metabolic derangements. Our objective was to determine if docosahexaenoic acid (DHA) given during pregnancy to obese mothers results in lower offspring adiposity. This study was a long-term follow-up of a randomized trial of mothers with gestational diabetes or obesity who were randomized to receive DHA supplementation at 800 mg/day or placebo (corn/soy oil) starting at 25–29 weeks gestation. Anthropometric measures were collected at birth and maternal erythrocyte DHA and arachidonic (AA) levels were measured at 26 and 36 weeks gestation. At two- and four-year follow-up time points, offspring adiposity measures along with a diet recall were assessed. A significant increase in erythrocyte DHA levels was observed at 36 weeks gestation in the supplemented group (p < 0.001). While no significant differences by measures of adiposity were noted at birth, two or four years by randomization group, duration of breastfeeding (p < 0.001), and DHA level at 36 weeks (p = 0.002) were associated with body mass index z-score. Our data suggest that DHA supplementation during pregnancy in obese mothers may have long-lasting effects on offspring measures of adiposity.

Epigenetic Effects of n-3 LCPUFAs: A Role in Pediatric Metabolic Syndrome

“…A study led by Foster and colleagues studied the effects of DHA 800 mg/day supplementation vs. placebo in obese or diabetic pregnant women from 25–29 weeks of gestation. Differences of adiposity were not significant at birth, but at two and four years of follow-up, it was found that the BMI z-score was inversely associated with DHA intra-erythrocyte levels during the 36 th week of gestation [60]. Consistent with this finding, other trials found an association between DHA levels in human milk and BMI in childhood up to age seven.…”

The effectiveness of ω-3 polyunsaturated fatty acid interventions during pregnancy on obesity measures in the offspring: an up-to-date systematic review and meta-analysis

“…It is important to note that most of the trials were primarily designed to investigate other outcomes in children such as neurological development, maternal insulin sensitivity; and growth measures in the offspring are also reported as secondary end-points [31, 34, 35, 39, 41, 44, 52, 54, 55]. Only two trials [47, 56] were originally designed to evaluate the effectiveness of prenatal n-3 LCPUFA supplementation on infant’s body composition.…”

“…One trial was conducted in atopic women [34] and another in women who were obese or had a history of gestational diabetes [55]. The remainder of the trials involved healthy pregnant women with non-complicated pregnancies.…”

“…The remainder of the trials involved healthy pregnant women with non-complicated pregnancies. Studies varied in their sample size at randomisation from 72 [55] to 1660 [52] pregnant women.…”

Evaluation of Maternal Dietary n-3 LCPUFA Supplementation as a Primary Strategy to Reduce Offspring Obesity: Lessons From the INFAT Trial and Implications for Future Research

“…N-3 LCPUFAs are known to exhibit anti-inflammatory and anti-obesogenic properties in animals ( 70 ), although data in humans do not consistently confirm these associations. One study that provided DHA supplements to pregnant women with obesity or gestational diabetes found no significant effects on offspring adiposity outcomes ( 71 ). More data are needed to determine whether supplementation in pregnant women in higher BMI categories may be a promising intervention to reduce offspring obesity risk.…”