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Nutrition Epidemiology Highlights Original Article

Omega-3 supplementation during the first 5 years of life and later academic performance: a randomised controlled trial




Consumption of oily fish more than once per week has been shown to improve cognitive outcomes in children. However, it is unknown whether similar benefits can be achieved by long-term omega-3 fatty acid supplementation. The objective was to investigate the effect of omega-3 fatty acid supplementation during the first 5 years of life on subsequent academic performance in children by conducting a secondary analysis of the CAPS (Childhood Asthma Prevention Study).


A total of 616 infants with a family history of asthma were randomised to receive tuna fish oil (high in long-chain omega-3 fatty acids, active) or Sunola oil (low in omega-3 fatty acids, control) from the time breastfeeding ceased or at the age of 6 months until the age of 5 years. Academic performance was measured by a nationally standardised assessment of literacy and numeracy (National Assessment Program Literacy and Numeracy (NAPLAN)) in school years 3, 5, 7 and 9. Plasma omega-3 fatty acid levels were measured at regular intervals until 8 years of age. Between-group differences in test scores, adjusted for maternal age, birth weight and maternal education, were estimated using mixed-model regression.


Among 239 children, there were no significant differences in NAPLAN scores between active and control groups. However, at 8 years, the proportion of omega-3 fatty acid in plasma was positively associated with the NAPLAN score (0.13 s.d. unit increase in score per 1% absolute increase in plasma omega-3 fatty acid (95% CI 0.03, 0.23)).


Our findings do not support the practice of supplementing omega-3 fatty acids in the diet of young children to improve academic outcomes. Further exploration is needed to understand the association between plasma omega-3 fatty acid levels at 8 years and academic performance.

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We thank the children and parents of the CAPS cohort, without whose participation this study would have been impossible to perform. Kitty Ng was instrumental in communicating with families, obtaining consents and blood samples over many years. This was not an industry-supported study. Bronwyn Brew is supported by an NHMRC research scholarship (#1038533), Guy Marks by NHMRC Practitioner fellowships (#1003500 & 402827) and the CAPS study by NHMRC Project Grants #974097, #991101, #211081, #352409 and #570919, and the CRC for Asthma. Catarina Almqvist was supported by the Swedish Research Council, the Swedish Heart-Lung foundation and the regional agreement on medical training and clinical research (ALF) between Stockholm County Council and Karolinska Institutet, Stockholm Sweden. Contributions of goods and services were made by Allergopharma Joachim Ganzer KGGermany, John SandsAustralia, Hasbro, TollRefrigerated, AstraZeneca Australia and Nu-Mega Ingredients Pty Ltd. Goods were provided at reduced cost by Auspharm, Allersearch and Goodman Fielder Foods.

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Correspondence to B K Brew.

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Competing interests

GB Marks sits on an advisory board for Novartis, who pay an honorarium on his behalf. The unit GB Marks works in has conducted the research funded by AstraZeneca. The remaining authors declare no conflict of interest.

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Supplementary Information accompanies this paper on European Journal of Clinical Nutrition website

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Brew, B., Toelle, B., Webb, K. et al. Omega-3 supplementation during the first 5 years of life and later academic performance: a randomised controlled trial. Eur J Clin Nutr 69, 419–424 (2015).

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