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BackgroundOmega-3 fatty acids are central to brain-development of children. Evidence from clinical trials and systematic reviews demonstrates the potential of long-chain Omega-3 supplementation for learning and behavior. However, findings are inconclusive and in need of robust replication studies since such work is lacking. ObjectivesReplication of the 2012 DOLAB 1 study findings that a dietary supplementation with the long-chain omega-3 docosahexaenoic acid (DHA) had beneficial effects on the reading, working memory, and behavior of healthy schoolchildren. DesignParallel group, fixed-dose, randomized (minimization, 30% random element), double-blind, placebo-controlled trial (RCT). SettingMainstream primary schools (n = 84) from five counties in the UK in 2012–2015. ParticipantsHealthy children aged 7–9 underperforming in reading ( Intervention600 mg/day DHA (from algal oil), placebo: taste/color matched corn/soybean oil; for 16 weeks. Main outcome measuresAge-standardized measures of reading, working memory, and behavior, parent-rated and as secondary outcome teacher-rated. Results376 children were randomized. Reading, working memory, and behavior change scores showed no consistent differences between intervention and placebo group. Some behavioral subscales showed minor group differences. ConclusionsThis RCT did not replicate results of the earlier DOLAB 1 study on the effectiveness of nutritional supplementation with DHA for learning and behavior. Possible reasons are discussed, particularly regarding the replication of complex interventions.

Background: \ud Omega-3 long-chain polyunsaturated fatty acids (LC-PUFA), especially DHA (docosahexaenonic acid) are essential for brain development and physical health. Low blood Omega-3 LC-PUFA have been reported in children with ADHD and related behavior/learning difficulties, as have benefits from dietary supplementation. Little is known, however, about blood fatty acid status in the general child population. We therefore investigated this in relation to age-standardized measures of behavior and cognition in a representative sample of children from mainstream schools.\ud \ud Participants: \ud 493 schoolchildren aged 7–9 years from mainstream Oxfordshire schools, selected for below average reading performance in national assessments at age seven.\ud \ud Method: \ud Whole blood fatty acids were obtained via fingerstick samples. Reading and working memory were assessed using the British Ability Scales (II). Behaviour (ADHD-type symptoms) was rated using the revised Conners’ rating scales (long parent and teacher versions). Associations were examined and adjusted for relevant demographic variables.\ud \ud Results: \ud DHA and eicosapentaenoic acid (EPA), accounted for only 1.9% and 0.55% respectively of total blood fatty acids, with DHA showing more individual variation. Controlling for sex and socio-economic status, lower DHA concentrations were associated with poorer reading ability (std. OLS coeff. = 0.09, p =

Background: \ud Omega-3 fatty acids are dietary essentials, and the current low intakes in most modern developed countries are believed to contribute to a wide variety of physical and mental health problems. Evidence from clinical trials indicates that dietary supplementation with long-chain omega-3 may improve child behavior and learning, although most previous trials have involved children with neurodevelopmental disorders such as attention-deficit/hyperactivity disorder (ADHD) or developmental coordination disorder (DCD). Here we investigated whether such benefits might extend to the general child population.\ud \ud Objectives: \ud To determine the effects of dietary supplementation with the long-chain omega-3 docosahexaenoic acid (DHA) on the reading, working memory, and behavior of healthy schoolchildren.\ud \ud Design: \ud Parallel group, fixed-dose, randomized, double-blind, placebo-controlled trial (RCT).\ud \ud Setting: \ud Mainstream primary schools in Oxfordshire, UK (n = 74).\ud \ud Participants: \ud Healthy children aged 7–9 years initially underperforming in reading (≤33rd centile). 1376 invited, 362 met study criteria.\ud \ud Intervention: \ud 600 mg/day DHA (from algal oil), or taste/color matched corn/soybean oil placebo.\ud \ud Main Outcome Measures: \ud Age-standardized measures of reading, working memory, and parent- and teacher-rated behavior.\ud \ud Results: \ud ITT analyses showed no effect of DHA on reading in the full sample, but significant effects in the pre-planned subgroup of 224 children whose initial reading performance was ≤20th centile (the target population in our original study design). Parent-rated behavior problems (ADHD-type symptoms) were significantly reduced by active treatment, but little or no effects were seen for either teacher-rated behaviour or working memory.\ud \ud Conclusions: \ud DHA supplementation appears to offer a safe and effective way to improve reading and behavior in healthy but underperforming children from mainstream schools. Replication studies are clearly warranted, as such children are known to be at risk of low educational and occupational outcomes in later life.\ud \ud Trial Registration: \ud ClinicalTrials.gov NCT01066182 and Controlled-Trials.com ISRCTN99771026.