Fatty acids and reading ability

Although now only available to subscribers, a short while back I was very peripherally involved in helping to write an article on the science of lipidomics (see here). The crux of that overview article was that the science of biological lipids - lipidomics (yes, another one of those -omics) - is really starting to make some waves when it comes to health and wellbeing. Also that one should not be too hasty in making snap judgements about fats; not all fats are equal and without them, well, none of us would be here.

Underneath the arches @ Wikipedia 

As if to prove the point, I'm talking today about a paper from Paul Montgomery and colleagues* (open-access) who suggested that science might do well to take a closer look at specific types of fats in relation to childhood behaviour and cognitive performance.

Before going further into the paper and its findings, it's probably a good idea if I frame this research with a little bit of history in this area. I'm sure that some of you might already have heard about the suggestion that fatty acid supplementation, fish oils if you will, might show some link to cognitive performance in certain groups of children and in particular, the results of the Durham trial**. I know there was some 'discussion' about other angles of fish oil use here in the bracing North-East of England but I'm not going to go into that here. Suffice to say that fish oil research has not had the easiest of rides so far.

The Montgomery paper is open-access, but a few points to note:

• This was a study looking at whole blood fatty acid concentrations ("broadly equating to the omega-3 index") from a fingerstick sample in just short of 500 UK children (aged 7-9 years) as part of the DOLAB study*** (open-access). DOLAB in case you didn't click on the previous link was all about seeing what happened when kids were given a DHA (docosahexaenoic acid) supplement, particularly those who were under-performing in terms of reading ability and other aspects of behaviour.
• Indeed the participants included in this study were those children who were finding some difficulty with reading performance and whether their fatty acid profiles were somehow correlated with their presentation. Various psychometric measures were employed to assess things like reading ability (BAS-II) and behaviour (Conner's Rating Scales) of participants.
• Results:  there were quite a few bearing in mind no control group data was included in this paper so we cannot necessarily rule out a more general 'deficiency' as being present in children. Primary among them was that blood levels of the omega-3 long-chain polyunsaturated fatty acids (LC-PUFAs) which includes both DHA and EPA (eicosapentaenoic acid), cumulatively made up only an average of 2.4% of total blood fatty acids in the group studied. The authors frame this within the context of guidance for good cardiovascular health which they report should be in the optimal region of 8-12%. Quite a disparity by all accounts.
• They also noted that: "blood Omega-3 LC-PUFA status in these UK children significantly predicted both their behavior and their cognitive performance". In other words, higher levels were associated with things like better reading ability and "fewer ADHD-type symptoms".
• Also notable too was the link between lower blood fatty acid levels and lower reported fish intake as per reference to parental reports on their children's eating habits.
• The authors conclude that because of their results "the benefits from dietary supplementation with Omega-3 LC-PUFA found for ADHD, Dyspraxia, Dyslexia, and related conditions might extend to the general school population".
• Just one last thing: for any Government official who happens to tune into this blogpost, a few interesting points to mark for your attention from the study. Reading scores were correlated with socio-economic status (SES) and behaviour problems were "higher for children entitled to free school meals" (another marker of SES). Poverty it seems, might exert an effect.

I find these to be very interesting results. I know to mention that what we and our children eat might actually have some affect on cognitive and behavioural presentation is still considered controversial in some quarters, but I personally find the research base to be worthy of attention. I'm for example, taken back to the work of Bernard Gesch and colleagues**** (open-access) on nutrition and behaviour covered by Dr Emily Deans (see here) as a template for the 'diet can affect behaviour' mantra outside of more traditional medical examples. Realising at the same time, that people are complicated creatures and dietary modifications are not a cure-all for every ill.

Also that this study was 'industry-funded' is something which some might point out as being 'significant'. For me personally, the important thing was that the COI was declared as it should have been for any research on any medicine in your medicine cabinet. Indeed one might see this as even more motivation for independent follow-up of these results...?

I've covered fatty acids previously on this blog, both with an autism research perspective (see here) and also from a 'not all good news for fish oils' perspective (see here). The lessons from both these posts were that fish oil supplementation as a sort of population-wide initiative is probably not going to be the best course of action recently emphasized by that prostate cancer link (see here).

But.... that there may be specific, perhaps many specific, groups of children or young adults who either present with certain patterns of behaviour or issues with important skills like reading alongside lower circulating levels of these fatty acids, I am finding it difficult to say we shouldn't be embarking on rigourous scientific trials looking for any potential effect from such a simple intervention. Given also that the brain for example is approximately 60% fat pointing towards our fatty evolutionary heritage, there is sound logic to ensuring adequate supplies of certain types of fatty acids are present and in particular for certain groups of people***** (open-access).

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* Montgomery P. et al. Low Blood Long Chain Omega-3 Fatty Acids in UK Children Are Associated with Poor Cognitive Performance and Behavior: A Cross-Sectional Analysis from the DOLAB Study. PLoS One. 2013 Jun 24;8(6):e66697. doi: 10.1371/journal.pone.0066697.

** Richardson AJ. & Montgomery P. The Oxford-Durham Study: A Randomized, Controlled Trial of Dietary Supplementation With Fatty Acids in Children With Developmental Coordination Disorder. Pediatrics. 2005; 115: 1360-1366.

*** Richardson AJ. et al. Docosahexaenoic Acid for Reading, Cognition and Behavior in Children Aged 7–9 Years: A Randomized, Controlled Trial (The DOLAB Study). PLoS ONE. 2013; 7(9): e43909. doi:10.1371/journal.pone.0043909

**** Gesch CB. et al. Influence of supplementary vitamins, minerals and essential fatty acids on the antisocial behaviour of young adult prisoners. Br J Psychiatr 2002; 181: 22-28.

***** dos Santos Vaz. J. et al. Dietary Patterns, n-3 Fatty Acids Intake from Seafood and High Levels of Anxiety Symptoms during Pregnancy: Findings from the Avon Longitudinal Study of Parents and Children. PLoS ONE 8(7) 2013: e67671. doi:10.1371/journal.pone.0067671

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Montgomery P, Burton JR, Sewell RP, Spreckelsen TF, & Richardson AJ (2013). Low Blood Long Chain Omega-3 Fatty Acids in UK Children Are Associated with Poor Cognitive Performance and Behavior: A Cross-Sectional Analysis from the DOLAB Study. PloS one, 8 (6) PMID: 23826114