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Dietary docosahexaenoic acid and arachidonic acid in early life: What is the best evidence for policymakers?

Dietary docosahexaenoic acid and arachidonic acid in early life: What is the best evidence for policymakers?
Dietary docosahexaenoic acid and arachidonic acid in early life: What is the best evidence for policymakers?
Background: A wealth of information on the functional roles of docosahexaenoic acid (DHA) and arachidonic acid (ARA) from cellular, animal, and human studies is available. Yet, there remains a lack of cohesion in policymaking for recommended dietary intakes of DHA and ARA in early life. This is predominantly driven by inconsistent findings from a relatively small number of randomised clinical trials (RCTs), which vary in design, methodology, and outcome measures, all of which were conducted in high-income countries. It is proposed that this selective evidence base may not fully represent the biological importance of DHA and ARA during early and later life and the aim of this paper is to consider a more inclusive and pragmatic approach to evidence assessment of DHA and ARA requirements in infants and young children, which will allow policymaking to reflect the marked diversity of need worldwide. Summary: Data from clinical RCTs is considered in the context of the extensive evidence from experimental, animal and human observational studies. Although the RCT data shows evidence of beneficial effects on visual function and in specific cognitive domains, early methodological approaches do not reflect current thinking and this undermines the strength of evidence. An outline of a framework for an inclusive and pragmatic approach to policy development on dietary DHA and ARA in early life is described. Conclusion: High-quality RCTs that will determine long-term health outcomes in appropriate real-world settings need to be undertaken. In the meantime, a collective pragmatic approach to evidence assessment, may allow public health policymakers to make comprehensive reasoned judgements on the merits, costs, and expediency of dietary DHA and ARA interventions.
0250-6807
210-222
Forsyth, Stewart
fa93bc08-41e9-4525-ab27-ea3644d1cddc
Calder, Philip
1797e54f-378e-4dcb-80a4-3e30018f07a6
Zotor, Francis
541a48de-9a32-4695-842b-942965e1bd7c
Amuna, Paul
e13560c6-cc46-4ee1-9275-337c285d7e53
Meyer, Barbara
740960a8-d72e-4320-82e6-ac27d68d95c5
Holub, Bruce
a68cf137-f49b-4640-982d-8ca226c803aa
Forsyth, Stewart
fa93bc08-41e9-4525-ab27-ea3644d1cddc
Calder, Philip
1797e54f-378e-4dcb-80a4-3e30018f07a6
Zotor, Francis
541a48de-9a32-4695-842b-942965e1bd7c
Amuna, Paul
e13560c6-cc46-4ee1-9275-337c285d7e53
Meyer, Barbara
740960a8-d72e-4320-82e6-ac27d68d95c5
Holub, Bruce
a68cf137-f49b-4640-982d-8ca226c803aa

Forsyth, Stewart, Calder, Philip, Zotor, Francis, Amuna, Paul, Meyer, Barbara and Holub, Bruce (2018) Dietary docosahexaenoic acid and arachidonic acid in early life: What is the best evidence for policymakers? Annals of Nutrition and Metabolism, 72 (3), 210-222. (doi:10.1159/000487271).

Record type: Review

Abstract

Background: A wealth of information on the functional roles of docosahexaenoic acid (DHA) and arachidonic acid (ARA) from cellular, animal, and human studies is available. Yet, there remains a lack of cohesion in policymaking for recommended dietary intakes of DHA and ARA in early life. This is predominantly driven by inconsistent findings from a relatively small number of randomised clinical trials (RCTs), which vary in design, methodology, and outcome measures, all of which were conducted in high-income countries. It is proposed that this selective evidence base may not fully represent the biological importance of DHA and ARA during early and later life and the aim of this paper is to consider a more inclusive and pragmatic approach to evidence assessment of DHA and ARA requirements in infants and young children, which will allow policymaking to reflect the marked diversity of need worldwide. Summary: Data from clinical RCTs is considered in the context of the extensive evidence from experimental, animal and human observational studies. Although the RCT data shows evidence of beneficial effects on visual function and in specific cognitive domains, early methodological approaches do not reflect current thinking and this undermines the strength of evidence. An outline of a framework for an inclusive and pragmatic approach to policy development on dietary DHA and ARA in early life is described. Conclusion: High-quality RCTs that will determine long-term health outcomes in appropriate real-world settings need to be undertaken. In the meantime, a collective pragmatic approach to evidence assessment, may allow public health policymakers to make comprehensive reasoned judgements on the merits, costs, and expediency of dietary DHA and ARA interventions.

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Dietary docosahexaenoic acid and arachidonic acid in early life - Accepted Manuscript
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ANM Table 1 December 2017 - Accepted Manuscript
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487271 - Version of Record
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More information

Accepted/In Press date: 28 January 2018
e-pub ahead of print date: 8 March 2018
Published date: April 2018

Identifiers

Local EPrints ID: 417850
URI: http://eprints.soton.ac.uk/id/eprint/417850
ISSN: 0250-6807
PURE UUID: d50c30f5-4836-42e1-b34a-fa5e074d15dd
ORCID for Philip Calder: ORCID iD orcid.org/0000-0002-6038-710X

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Date deposited: 15 Feb 2018 17:30
Last modified: 16 Mar 2024 06:12

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Contributors

Author: Stewart Forsyth
Author: Philip Calder ORCID iD
Author: Francis Zotor
Author: Paul Amuna
Author: Barbara Meyer
Author: Bruce Holub

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